Page 138 - 2020 JSOM Winter

Riverview Terrace Team

A Novel Special Operations Forces Medic Role
Emerges at the Forefront of the Fight Against COVID-19

Jason Valenzuela, BS, SSG, ATP *; Chaney Harrison, BA ;
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Joe Barajas ; Emily E. Johnston, MD, FACEP, DiMM

ABSTRACT

During the Spring 2020 COVID surge, a team primarily SOF medics refine their skill set in traditional didactic settings,
composed of SOF medics coalesces in New York City, rap- clinical rotations, and learn to treat patients in typical and
idly establishes a field hospital within a large academic teach- atypical settings. SOF medics are trained to function autono-
ing hospital, then transitions to step-down and ICU care as mously while integrating seamlessly into established social and
institutional needs evolve. Empowered to work as RNs, by cultural settings. Continually pushing the limits of knowledge
emergency decree, the SOF medics, remarkable performance and experience is an essential tenet of the SOF community
supports the need to define a novel role within the civilian (Figure 1).
healthcare system for these valuable, highly experienced, and
underused providers. FIGURE 1 SOF medic tenets.
Keywords: COVID-19; SOF medic; COVID surge; Special Op-
erations; field hospital; RVT

Introduction

Launched on 14 April 2020 in response to a surge of SARS-
CoV-2 virus (COVID-19) patients, our joint team, composed
of Special Operations Forces (SOF) medics, civilian physi-
cians, physician assistants (PAs), nurse practitioners (NPs),
registered nurses (RNs), and paramedics, found itself at the
forefront in the fight against the disease. Within our team, SOF medics comprised 70% of the clinical
and administrative staff, pushing the team’s commitment to
Our Riverview Terrace team (RVT) operated as a first of its high-level patient care, providing ongoing training to hospital
kind medical element, running a field hospital embedded staff within the broad clinical scope of their capabilities, and
within New York-Presbyterian (NYP)/Columbia University fundamentally driving the team’s evolution within the hospital.
Irving Medical Center in New York, NY. We were charged
with exclusively managing the care of COVID-19 patients, en- Recognizing the depth of the SOF medic’s scope of practice,
abled by New York Governor Andrew Cuomo’s emergency NYP granted us the ability to practice as SOF RNs, equivalent
order allowing military, former military, and out-of-state ci- to our civilian counterparts. This directive permitted SOF med-
vilian healthcare professionals to provide clinical care within ics to drive patient management, as well as team operations at
the state. The team initially built and staffed the field hos- large, in a nearly autonomous capacity. Stringent adherence
pital, then dynamically moved into the intensive care unit to elevated operating standards allowed us to identify and
(ICU), step-down unit, and other roles as the COVID-19 surge utilize team strengths, while continuous lateral cross-training
progressed. ensured the highest quality patient care possible.

SOF Medics Riverview Terrace Phase 1
SOF medics are clinically educated and experienced providers April 2020 ushered in a continuous surge in COVID-19 pa-
with a broad range of skills, including rapid interpretation of tients, and existing nursing staff struggled to meet the demands
diagnostics, advanced clinical procedures, acute stabilization, of the crisis with the hospital operating at nearly twice its nor-
and long-term management of trauma and medical patients. mal ICU capacity. In a measured and passionate response, the
*Correspondence to rvtdynamic@gmail.com
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1 Mr Valenzuela is affiliated with the 19th SFG (A). Mr Harrison, PJ, MSGT, NRP, and Mr Barajas, PJ, NRP, are affiliated with the 308th RQS,
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Patrick AFB. Dr Johnston is affiliated with the Cascadia Mountain Medicine Institute.
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