Monday, December 14, 2020

By Jamie Nicpon | Office of Communications & Marketing | 12-14-2020

This winter, a staggering number of U.S. health care facilities experienced a dramatic surge in COVID-19 patients. As facilities attempted to add physical space in order to care for this influx in patients, administrators were also scrambling to find enough clinicians to provide care. Consequently, many health care providers needed to be reassigned.

The University of Iowa Hospitals and Clinics faced these challenges as well. As the hospital's capacity was stretched, many of its specialized care providers were reassigned to help in the areas most heavily impacted by the surge of COVID-19 patients, particularly the hospital’s intensive care units (ICUs).

With a reduction in UIHC’s general surgical capacity, hospital administrators reached out to its certified registered nurse anesthetists (CRNAs) to help staff its ICUs. A large portion of the CRNAs who have stepped up to fill the void are graduates of the UI College of Nursing’s doctorate-level anesthesia nursing program.

“UIHC administrators specifically asked for CRNAs because they are required to be ICU nurses prior to applying to the college’s anesthesia nursing program,” explained Cormac O’Sullivan, PhD, CRNA, ARNP, associate professor and director of the college’s anesthesia nursing program. “So, we assigned some of our most recent graduates as they would have the most recent ICU experience and are familiar with how UIHC’s ICUs are run. This is a big change for them from anesthesia, but they will do it as long as needed to support UIHC and care for these patients.”

Working 12-hour day/night shifts, these CRNAs have rapidly been trying to get themselves reoriented to the ICU. In total, six of the college’s former student registered nurse anesthetists (SRNAs) have been called into this role, thus far.

One of UI’s CRNAs who was reassigned to help the ICU deal with the immense surge of COVID-19 patients is David Villanueva, who graduated from the College of Nursing’s Doctor of Nursing Practice (DNP) program in 2020.

To aid the speed of transition, Dr. Villanueva was ultimately reassigned to the ICU where he had once been a staff nurse.

“Coming back to the intensive care unit where I once worked has been illuminating. My approach has changed with the newfound knowledge I have gained, ensuring that each patient I care for can benefits from my hard-earned skills,” said Dr. Villanueva. “I have also worked to collaborate with the staff nurses and physicians to present the unique skills and knowledge I’ve acquired. In this era that brings so many new things, I have strived to demonstrate the usefulness and utility a nurse anesthetist brings to every encounter.”

Current CRNA (and former SRNA) Austin Blay was also asked by UIHC to help manage its patient surge in the ICUs.

Austin Blay

“It has been a whirlwind to say the least,” said the Council Bluffs, Iowa, native, who also graduated from UI’s DNP program in 2020. “At first, before we were assigned to do patient care, I was able to utilize my CRNA skills by intubating and placing invasive lines to better care for these very sick patients. Once our roles became more defined, it was like riding a bicycle and I have been happy to help wherever and however I am needed.”

Dr. Blay emphasized that despite the unpredictable nature of the virus forcing the hospital to stretch its resources to capacity, the care and compassion that the ICU teams continue to deliver is second to none.

“They are an amazing group of health care providers and I have been honored to work alongside them.”

For Dr. Blay, the entire experience has just further reinforced how devastating and life altering COVID-19 can be.

“From watching patient’s struggle to breathe while lying in bed, to watching their loved ones suffer in agony as they can do nothing, is so heart wrenching. It has been both mentally and physically exhausting and I can’t thank the ICU frontline workers enough for all they’re doing,” he said. “You read all these articles, see all the statistics, and watch and hear what is in the media, but until you are at the bedside and seeing what COVID is doing to these patients you truly don’t understand how devastating it is.”

When asked to describe his experience in the ICU during the pandemic, Dr. Villanueva echoed very similar sentiments.

David Villanueva

“My time in the intensive care unit has taught me that COVID-19 is a relentless disease that lingers for much longer than many realize. Patients are pushed to the brink for weeks on end, teetering on the furthest edge of modern medical science,” said Dr. Villanueva. “I have witnessed the exhaustion of patients who remain on maximal oxygen therapies, fatigued and hopeless, wondering if tomorrow will finally be a better day. I have seen tired hospital staff drained beyond belief, watching patient after patient endure daily battles to stave off this deadly virus. I have definitely learned the true meaning of perseverance.”

UI’s anesthesia nursing program provides future CRNAs with top notch didactic and clinical instruction that prepares them to deliver high-quality anesthetics from day one. Thanks to their broad and extensive clinical backgrounds, these nurse anesthetists are also able to evolve and adapt their skills, enabling them to face countless health care emergencies, even a crisis the scale of a global pandemic like COVID-19.

“We are immensely proud of our graduates and their willingness to do great things when asked,” added Dr. O’Sullivan. “Even when faced with some of the greatest adversity the health care profession has ever known, they continue to rise to the challenge.”

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