Alumna Josy Cash Cassin '06 Helps Heal New York
Josy Cash Cassin ‘06 is a Certified Registered Nurse Anesthetist who currently works at Mount Sinai Hospital in New York City where she has been for the past five years. Her days have never been routine, since for her, administering anesthesia covers all specialties ranging from orthopaedics and plastics to neurology and obstetrics. Prior to COVID-19, her typical day began with pre-operative interviews with patients and formulations of individualized anesthesia plans. As she accompanied her patients to surgery, she continually monitored their brain, heart, lungs, fluids, and pain levels. Even after surgery, she helped her patients transition from the recovery area to discharge.
During the COVID-19 pandemic, all of this has changed, and Josy has adapted to new roles because elective surgeries were put on hold. Due to the unique skill set of anesthesia providers, Josy was put on an emergency COVID-19 intubation team for the hospital. Intubation essentially involves placing a breathing tube in the trachea, and this has been needed more often with patients in respiratory distress from COVID-19. Her “new normal” includes shifts being altered to cover weekends with nights and hours increasing to thirteen hours around the clock. In addition, Josy and her colleagues manage patients in an overflow ICU unit which was built into the surgical recovery area (PACU) in less than two days. In the ICU, the team of anesthesiologists mainly function as intensivists and perform a number of tasks, including interpreting radiology and lab reports, running ventilator machines, placing breathing tubes and accessory IV lines, telephone conferencing family members, and adjusting treatment plans. She accomplishes all of this while continuing to learn the intricacies of COVID-19.
During this uncertain time, Josy and her colleagues have adapted quickly to help in as many ways as possible, never hesitating with each new challenge as hospitals have morphed into unknown territories, the details of which are difficult to describe. In her own words:
When I walk into the hospital in the morning, I often wonder how many people will need an intubation or how many will have a cardiac arrest that day. We are called so often to intubate and attend cardiac arrests that it is hard to keep count on certain days. Increased demand for high acuity patients is sadly the new reality for us. The combination of uncomfortable head to toe PPE (personal protective equipment) and the increased pressure really adds to an already stressful environment. We have all been taken out of our comfort zone, but despite it all, my colleagues and I have adapted to the change and continue to support each other and keep morale high. COVID 19 patients become very sick, very fast. As we all know, the virus primarily attacks the lungs. It also can cascade into kidney failure, coagulation (blood clotting) problems, sepsis, heart failure and death which has been the most challenging to witness. The underlying nature of the virus is extremely unpredictable and has been observed across all age groups and there remains much more to learn about its intricate patterns. I think the most challenging aspect for healthcare providers is that despite our best efforts to save everyone, a majority of patients on extended ventilator support due to the virus cannot be saved.
For her home state of Arkansas, Josy has specific instructions as sheltering in place is underway to flatten the curve. These include more than medical advice:
My advice is stay mindful amongst the uncertainty and despair. As we navigate toward a new normal, please keep doing your part. Social distancing is working and we must all be in this together. Listen to the scientists and pay close attention to your physical and mental health. The burden of isolation can be stressful and take a toll on us mentally. Now more than ever, keep these things in check. Stay active. Break away from the news. Wear your mask. Wash your hands. Be still and reflect on this time at home. And most importantly, embrace this extra time with family and keep your loved ones close. Remember that this is temporary and though our “new normal” might look different in the future, we are resilient and will persevere through these tough times.
Despite working during the pandemic, Josy says that one positive aspect of working the frontline lies in the examples of support and resilience demonstrated by New Yorkers. This is witnessed every evening as the city becomes elated with clapping and music to honor healthcare workers. This is a favorite time in the evening for Josy and her husband, and she describes it as:
It’s a time of gratitude that radiates joy amongst all the despair. There is no greater feeling than to know so many support you and are cheering for your efforts. It gives me courage to wake up and do my job all over again, despite the physical and mental exhaustion. Friends, family, strangers, neighbors and so many more have reached out with calls, texts and gifts all of which motivates me to work even harder. I am not a hero. This is what we as health professionals have always been called to do. My work has not changed, only the circumstances. I am grateful to help make a difference during this pandemic and so appreciative to the volunteers and all medical staff dedicating all their energy to this fight. Together we make the difference.
Maintaining a positive and optimistic outlook has been key for Josy and all of New York. With so much despair surrounding the pandemic, she insists that choosing to see the glass as “half full” is important, and she makes the case that optimism is powerful, contagious, and leads to positive results by quoting former US Security Advisor, Colin Powell as he said “Perpetual optimism is a force multiplier.” This is something Josy says she believes as her husband and family and friends cheer her on and offer endless support. She also credits Episcopal Collegiate School for aiding her in her career by helping her to achieve her goals in academics and athletics by teaching her the importance of structure, hard work, and accountability. She is grateful to have learned responsibility and motivation at such a young age. An accomplished member of Concert Choir, Cheer, Varsity Girls’ Basketball, and Volleyball, Josy’s favorite memory is singing in famous cathedrals throughout Rome, Florence, and Venice during a choir tour of Italy, a trip that inspired her love of travel and other cultures. She is also thankful for her life-long friends made at Episcopal, most of whom she still sees and speaks with frequently.
Josy Cash Cassin is a member of Episcopal Collegiate School’s third graduating class, the Class of 2006. After graduation, she earned a Bachelor of Science (BSN) from the Eleanor Mann School of Nursing at the University of Arkansas in Fayetteville. Shortly thereafter, she joined St. Vincent Health in Little Rock in the Cardiovascular Intensive Care Unit. She then went on to complete her Masters (MSN) in Advanced Practice Nursing in Anesthesiology at Arkansas State University. Josy and her husband, Nicholas, were married in October of 2019 and are expecting their first child this fall.
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