The first COVID-19 cases in Michigan were reported on March 10, 2020. As the highest risk procedures were identified by CDC guidance to be aerosol-generating procedures, Amanda Ahrens, Julius Sawyer, and the entire CRNA team had growing concerns for the staff safety. Due to the reported method of transmission, Amanda secured a Powered Air Purifying Respirator and assembled a travel bag of Personal Protective Equipment so that the CRNA staff could safely intubate patients in the Emergency Department and throughout the hospital. In concert with HFAH Incident Command Center and Anesthesia group, The CRNAs worked diligently to ensure that safety was a priority for patients and for the team members.

The CRNA staff developed a team to take over house-wide intubations, to decrease exposures and limit risk for all. They always assigned two CRNAs to this team for airway response. The CRNAs underwent training to be redeployed to the ICU setting to collaborate with the Physicians, Respiratory Therapists, and Nurses. The CRNA team began preparing to work in this capacity in order to meet the needs of the overwhelming number of ventilators being used to treat COVID patients. The CRNAs also worked closely with the Anesthesiologists to manage airways and arterial lines dally.

The CRNA team supported the HFAH Nursing Mission, Vision, and Values through their supportive actions. They provided patient-centered care to our patients while limiting potential exposure and protecting our staff members. They applied evidence-based practice utilizing guidance from the CDC as well as their national CRNA association to make recommendations that intubations should occur sooner than later and the most experienced airway providers should do the intubation, hence the two CRNA intubation team. Innovation in practice was exemplified by their plan. They demonstrated the value of responsiveness and efficient use of resources by being incredibly agile, and agreeable to pivot as the plan changed and evolved for redeployment. They lived our nursing philosophy by creating a collegial atmosphere where the collaborative practice is valued and encouraged while providing nursing care and advanced nursing practice to the patients and families.

The CRNA team worked tirelessly to meet the ever-changing needs of our patients and staff. The collective attitude of the entire CRNA team was to do whatever the hospital and patients needed, and for however long they needed it. The CRNA team members provided ongoing support to the Physicians, fellow APPs, nursing, respiratory therapy, and most importantly to the patient.