As Health Center director, McCaskill proves up to the challenge of Covid-19
It should come as no surprise that the past year has been the most challenging of Sherrie McCaskill’s 13-year career at Wingate University.
The director of the Health Center has hardly had a chance to breathe since it became apparent in late February that Covid-19 presented a serious threat to the health of the University and the nation. Planning, procuring supplies, testing, checking on Covid-positive students, setting up a telehealth system – it all seemed overwhelming at times.
“You just feel like you’re on a hamster wheel and you can’t get off,” she says.
Keeping students safe while providing a quality, (at least partially) in-person education was the University’s top priority last semester, which made McCaskill perhaps the most indispensable person on campus. With so much on the line, she was given help in the form of additional employees, including three temporary registered nurses (RNs) and two certified medical assistants (CMAs), who have primarily assisted with testing, manning the phones and following up with patients in quarantine or isolation, since the Health Center staff still has non-Covid duties to attend to.
The extra hands have been a big help, but the pressure is still on, especially as North Carolina (in line with the rest of the nation) has seen Covid-case numbers rise and rise some more since early December. Just as students were returning to campus in mid-January, the state was experiencing its highest daily case numbers and test-positivity rates.
When Covid began to spread in the U.S. last spring, McCaskill assumed it would be corralled in some form or fashion over the succeeding few months. It hasn’t worked out that way.
“From the start, I don’t think that I realized it would be continuing on as long as it has, to the extent that it has,” McCaskill says. “I felt like at some point we would start to get a little bit of control, but it just hasn’t happened.”
It has meant a year like no other for Wingate’s Health Center staff.
Making a difference
Luckily for Wingate, McCaskill’s background lends itself to handling urgent situations. She spent much of her early career as a nurse in emergency rooms and urgent cares, where keeping a cool head is paramount. She tended to patients of all ages and with every injury or illness imaginable and, she says, was “thrown every curveball in the book.”
That includes some of the worst traumas imaginable: gun shots, suicide attempts, infant drownings. Through it all, McCaskill had to learn to keep her emotions in check and focus on the job at hand. “If you can imagine the trauma, I have probably seen it,” she says. “It taught me a lot. It’s hard not to cry with the families at times, but I think that’s what makes us human.”
That experience made her a great choice to lead Wingate’s Health Center. Students come to see McCaskill and her staff with all manner of ailments and questions, and she has to be quick on her feet and constantly draw from her vast reserve of medical knowledge.
Five years ago, a norovirus outbreak on the Wingate campus nearly stretched the Health Center to the breaking point. “We treated over 100 cases in just a week,” McCaskill says, “and the majority of the cases needed IV fluids, which really taxed our staff.”
Luckily, those situations are few and far between. In general, McCaskill appreciates being the primary healthcare provider for young adults, acting as something of a bridge between childhood and adulthood for many of them. “It’s a fun group to work with,” she says. “It can be challenging at times, but sometimes when a student comes to college, it’s the first time they’ve ever been away from their parents, and they’ve never navigated the medical world alone before.” In that sense, McCaskill is something of an educator herself, teaching students about medical processes and the healthcare system.
She also now cares for many of her fellow employees. Over the years, the University has expanded its Health Center offerings to employees and their spouses and dependents, who can now come to the Health Center for routine appointments, such as to get their flu vaccine or have a yearly well check, as well as if they are sick or have other medical questions.
It’s been a welcome change for McCaskill. “It’s nice to see the faculty and staff, because they’re a different age population, and we do make different connections there,” she says. “It’s nice to have that change-up. It’s not the same thing every day.”
It also enables her to have deeper relationships with her patients, something that the transient nature of student life doesn’t usually afford. In fact, it was while doing yearly wellness evaluations, in the early 2000s, that McCaskill first became attached to Wingate. Wingate contracted with Community Medical in Marshville, where McCaskill worked at the time, to provide the well checks, which McCaskill would perform once or twice a week. When she left Community Medical for another job, it meant she left Wingate.
She felt the absence. “I’d made a lot of close relationships with people here and a lot of good connections,” she says.
In 2008, when Wingate found itself in need of a Health Center director, McCaskill quickly applied. It’s been a good fit.
“I love it,” she says. “It feels good to feel like you make a difference. It feels good to feel like you can help someone, whether it’s for a medical reason or just education. It’s the one-on-one patient interaction that I really enjoy.”
In the past year McCaskill has had to continue her regular duties while also helping the University plan for the ever-changing “new normal.” She’s worked closely with top administrators to devise plans for bringing students to campus and keeping them there. She secured the use of the University’s health bus and stationed it in the Health Center parking lot. All Covid-related cases are handled there, thus lessening the threat that Covid will spread in the center itself.
Getting a telehealth system up and running on short notice was tricky. McCaskill had to navigate HIPAA rules and federal and state laws, not to mention learn technology best practices. It worked. Now, about half of Health Center visits are conducted virtually, and it’s likely that some element of that setup will remain even after Covid is under control and the country has reached herd immunity.
Despite the rollout of two vaccines in the U.S., that day still seems a ways off. The situation, although more promising than a few months ago, continues to concern McCaskill, who says that much of the stress surrounding the disease is caused by its mercurial nature.
“There’s no way to predict which person is going to have a severe case,” she says. “I mean, one of our football players was in ICU for probably two weeks. A really healthy guy. There’s no reason COVID should have hit him that hard. One of our faculty members was hospitalized for a week because it was severe. She had no other medical problems.”
The baffling nature of the disease has kept McCaskill and her staff on their toes for nearly 12 months. Add the seasonal flu into the mix, and it’s a recipe for disaster. That potentially hazardous concoction keeps her up at night.
Managing a staff that is working on the frontlines adds to her stress levels. McCaskill worries about them: Are they in danger? Are they overworked? She’s grateful for the additional help she’s been allotted, but she knows that the work level remains high.
“It's still a lot and it’s very stressful, and my staff are in front of these Covid people every day,” McCaskill says. “I mean, they’re frontline. They’re exposed every day. What’s made it challenging is trying to make sure that they’re not overworked to the point where either their job satisfaction is completely in the ditch or that we sacrifice quality.”
But this is what McCaskill signed up for, and it’s where she shines. She changed her major from prepharmacy to nursing as an undergrad at UNC-Greensboro in the 1990s, because she discovered that she preferred having more interaction with people. She found that emergency care was her niche.
Working in emergency and urgent-care settings was great training for the year of Covid: Despite the worry, stress and workload, she’s able to stay level-headed and calm.
“You didn’t know what was going to walk in the door next,” McCaskill says of her ER days. “You didn’t know how many were going to walk in at one time. And, being part of a level-one trauma center, where you absolutely had to deal with everything, you kept your head down, you focused on what you were doing, and you didn’t let the extra noise around you affect the ability to make decisions. And you had to prioritize. ‘Here’s what I have to do, but what is critical? What can wait?’”
It might not be quite that hectic at Wingate, but it is interesting. And whether in person (wearing masks) or over Skype, she still gets that personal contact that drove her into nursing in the first place.
“It’s the connection, the human connection, that keeps me attached to the job I’m in,” she says.
- ODOD 2021