We’re All In This Together
Over the past year, it has become normal for “COVID talk” to creep its way into everyday conversations. Whether it’s with someone who is venting their vaccine opinion, or with another whose loved one is struggling on a vent in the Intensive Care Unit, it has become normal to accept that COVID-19 has crept in and decided to stay awhile. This unwelcomed guest has brought a myriad of challenges to our local health systems, and in a recent conversation, we were able to sit down with two women who are leading on the front lines. Dr. Loren Robinson, Chief Medical Officer and Vice President of Medical Affairs at CHRISTUS St. Michael Health System and Shelly Strayhorn, Chief Nursing Officer at Wadley Regional Medical Center shared their viewpoints on topics such as getting the vaccine while pregnant, the truth about Ivermectin and revealed the current state of Texarkana’s hospitals. Surprising yet heartwarming was the underlying unity these women, and the health systems they represent, are demonstrating behind the scenes. Having two unique health systems in a smaller town is a rare but an invaluable resource for our community. Pull up a chair and join our conversation.
What was the path you took to your current role?
Shelly Strayhorn “I started as a nursing assistant over 34 years ago on the Progressive Care Unit at Wadley [Regional Medical Center] while I was in nursing school. My nursing experience includes roles as Director of Critical Care, Surgical Services Medical/Surgical Unit, and the Director of Regulatory Compliance and faculty at Texas A&M-Texarkana. I have been the Chief Nursing Officer of Wadley Regional Medical Center and Wadley Regional Medical Center of Hope since 2011.”
Dr. Loren Robinson “My path has been a winding one. I went to medical school thinking I wanted to do Patient Care, which I love. I love patient stories which I think motivated me to go into medicine. The change for me came prior to working for CHRISTUS St. Michael. I wanted to improve health care at a more administrative level. I served as the Deputy Secretary of Health for the State of Pennsylvania. I am currently the Chief Medical Officer and Vice President of Medical Affairs at CHRISTUS St. Michael Health System.”
How has COVID-19 affected you personally over the past year?
Dr. Loren Robinson “I think in our personal lives it’s as big an experience as in our professional lives. I think everyone has their own story. For me, the thing that totally changed was that we became pregnant last fall. We have a two-year-old son, and we were so excited to welcome the newest member of our family this June. In the middle of all that, the vaccine was rolled out. I was nervous because it came out fast, and it came to Texarkana quickly. I was sure I was going to have to go to Dallas or some big city to get this vaccine, and then it showed up on the hospital’s doorstep. We were expected to get it to our associates and patients and offer it to the community. Then they started talking: ‘What about pregnant women?’ And there just was not enough information. I was nervous, so I waited to get more information. I think we had this natural experiment where the whole world got to see what happened to those who went first. I had colleagues, I had doctors, administrators and nurses, who took the vaccine because they wanted to protect their families, and I got to see they were okay, and they remained COVID-free. Or, if they got sick, symptoms were mild. So, I felt comfortable making that decision for myself, and I got vaccinated in April 2021. I was about 32 weeks pregnant, and I think the main reason I did that is because I wanted to make sure I could protect my baby. I knew I would not be giving a newborn a vaccine right away. That was off the table. But I found out that it’s true when pregnant women get vaccinated, they pass antibodies on to their babies. Those antibodies are also present in breast milk. So here were two ways that I could get just a simple vaccine and a sore arm, maybe a little bit of fever, but totally worth it to me to make sure my baby is as healthy as possible. I had hoped COVID would be gone by now, but now that the Delta variant is here and we know more variants are coming down the line, I’m so glad I made that decision. Every time I look at my baby who is laughing or smiling or trying to roll over, I think, ‘You can do that because you’re healthy, and you are healthy because I made the decision to get vaccinated.’”
Shelly Strayhorn “It has been a whirlwind since March 2020. I have spent many more hours at the hospital planning, developing, revising and implementing procedures to ensure quality care is delivered to our patients, than I have at home with my family. My nephew lives with us, and he was doing remote learning. It was difficult because I would get online to make sure he was doing all his assignments, and I would follow up after working a full day. It was 2:00 a.m. sometimes when I was trying to make sure Jacob was doing okay, and all was well with school. Trying to balance everything was a challenge.”
What is the reality of what we are currently facing with COVID-19 in Texarkana?
Shelly Strayhorn “The health care facilities are stretched to the max, and the staff is growing weary. It is not just physically demanding, but emotionally demanding as well. Currently, because of the need for inpatient beds, elective, non-emergent cases are evaluated daily to ensure hospital beds and staff are available. We must get our vaccine rates up. Around 90% of all admissions to our hospital are unvaccinated. We are seeing younger patients and children in need of care. Availability of children’s beds is extremely tight. Since they cannot yet be vaccinated, we must take all precautions to keep our children safe.”
