KU Cares: Jayhawks on the Front Lines - Pediatric Pharmacist Danielle Herrmann

Danielle Herrmann was a member of the Kansas swimming and diving team from 2005-09. After she completed her swimming career, she continued her education at KU, graduating from the pharmacy school in 2013. Now, she works at the Valley Children’s Hospital in Fresno, California, as a pediatric pharmacist. Her duties include medication verification, consulting for medication dosages or selection, responding to codes as well as patient education on their medications. Herrmann and all those who work at the Valley Children’s Hospital are helping the city get through the COVID-19 pandemic.

Q. What has the last month or so been like for you?

“This last month has been like nothing I have ever experienced before. It’s hard to put into words what this experience has been like and I feel like everyone has their own unique experience during this time. There are so many unknowns like how long this will last, what the best treatment is for these patients and how it will affect our community. However, even though it is stressful I have a great sense of gratitude because of how much our hospital staff and community have worked together to prevent spikes in COVID cases and keep everyone safe.”

Q. How has the virus affected your community?

“As a state, California was early to implement the shelter in place order and I think that really helped us. In Fresno, we have been fortunate to not have many positive cases yet (191 cases as of April 11). At Valley Children’s we have a lot of community support. We have had many families make cloth masks for the staff, providers and dentist offices providing us with extra PPE (personal protective equipment), restaurants provide meals, tons of love and verbal support from the community and many people who just want to help in any way they can.”

Q. What have been the biggest changes at your place of work?

“I think the biggest change has been how quickly all these adjustments are happening. Typically, it takes weeks for new policies and procedures to go into place, however, due to necessity some of these new procedures have been implemented in a matter of hours.”

Q. How has it affected the way you do your job on a daily basis?

“We have been fortunate in that we haven’t had many cases in our community and no cases in our hospital to date. On a day-to-day basis, the whole hospital staff has been very diligent about heightened cleaning protocols, washing our hands often, keeping a six feet distance from others when we can, and wearing masks when unable to maintain a six feet social distance. With this whole pandemic being so unknown for the country things are changing day-to-day based on any new information that is learned. As soon as this pandemic started our hospital adopted a policy limiting the visitors to just one visitor per child. As the weeks have gone on we have seen many more changes go into effect including temperature checks and wellness screenings before we start our shift, visitor screening, the cancelation of elective surgeries, telehealth appointments instead of in-office visits, drive up testing clinics, working out of remote satellites to verify orders instead of working out on the floors, doing medication reconciliation from over the phone for our rule-out patients and can now run the COVID test at our hospital. Early on when we were unable to run the test at our hospital it was taking days to get results back. Now that we are able to run the COVID test in our lab we are able to get the test results back in a matter of hours.

“In the pharmacy, we are facing drug shortages. We are coming up with strategies to avoid running out of those medications that are on national backorder. One of the shortages we have faced is the shortage of inhalers due to allocations and the need to use MDIs (metered-dose inhaler) versus nebulizers in potentially positive patients. We are limiting the number of stock bottles of medications we make beforehand to allow for longer dating. This is important because once reconstituted some medications will have shorter expiration dating.

“Early on there were many shortages on PPE so our IV technicians were having to be cognizant of the number of masks they were using to prepare intravenous medications. Now we have gotten to a point where we have enough.

“While we have not yet had any COVID-19 positive patients, we are preparing for when and if we do. We have done a series of code simulations to emulate what it would be like if we had to rapidly intubate a COVID-19 patient while providing the best and quickest care to this patient and staying safe ourselves. I am so grateful that we have had the time and resources to be able to practice scenarios like this before we have to do this on any COVID positive patients.”

Q. What does a typical work day look like for you right now? What is your work schedule like in terms of hours and days?

“I have been fortunate in that my work schedule has remained the same in my four- 10-hour shifts per week. Valley Children’s has been very proactive in their preparations and early on had asked all of the staff what its availability was for extra days or hours if we had a surge of patients. We haven’t had to work any extra hours yet but many people offered up their time if needed.”

Q. What is the general feeling/morale that both you and your coworkers have right now?
“I think in general everyone is trying to stay positive and as prepared as possible. As healthcare workers, we know there are certain risks involved with the work we do and that one of the most rewarding parts of our job is getting to help others. So I think everyone is really happy to be helping where they can. We have been lucky to have low numbers in the Central Valley but we could see a spike at any time. It has been very helpful that our hospital has kept us all prepared and informed.”

Q. What has been the most challenging thing for you during this time?

“I think the most challenging thing has been a fear of the unknown and the fact that things are changing at such a fast pace.”

Q. Do you see any changes that are going to come from this pandemic once it is under control?

“It’s hard to predict the types of changes that will come from all this as decisions are being made and changing by the hour. I think it will take time to fully get this virus under control and I believe that we need to continue to be careful even after the restrictions are lifted as there could always be a resurgence of the virus.

“Despite this being a difficult time, I hope that through all this we will see some positives that occur such as an increase in preventative precautions, a greater appreciation for things we used to take for granted, increased community spirit, new innovations inspired by the pandemic and increased family and friend connections, to name a few.”

 Q. How have you been spending your time when you’re not working?

“Prior to this COVID-19 pandemic I was training for the 2020 Olympic Swim Trials set to start mid-June, so typically I have a pretty strict workout regimen with a swim workout six days a week for 1.5-2 hours per day and a weight workout three days a week. It has been very hard to maintain this same regimen with all the gyms and pools closing. The Olympic Trials have been moved back to June 2021 which has been good as it takes the pressure off needing to train to that same extent until this whole pandemic is clear. In the meantime, I have been doing a backyard pool workout three days a week on my off days and a weight workout with a run or a bike the other four days of the week. The pool is only 10 yards versus a normal 25, so I have had to get creative with using bands and power towers but it has so far worked well. My husband and I were lucky in that we ordered a bunch of strength equipment prior to the shelter in place. So for the dryland training aspect, it has been fun to stay in shape via other outlets than I had been used to before, but I have been very sore as well. It has been nice to be able to still work out, as it is a constant that I have been able to maintain during this outbreak.

“When I am not working or working out I have spent a lot of time on the phone or Zoom with friends and family. It has been really awesome to get to connect with loved ones during this time! I don’t necessarily have more time than I had before but I am finding different ways to use the time I have.”

Q. Do you have any suggestions/recommendations to help people get through this? What can people do on their own to help the medical professionals working on the front lines?

“I think the most important thing that people can do to get through this time is to take the preventative measures that the CDC has recommended: washing hands frequently, avoid touching face, eyes or mouth, limit contact to anyone outside of the household and maintaining good sleep nutrition and exercise. This is a very stressful time and there are many things to worry about; however, it is best to focus on the things we can control. I think if everyone does these small things that they can do to stay healthy, we will be better off to prevent any big spikes in cases.”