Federal medical team leader touts positive experience

Disaster assistance group deployed to San Juan County

FARMINGTON — After more than two decades of service as a reservist for the National Disaster Medical System, there isn’t much Norm Wrona hasn’t seen when it comes to providing emergency medical assistance to areas that have been overwhelmed by natural disasters or pandemics.

But during his recent deployment to the San Juan Regional Medical Center as commander of a disaster medical assistance team (DMAT), Wrona still managed to experience something rare.

“The level of hospitality and gratitude the hospital staff and the community expressed were amazing,” Wrona said during a telephone interview on Nov. 19 after rotating back to his home in Fredericksburg, Virginia, just south of Washington, D.C. “It was probably the greatest amount I’ve ever experienced in 22 years in NDMS. … You don’t get that very often.”

The DMAT group was deployed to San Juan County by the U.S. Department of Health and Human Services after the hospital enacted crisis standards of care last month because of its surging COVID-19 caseload. The Tampa-based team served here from Nov. 4-17, having been replaced for the latter half of the month by a second DMAT unit from Ohio.

That warm welcome certainly made it easier for Wrona and his nearly 30-member team of physicians, advanced healthcare practitioners, nurses, paramedics, pharmacists and support specialists to do their job, he said. The team’s experience here also was buoyed by the approach hospital administrators and staff members took toward integrating the DMAT team into their operations, Wrona said.

“One of the challenges we often face is, some facilities try to fit us into the same template they use for contract or traveling employees, and that’s like trying to fit a square peg into a round hole,” he said, explaining that DMAT teams are designed to serve specific purposes and fill certain roles, but not others.

Officials at the San Juan Regional Medical Center understood well in advance the parameters of the DMAT team’s mission here, Wrona said, and that eliminated the possibility of any misunderstandings.

“It was one of the easiest transitions I’ve experienced,” he said.

Wrona said the hospital’s CEO, Jeff Bourgeois, was so accommodating, he even turned over his boardroom to the DMAT team to use as a command center.

The group’s experience here stood in stark contrast to what it has met sometimes while being deployed elsewhere, he said.

“On some other missions, you spend so much time with a bureaucratic process, it really hampers the mission,” he said.

Wrona said San Juan Regional Medical Center’s status as the only facility of its type in the county serving the general population is not what his team is accustomed to seeing, and that left him feeling sympathetic to the challenge the hospital faces.

“They don’t have another hospital down the street they can share resources with,” he said. “There’s no way to offload (a surging caseload). I think they did a phenomenal job with the resources they had.”

Since the pandemic began, Wrona has joined his team on several other deployments, including to facilities in Tennessee and Montana. He said the methods of treating COVID-19 patients don’t differ greatly from previous iterations of the virus such as SARS, but he said outside influences have impacted the work his team does.

“The difference is, you have to take into account the social or political environment in which you’re operating now, as compared to previous forms of the virus,” he said. “During those (outbreaks), we were not so affected in our ability to provide treatment.”

When his team members do encounter resistance to medical treatment because of those social or political beliefs, he said, it can put them in an awkward position.

“Our response is to provide the best medical care we can while respecting the wishes of the population,” he said. “So we sometimes walk a little bit of a tightrope.”

Wrona said that wasn’t much of an issue in San Juan County.

“We actually saw a lot of support for the virus mandates, both at the hospital and in the community,” he said.

Wrona said he is likely to recall his deployment here a little more fondly than he has in other locations.

“This particular mission was a little bit more rewarding from a personal point of view because we could tell we were making a little bit more of a difference in relieving the burden of the hospital staff,” he said.

While members of Wrona’s DMAT team have returned home after finishing their two-week deployment here, he said they remain on call for another emergency for the rest of November. And with the virus continuing to surge in locations across the country, he is confident this was not his last deployment to a site overwhelmed by the pandemic, even though there are 50 such teams in the U.S.

“There is a good likelihood we will be redeployed to another area in the U.S. or its territories,” he said.