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PA program prepares Rickher (’14, ’16) for uncertainty of COVID pandemic

by Chuck Gordon

All healthcare providers probably feel like they’re in unknown territory right now, but Allison Rickher is just about as prepared as a 28-year-old on the frontlines can be.

As a student in Wingate’s Physician Assistant Studies program, Rickher accompanied Dr. Roy Blank, the program’s medical director, on a medical mission to Nicaragua, during the Zika-virus outbreak. The trip provided training that Rickher is leaning on now as she tests patients for COVID-19 at a Novant drive-up facility in Matthews.

“That was an incredible, incredible trip,” Rickher says of her weeklong stay in Central America. “I did things on that trip that I wouldn’t have had the confidence to do in the States, because it was just true medicine. I mean, just like me and the patient and we’re trying to figure out what to do to make you better.”

Allison Rickher head shot (wearing PPE)

Rickher, a two-time Wingate grad (undergraduate 2014, PA 2016), has her hands full these days. She normally works as a physician assistant at First Charlotte Physicians in Matthews. But after the coronavirus outbreak became a pandemic and really started taking hold in the United States, Novant opened a makeshift clinic in a strip mall in Matthews and asked for volunteers.

Rickher mulled it over, and when Novant asked a second time, Rickher raised her hand. She’s been at the clinic, doing car-side exams, since March 23.

“I don’t have children. I’m thankfully very healthy. I’m young,” she says. “I felt that I could go and work at a place like this and not have a huge impact on other people. I don’t have to go home to young children. I don’t have any health conditions that put me at increased risk. So I thought, Why don’t I go, as opposed to having someone forced to go who has health risks and concerns?”

Rickher and the doctors, nurses and other PAs at the clinic work banking-hours shifts every day, testing patients in their cars and bringing the sicker ones inside for more-extensive examinations if necessary.

Rickher says that initially, when the clinic offered only drive-up service, she and her colleagues tested about 200 people per day. That’s down to 40-50 now.

No matter the volume, it’s arduous. Rickher says she sees seven to 10 patients a day. The car-side exams take about 10 minutes and include a swab plus a check of vital signs. She has patients wait for their results, which are back in 20 to 30 minutes. If someone’s having trouble breathing, she might recommend they come in for an X-ray. Rickher has encountered plenty of COVID-19-positive patients, and a few of them have been taken to the hospital by ambulance.

And she answers question after question all day. How can I reduce my chance of passing this on to someone else? How will I know that I can go back out into society? How can I keep my family members safe? And perhaps the most common one: I’ve been very safe. How did I get this?

“No one’s perfect,” Rickher says. “You’re going to forget to do something one time or you’re going to cross-contaminate and not realize you cross-contaminated. We’re just educating people on that.”

Through it all, she’s covered head to toe, with her face getting three layers of covering. Wearing two masks plus a face shield makes it hard to breathe and to communicate, and every layer increases her body temperature. Luckily, this spring hasn’t been overly hot, but even so, Rickher says, “you just sweat the whole day.”

“I think all of us would say we’re absolutely exhausted at the end of the day,” she says. “I definitely fall asleep on the couch at like 8:30.”

Overcoming fear

Rickher was a standout volleyball player at Weddington High School, the player of the year in the Southern Carolina Conference. Still, she knew it would be difficult getting playing time at a Division I school and thought she had put her athletic career behind her when she was contacted by Shelton Collier, Wingate’s volleyball coach.

He persuaded Rickher to visit the University. She was blown away.

“I remember it vividly: I didn’t really know if I wanted to go on the visit at all,” Rickher says. “My dad was like, ‘Let’s just go. Let’s see what it’s like.’ And afterward I remember getting in the car and we looked at each other like, Is this too good to be true? What’s the catch? You know, there wasn’t a catch.”

Allison Rickher during her Wingate volleyball days

Rickher was a role player in her first couple of years on the team, but she developed into a solid contributor as a middle blocker, even being named second-team All-South Atlantic Conference after her senior season. She was also a team leader and helped the Bulldogs to a program-high ranking of seventh in NCAA Division II.

Aside from her physical performance on the court, Rickher brought a number of intangibles to the team.

“When I think of Allison, I first think of her engaging smile,” Collier says. “Then I think of her always having mature, awesome perspectives on everything.”

As a biology major with minors in chemistry and psychology, Rickher was an outstanding student, and one selling point for Wingate was the PA Advantage program, which gives preferential treatment to Wingate undergrads looking to get into the program, provided they meet and maintain certain criteria. Rickher, who came to Wingate after finishing No. 4 in her class at Weddington High, kept up her end of the bargain and stayed on at Wingate for grad school.

“Wingate’s PA program, I can’t say enough about it,” she says. “I mean, they’re phenomenal. I take students now from the Wingate PA program, I precept them, and they’re better than any students I’ve ever encountered.”

The program gave her the opportunity to do real, in-person, dire-need medicine in one of the poorest countries in the Western Hemisphere. For several years, Blank served as the medical director of Bless Black Worldwide, a mission organization with operations in Haiti and Nicaragua, and he would regularly enlist students to help out.

For RIckher, it provided invaluable hands-on experience.

“It is unlike any other opportunity, because when you’re down there, you’re basically functioning as your own provider,” she says. “When you’re in school, in the States, you are talking to patients, you’re examining patients, but ultimately there’s somebody else there that’s going to make the final decision. You can try to impact it, but they’re the ones that are making the final decision.

“When I was in Nicaragua, it was me. I mean, Dr. Blank was there, there were other physicians, other PAs. But at the end of the day, if I was going to make a decision about something, that’s what was going to happen.”

The experience taught Rickher one particularly important lesson that she’s using today, during an unprecedented global crisis: fear of the unknown can be a good thing.

“I think an appropriate amount of fear is good, because that means that you’re going to be on your toes,” Rickher says. “You’re not going to let certain things slip through the cracks. You know, being overconfident I think can be detrimental.”

She also has to deal with others’ fears. Many of the patients Rickher sees at the clinic come to her feeling anxious about COVID-19, the lockdown and the future. Rickher is patient and understanding, in part because she has a lot of the same feelings.

“I think everyone has an appropriate level of fear and anxiety, because it is an unknown,” she says. “There’s no light at the end of the tunnel right now. But I have seen that with some populations, the knowledge that we can give them, the education that we can give them, really does bring people a sense of peace. I try to explain to my patients why I don’t think they need to be hospitalized and why I think that they’re going to be fine throughout this, and that seems to help them.

“I think education is key. I think people have an appropriate amount of anxiousness, but most people are incredibly grateful for what we’re doing. I think for most of us, this is our job and we’re happy to do what we need to do.”

May 1, 2020

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