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Frontline Heroes

Frontline Heroes

Emergency nurses lead out in front as COVID-19 first responders

Elda G. Ramirez, PhD, RN, worked feverishly with medical staff to intubate a man suffering from respiratory distress likely caused by COVID-19. They labored so intensely that when Ramirez left the room, a hospital tech pointed out something strange.

“I had sweat so much that my plastic gown was attached to my skin,” says Ramirez, an emergency nurse practitioner.

As the pandemic raged across Houston, Ramirez and her fellow emergency nurses persevered through long hours, stifling protective gear, and the ever-present fear of contracting COVID-19.

“We started thinking that we might bring this virus home to our families,” she says. “In that kind of environment, it’s both professional and personal.”

While Ramirez has seen and experienced a great deal during three decades as a practitioner, educator, and researcher, she lives a new level of intensity as a pandemic first responder. When serving as a hospital screener, she makes the vital decisions on which patients go to special COVID-19 areas. In the COVID-19 treatment units, she wears head-to-toe protective gear and makes critical life-and-death decisions.

“For those of us who are on the frontlines in health care, it is more than a job,” Ramirez says. “It’s almost like a genetic trait or calling because not just anybody can do it.”

Ramirez served as co-chair of the COVID-19 task force for the American Academy of Emergency Nurse Practitioners (an organization she founded), leveraging her experience to help other nurses. During the early days of the pandemic, the group assisted emergency nurses in finding scarce personal protective equipment and held educational programs on the virus as new and sometimes conflicting information surfaced. It also served as a resource for nurses who lost their jobs due to hospital funding cuts and guided nurses in best practices for treating COVID-19 and avoiding infection.

Even before the pandemic, Ramirez held a deep commitment to teaching nurses the skills to serve in emergency situations. She founded UTHealth’s emergency/trauma nurse practitioner program in 1994 and helped establish the first international competencies for nurse practitioners in emergency care. The State of Texas has granted Ramirez $2 million since 2016 to further her student training, including bringing the coursework online and expanding the program to The University of Texas Health Science Center at San Antonio (UT Health San Antonio).

Part of Ramirez’s work in nursing education involves hands-on mass casualty drills for emergency nurse practitioners. Now an annual staged simulation typically held at the Houston Fire Department’s Val Jahnke Training Facility, the training day brings together first responders and students from the six UTHealth schools and UT Health San Antonio.

“After 9/11, most organizations started to train on multiple levels for a disaster, but not across the several disciplines of first responders,” Ramirez says. “Our program adds in interdisciplinary practice. The more we learn to work together, the more we learn that each person is a key piece in providing the care needed to save lives during any kind of disaster.”

In addition to her educational work, Ramirez’s research delves deeply into the role of emergency nurse practitioners—their training, their abilities, the future of the specialty, and how to foster ongoing leadership and excellence within the ranks. PARTNERS, a community organization that supports Cizik School of Nursing at UTHealth, awarded her the three-year PARTNERS Faculty Research Scholar endowment in 2017 so she could pursue these discoveries.

“PARTNERS offered me the opportunity to really explore the things I love in my career, and this research not only grew me professionally but also allowed me to help junior faculty members get started in their own work,” she says.

Whether enduring the struggles of COVID-19 or preparing for mass casualty events, Ramirez says that the dedication to taking care of patients runs strong within nurses, and this year has brought their exceptional qualities to the forefront.

“We’re not soft,” she says. “We’re strong. We’re dedicated. We’re not running away from this.”

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Goettl - Ramirez - McCrea
Emergency nurses Bradley Goettl, DNP; Elda Ramirez, PhD, RN; and Deborah McCrea, RN, lead a mass casualty simulation drill open to students across UTHealth and, more recently, UT Health San Antonio.
Frontline Heroes