In honor of National PA Week, Envision Physician Services is proud to support the medical professionals who make up nearly 30 percent of clinicians. In recognition of our physician assistant (PA) workforce, we present the firsthand account of two PAs who were critical to the care team who saved lives after the El Paso mass shooting.

April Frowner

While April Frowner, PA-C, raced down El Paso, Texas’ I-10, she remained focused as a constant stream of first responders whizzed past in the opposite direction. The frenzied scene did not shake the experienced clinician because she knew both she and those racing to the Walmart near Cielo Vista Mall were ultimately heading to the same destination.

Frowner had just started patient rounds at Las Palmas Medical Center on the morning of Aug. 3, 2019, when word came in of a shooting at the major grocery supermarket retailer. Reports quickly followed the shocking news that multiple victims were being transported to Del Sol Medical Center.

“We cover Del Sol and Las Palmas together as a group, so if a situation becomes dire, it becomes ‘all hands on deck’ and the physicians at Del Sol are able to call for reinforcements from Las Palmas,” said Frowner, who has been with Envision Physician Services for four years. “So, when we received word from Del Sol Medical Director of Trauma Stephen Flaherty, M.D., FACS, that Michael Gilligan, M.D., and I would be needed, we stopped what we were doing, got to our cars and hurried over to assist.”

After arriving at Del Sol, Frowner and Gilligan wasted no time in joining Dr. Flaherty, Jiselle Del Cid, PA-C, and a team of Envision Physician Services clinicians and staff including trauma surgeons, radiologists, physician assistants and nurse practitioners. They worked tirelessly to provide expert and compassionate care to the victims of the mass casualty shooting and who helped coordinate interdisciplinary services to ensure the continuity of care for our patients.

An Out-of-Body Experience

Jiselle Del CidThe morning also had just begun for Jiselle Del Cid when she was alerted to the day’s tragic events. And as it became clear that the hospital’s operating rooms would be receiving victims, Del Cid and her team got to work preparing as best they could.

“As we started to learn what happened, we took inventory of the day’s surgeries and rescheduled them because we knew we would be performing urgent procedures on shooting victims,” Del Cid said. “We needed to have every operating room available.”

As victims arrived in ambulances, Del Cid, Frowner and the rest of the trauma team at Del Sol worked quickly to assess patients. Many victims who were transported to the medical center required immediate surgery for life-threatening injuries, while others received immediate care by clinicians in a separate area of the Emergency Department.

The team prepared patients for surgery, and PAs assisted surgeons during procedures that were, in many cases, exploratory in scope.

“Reflecting back on that day, it’s an amazing feeling to know that I have the training and support to be able to care for patients in any situation,” Del Cid said. “April and I both were taking the lead in many cases, and it was important that we maintained our composure despite the circumstances.”

Frowner echoed the sentiment, as even she was surprised by her body’s reaction to the flurry of activity it experienced.

“As soon as I arrived at Del Sol, my adrenaline began flowing and my senses became so heightened; you begin performing all the functions of care at such a level that you’re not even thinking about it,” Frowner said. “And the same goes for the entire team at Del Sol – we all came together as a family and worked together to care for the victims.”

Putting Their Community First

For Frowner and Del Cid – both El Paso natives – their role in the events of Aug. 3, 2019, was a test of their professionalism. As desperate patients rushed in and out of their care, their own emotions were sidelined. They had to put aside their fears and concerns of injuries to friends and family in order to care for members of the very community they called home.

“That day made me realize what I’m there for as a PA,” Frowner said, “To see how everyone on our team and at the hospital came together – we were dealing with all that stress and expending all that energy, yet we experienced a strange calmness because we knew what we needed to do and how important it was that we got it done.”

The work of PAs like Frowner and Del Cid are critical to a medical team, said Dr. Flaherty. Viewing their diverse set of skills and training as extensions of surgeons like himself.

“On a typical day, PAs round with the physician, coordinate the plan of care, provide independent assessments of patients and assist in the operating room,” Dr. Flaherty said. “On that day, we relied on their experience to serve as extensions of ourselves while ensuring ongoing care to patients. I’m so proud of the way April and Jiselle seamlessly integrated into this mass casualty incident and provided outstanding care.”

Frowner and Del Cid were not spared by the day’s events, joining their teammates in a struggle to process their emotions in the days that followed. The team was not left alone, however, with Del Cid noting each team member had the support of Envision as they came to terms with their experience.

“I am so unbelievably grateful to be working for a company like Envision because they were as concerned for us as we were for our patients,” Del Cid said. “As we were still coming to grips with and processing what we had been through, it was Envision that had people on the ground there with us to be there and make sure our needs were being met.”

Whether in a patient’s home, at an ambulatory surgery center or at a hospital in the middle of one of the deadliest mass shooting in the United States in 2019, Envision Healthcare’s more than 25,000 clinical heroes work tirelessly to carry out its mission of improving life in communities one moment at a time.

Envision Vice President of Advanced Practice Provider Services Caroline Hodge, PA-C, said the company is excited to be looking at new and innovative opportunities to best utilize the skills of PAs to improve care in each of the communities it serves.

“PAs are adaptable – they are smart, driven medical professionals who understand how to work in teams,” Hodge said. “What we saw from the team in El Paso was that they adapted to this unbelievable situation, set the tone for how patients received medical care and took leadership roles. PAs have so many different talents beyond just their clinical skills, and if we can tap into that and foster their development, we can discover so many more ways to improve care.”