Dr. Loren Robinson “Nobody anticipated this summer would look worse than last summer. We really thought that COVID-19 would be in a more manageable place. Instead, our numbers are higher than ever in terms of our outpatient visits to clinics and folks getting tested and testing positive. Looking at who is coming to the hospital, our patients are younger than before. Most of them are unvaccinated, and that’s sad because we are seeing young people pass away. We’re seeing people in their 20s, 30s and 40s pass away. And they shouldn’t have passed away. These are folks who were previously healthy. Interestingly, even though our hospitals are not connected as a health system, we each have the same rate in terms of admitted patients who are vaccinated versus unvaccinated. Only one in ten people who are admitted to our hospitals with COVID-19 are fully vaccinated. Meaning, if you admit ten people into the hospital, nine of those people are not vaccinated. So, if you’re vaccinated, your chance of actually having to be admitted into the hospital is much lower. If you get COVID and you’re vaccinated, you’re more likely to have fewer symptoms and be able to manage that at home and get back to work and back to life as normal, as opposed to being admitted to the hospital and maybe ending up in the Intensive Care Unit (ICU) or on a ventilator. I think that’s the thing that is so different this time—we’re seeing so many more young, healthy people getting sick quickly. It has been slower for us to get the help we needed at the hospital in terms of those extra nurses coming from the State. We have those now, and I think that’s helping. It’s helping us open our surgery schedules. But it changes so much day to day, that it is really a challenge and continues to be something we are working on every single day.”
“From December 2020 to May 2021, we administered over 25,000 vaccines.” —Dr. Loren Robinson, Chief Medical Officer and Vice President of Medical Affairs
CHRISTUS St. Michael Health System
Are patients able to remain in local care?
Shelly Strayhorn “We have been able to effectively and safely care for patients of all ages in our community, ranging from non-critical to critical. Of course, there have been times we have transferred to a higher level of care or to a long-term care facility. And young children are typically transferred to a children’s hospital.”
Dr. Loren Robinson “As the COVID numbers continue to go up, there’s this question of ‘Is the hospital still a safe place for me to receive care?’ And I would say, ‘Yes!’ Both for Wadley and CHRISTUS St. Michael. So much so that some of the smaller hospitals are calling and asking to transfer their patients in. I think one thing that is a blessing about having both hospitals in the area is that if one of us gets very busy and gets full, for whatever reason, the other hospital isn’t as busy or as full at that exact moment. Having that ability and being able to lean on each other, knowing we are just a phone call away, is an invaluable resource. It may seem that I’m pushing the vaccination, but it’s very striking to me when I see the news, that these ICUs are filling up. Specifically, if you look at pediatrics. If something were to happen and a child needed severe ICU or pediatric specialists, we’d want them to go to a pediatric hospital. But when you see that Texas Children’s in Houston is full, Dallas Children’s is full, Arkansas Children’s Hospital in Little Rock is full, Vanderbilt’s Pediatric ICU in Nashville is full. Where would our babies go? We are having to look as far away as Chicago and that means there’s a challenge. We want to make sure that by being vaccinated, we can keep people out of the hospital. We can help keep these ICUs empty, so if a child is really sick, we can easily transfer them to one of our centers close by, whether Dallas Children’s Hospital or Arkansas Children’s Hospital. We need for them to open up, and for that to happen, the solution is for people to get vaccinated.”
How many vaccines has your hospital distributed locally?
Shelly Strayhorn “We have administered over 2,500 at Wadley Regional Medical Center in Texarkana and 200 at Wadley Regional Medical Center in Hope.”
Dr. Loren Robinson “At CHRISTUS St. Michael we were excited to administer about 2,000 vaccines to our employees, physicians and local frontline workers. Then, in February 2021, the State of Texas recognized the hospital as a vaccination hub. The State was sending us vaccines every single week. From December 2020 to May 2021, we administered over 25,000 vaccines. That was really exciting for our area because we know that we have fully vaccinated folks who are trying to get back to their new normal. It was interesting because we had people come from outside Texas and our region even. We had someone come from Spain, some who came from Mexico, and I’m glad we were able to deliver care to those folks. Sometimes people discount small towns and think they can’t get top care there, but they can! We led the region and are a leader in the country in terms of how we did our vaccinations.”
What are your thoughts on alternative or preventative treatments such as Ivermectin that have become popular?
Dr. Loren Robinson “I think Ivermectin is a hotly debated issue. Ivermectin is an anti-parasitic drug. It’s most popular for use in horses and dogs for heartworms. But especially in our area, it is used on cows and horses. I think one challenge is that for medications for your animals, it is easier to get them than going to a doctor. What I’m cautioning people about is don’t take medicines that are made for animals. The concentrations are different. You are not a horse, so do not take horse medication! That being said, Ivermectin is available for humans and there are doctors who are prescribing it. If you are interested in that, talk to your doctor about it. I’ve talked to doctors who are taking it for prevention. I think there is less evidence there for that. But what we do know is that there is some evidence that Ivermectin can work in the early stages of COVID-19; however it is not approved by the FDA for the treatment of COVID-19. We don’t know exactly how, so I think some doctors are reluctant to say, ‘Yes, let’s do Ivermectin.’ I think it is a little premature right now, but I think it’s very important for folks to be talking to their doctor to find out if it’s something that may be right for you.”
