Intensive Care Unit Nursing: Treating COVID-19 Patients

When Katherine Dominguez, RN, wakes each morning, she starts her day with a prayer asking for strength in her work in Adventist HealthCare White Oak Medical Center’s Intensive Care Unit (ICU).

It’s been more than two years since hospitals began treating patients with COVID-19. When Katherine graduated with her nursing degree, she never imagined her career would include caring for patients during a global pandemic, or how important her skills would become for her family.

An Unexpected Turn

During nursing school, Katherine had rotations at Adventist HealthCare Shady Grove Medical Center in several departments, including Labor & Delivery, Medical/Surgical and Psychiatry. In February 2020, she joined the Emergency Department at White Oak Medical Center as part of Adventist HealthCare’s nurse residency program. Right afterward, community transmission of COVID-19 began to increase in Maryland.

"When the pandemic began, we didn’t know how to deal with COVID,” Katherine said. "Even the experienced nurses I worked with didn’t, so we all learned together." As a team, they learned how to treat COVID-19 patients, protect themselves with personal protective equipment and continue to provide exceptional care.

Working in the Emergency Department during multiple COVID-19 surges allowed Katherine to learn about critical care more quickly than she would have in a world without a pandemic. She always wanted to work in the ICU, and her pandemic experience solidified that desire.

After nearly seven months of working in the Emergency Department, Katherine suffered an injury at home that limited her ability to work. She felt stressed and frustrated, but her parents kept telling her, “God does everything for a reason.”

COVID-19 Hits Close to Home

In December 2020, Katherine’s father and one of her brothers contracted COVID-19. Their symptoms worsened, so they headed to White Oak Medical Center for care. While being evaluated in the Emergency Department, they learned their oxygen levels were low, They were admitted to the Intermediate Care Unit (IMCU) before eventually being transferred to the ICU.

Katherine, still sidelined by her injury from working at the hospital, uniquely understood COVID-19 from a nurse’s perspective. She became the decision maker for her father’s and brother’s care. She wore two hats: one as a nurse who had treated COVID-19 patients, and another as a daughter and sister.

She struggled to help her family members understand what was happening and explain how treatment can affect a person’s body. “In this situation, it’s hard to not just think about your own feelings, but theirs too,” Katherine said. “You have to think about what they would want.”

As 2021 began, her father and brother’s health continued to decline. They were transferred to a trauma hospital for an even higher level of care. Sadly, Katherine’s father passed away from complications from

COVID-19 in January, and her brother passed away from complications from COVID-19 several months later.

Moving Forward

When Katherine felt ready to return to work at the hospital, it was hard on her family, especially her mother. They were scared for her to return and be around COVID-19 patients. But Katherine chose to return, and her colleagues surrounded her with support.

“My coworkers were always making sure I was doing okay, and they would check in on me on my days off,” Katherine explained. Her supervisors temporarily moved her to the “fast-track” section of the Emergency Department, which traditionally treats bumps, cuts and bruises, and did not often treat COVID-19 patients.

As the year continued, Katherine felt ready to make the jump to a new unit, the one she always planned to work in, the ICU.

Katherine enjoys her work in the ICU but the memories there are difficult at times. She knows the room in which her father was intubated, and the room where her brother received care. However, she uses her experience to provide a unique perspective to her patients and their families.

On the first anniversary of her father’s passing, Katherine was assigned to a patient in the room where her father stayed during his time in the ICU. “It was a hard day, but I focused on how I was able to help care for someone in a similar position that my father was in and make a difference in their life,” she said.

She cares for her patients and their families like they were her own. “When patients are scared and their family can’t be there, I’ll go hold their hand and comfort them,” she said.

On the tougher days, she focuses on how proud her dad was of her becoming a nurse and says it motivates her to keep going.

"When I’m helping people, I know he’s still proud of me."