MSN Graduate Treats Patients with COVID at University Hospital
By CATHERINE DUNCAN
Adriana Munoz, MSN, AGACNP, RN, completed the BSN to MSN program at the School of Nursing in August 2018 and began working at University Hospital in February 2019 after passing her licensing exams.
For a year, Munoz worked with the hospital medicine team with 14 to 15 patients at a time. Paired with a physician, she performed daily assessments of their condition, ordered imaging, consulted with specialty physicians, prescribed medicine and more.
“We did a lot of consulting as the hospital medicine team. We figured out who needed to be involved with specialists,” Munoz said.
However, little did she know her job—as well as the world—was about to change tremendously. “Initially, we were watching everything in New York develop regarding the new coronavirus. I took that downtime to do research about COVID-19 and patient care. I studied information coming out of China and Italy. But, no one was coming here to University Hospital. Then, the COVID-19 patients started coming in,” she remembered.
At first, the hospital surveyed the hospital medicine team to determine existing medical conditions in relation to treating patients during a pandemic. “I have a chronic condition—asthma. That was a fear for me. I have four kids and am a single parent. There was a lot of fear initially.”
At the hospital, the initial COVID-19 patients went straight to the ICU. “We didn’t see any of those patients at first,” Munoz said. “Then came the first real surge, and the ICU couldn’t handle the volume. They transitioned our fifth floor to a COVID unit. Our group had a maximum of six patients. We were one of the first hospital medicine teams for COVID. Then, they kept expanding medical teams.”
Munoz credits the emergency medicine team for doing a great job with patients when they first arrived at University Hospital. She saw the hospital implementing procedures for personal protective equipment and sanitizing all areas.
“There was a lot of preparation and planning. That made me feel safer. I knew we had to help these patients,” Munoz said. “I’m very glad I was at University Hospital with UT Health San Antonio’s support. We always had PPE. I always felt protected.”
When she left the hospital, Munoz said she put her work shoes in a box in the trunk. She had another pair of shoes she wore home. Then, she undressed in the laundry room at home and washed all her clothing in hot water. “I showered before seeing my kids or being in the house at all.”
Munoz said the worst part of the experience was seeing patients die alone. “We were trained to treat people in normal circumstances. At first, people were dying despite everything we were doing. Their family and friends couldn’t be there with them.
“The hospital was great about supplying iPad tablets so patients could communicate virtually with their loved ones,” she said. “I remember a husband and wife who both came in COVID positive. When I saw the husband was close to dying, I asked for a family meeting via the iPad. Although they had been treated on two different floors, we took the wife to the husband so they could see each other. The husband was able to tell his wife and children his last wishes. He decided he wanted to be taken off life support. Everyone was crying, but you can’t even wipe your eyes with all the PPE.”
That was not an isolated moment, Munoz said. “The emotional toll was the worst of all of it,” she said. “Then we started to figure out what to do as soon as they arrived. We understood more about treatment. It became more tolerable; we were able to save more people. I remember an elderly man who was intubated for weeks. He lived through it all and was able to go home. Those moments make it all worth it.”
Munoz, who is now pursuing her PhD through the School of Nursing, is conducting research—with fellow doctoral students Lisa Dodge and Holly Johnson-Rodriguez—about health care providers’ experience caring for COVID patients who die in the hospital. The three are collecting and analyzing data for their research project. Professors Sara Gill, PhD, RN, IBCLC, FAAN, and Janna Lesser, PhD, RN, FAAN, are guiding their efforts.
Munoz decided to earn her PhD so she has the option of pursuing a career in nurse education and research. Her two sons have hemophilia, and through their diagnosis experience, she saw the struggle for a diagnosis by other parents. “At that time, many doctors thought it a condition only for males. I saw that wasn’t true, but to change something you must have the science to prove it.
“I want to help find better treatments and procedures using evidence-based practice,” she said. “With my MSN and PhD from the School of Nursing, I know I can find ways to improve health care. UT Health’s incredible nursing professors are helping me to become a better nurse leader.”