Shelly Strayhorn “Ivermectin is not authorized or approved by FDA for prevention or treatment of COVID-19. The National Institutes of Health’s COVID-19 Treatment Guidelines Panel has also determined that there is currently insufficient data to recommend Ivermectin for treatment of COVID-19. Clinicaltrials.gov has listings of ongoing clinical trials that might provide more information about these hypothesized uses in the future. My recommendation is good hand hygiene/hand washing, social distancing, wearing masks and getting a vaccination.”
“Around 90% of all admissions to our hospitals are unvaccinated.” —Shelly Strayhorn, Chief Nursing Officer Wadley Regional Medical Center
Do you have a message you would like to share with the community?
Shelly Strayhorn “Continue to go to your doctor for primary care and preventative care. It is safe to come to the hospital. We take precautions, and we will take care of you. Also, it is ok to come to the hospital for emergency care because we see people waiting too long that are having STEMIs (ST-Elevated Myocardial Infarction, a very serious heart attack), that are having strokes that we could have taken care of, and the outcomes could have been different if they would have come earlier.”
Dr. Loren Robinson “In terms of what we know right now in this moment, getting vaccinated against COVID-19 is your best chance at avoiding getting very sick, of avoiding having to go to the hospital, and avoiding ending up on the ventilator. I think that’s the biggest message I would share with people. It’s easy to sit in my office and just look at numbers, but I spent last week in the ICU. And when you’re at the bedside of a family and see a child lose a mother, or last week I saw a six-year-old girl lose her dad. I will never, ever, forget that. It will impact the way I look at this pandemic for the rest of how long we work on this, and I will keep that little girl in my mind and say, ‘What can I do to make sure nobody else experiences that?’”
As a woman in leadership, how have you seen the resiliency of those on the front lines who serve with you?
Dr. Loren Robinson “I am extremely humbled by the people who get up and come to work at the hospitals every day. At the beginning of this, we hoped it might only last a few months. Or maybe it would be like the flu and just last a season. Now, we’ve been going at this break-neck pace for over a year, and people are still showing up. They’re showing up at CHRISTUS St. Michael and at Wadley; there’s no difference there. We’re all in this together, and we’re saying that we don’t know how this is going to end or when it’s going to end, but we’re going to take whatever steps possible right now, in this moment, in this day, to give every patient the best possible care and a fighting chance at getting over this disease.”
Shelly Strayhorn “I agree with Dr. Robinson. Our employees are the true heroes in the pandemic. They come back every day and have a smile on their face and take care of the patients. They continue to show up and give the best care possible in sometimes very challenging circumstances. I do whatever I can to assist them, to give them a little bit of a break because they are exhausted and growing weary. We’re just very lucky at both facilities, Wadley and CHRISTUS St. Michael, to have such dedicated employees who have seen us through this.”
What has most impressed you regarding the hospital staff and community coming together amid the pandemic?
Shelly Strayhorn “By far, it is the dedication I have seen in our nursing staff, as well as all staff who continued to come to work, even in the early days of not knowing exactly what we were facing. The nurses who volunteered to work in the COVID units, with all the risks associated with it, stepped up to the plate and honored their oath of taking care of patients in need. When there seemed to be too many dying of this terrible virus, they were holding hands, taking their phone into the room to let their loved ones talk to the patient. It was and is very emotional for our nurses and the staff taking care of these sick patients. I remember the first patient that we had in the COVID unit on a vent and ultimately was able to be discharged. We had staff from every department line the lobby with signs and cheer for this survivor!”
Dr. Loren Robinson “The pandemic came at a time when I thought our nation couldn’t get more divided. Whether it was politics or racial strife, there was a lot in this country that really was pulling us in a lot of directions. If you ever took a survey, you’re rarely going to find 100% of Americans agreeing on much. But 100% of Americans would agree that COVID is bad. And so I use that as my starting point. I think that while COVID-19 is terrible, it has also brought out the best in humanity. I’ve seen some of the best in people who we probably had dismissed because they didn’t share the same political views, or they’re not from where we’re from. For me, that has warmed my heart. My family moved to Texarkana right before COVID-19 hit, and we didn’t really know anybody here at all. But the support that we have received from the hospital and this community has shown me that Texarkana is the place where I love raising my family. I felt comfortable having a baby in the middle of the pandemic because I knew I would have excellent medical care and excellent support from the folks I work with. I think it has just shown us the best in both of our hospitals, and I’m proud to be a part of that.”
So as we look back from the beginning of this terrible disease with all the unknowns and dark days that ensued, may we learn what we can, forget what we need to and fix our gaze on what is ahead. Because, as Dr. Robinson so beautifully stated, “We’re all in this together,” knowing that the frontline heroes who lead us will continue to show up for us, no matter what may come.