“Never give up.”
Those three words have defined much of Valentina Obreja’s adult life. It’s what she told herself when she and her husband left Romania in 2006, with little more than four pieces of luggage and a dream, to start a new life in the U.S.
It’s what she told herself while bagging groceries at a supermarket as she awaited approval to take her nursing licensure exam. It was also her dedication message in her doctoral dissertation at UCLA School of Nursing in 2021, and it’s what she tells her patients in the intensive care unit every day:
“Never give up.”
Dr. Obreja, DNP, AG/AC, NP-BC, is a clinical nurse in the Cardiothoracic ICU at UCLA Health, where she’s worked for 17 years. She has dedicated her career to improving the care of ICU patients receiving Extra Corporeal Membrane Oxygenation (ECMO), which is essentially a heart/lung bypass machine that takes over the work of the patient’s heart and lungs, giving the native organs time to heal.
ECMO is a complex piece of medical equipment combined with therapy that offers a lifeline to critically ill patients. Whereas ECMO was primarily used during open-heart surgery or as supportive therapy for patients awaiting lung or heart transplant, during the COVID-19 pandemic, ECMO was used to support some of the patients with COVID-19 infection.
For Dr. Obreja, working with such patients is not just a career – it’s a calling. Although she graduated from medical school and had an established career as a physician in Romania, she says nursing is where she has found fulfillment.
“It’s the most generous and gratifying profession ever,” she says. “I think it’s the connection with the patient – with a human and human nature – and the complexity of the role when you’re in the middle of the chaos trying to align all the factors in the ICU environment.”
Soon after passing her nursing boards, Dr. Obreja interviewed for a position at UCLA Health, where she started in the medical observation unit. With the expansion of the ICU to 24 beds, she transferred to her current position.
Living under communism in Romania meant her career opportunities there were limited, she says. It was her dream to work at UCLA Health.
“I always wanted to have the experience of working and doing my profession in an intense environment, and then to be surrounded with people interested in research and also approaching very complex cases.”
In the U.S., she has earned both a master’s degree and a doctoral degree in nursing practice at UCLA School of Nursing. She also achieved national certification at the Fuld National Institute for Evidence-based Practice at Ohio State University School of Nursing, which she says helped ground her in the fundamentals of delivering care that incorporates current scientific evidence, clinical expertise and patient/family preference.
Putting knowledge into practice
As part of Dr. Obreja’s doctoral studies, she worked on a project to safely mobilize ECMO patients, many of whom were physically debilitated. Using her knowledge of evidence-based practice, she turned to the literature, created the protocol, and began implementing the project in her unit.
“It was perfect timing,” she says. “It was in the midst of the craziness of the pandemic and working extra shifts and working at the bedside with all that protection equipment. I think it was the combination that kept me focused outside of work and pushed me forward and motivated me to make it to the end.”
But that wasn’t the end.
Another project soon materialized, prompting Dr. Obreja to look critically at their practice of dressing changes on ECMO patients. Next, she worked with the ECMO coordinator, critical nurse specialists, leadership, and the nursing team to put guidelines in place for caring for ECMO patients.
“It was one project after another, and at some point that helped the ECMO program to consolidate and get better,” she notes. “It’s essentially new knowledge, analyzing all the ECMO results. We need to know beyond stories and successes what it is exactly. ECMO is expensive technology, and it’s not suitable to everybody. Trying to get better in this is the work that we are currently doing.”
Meanwhile, the mobility protocol was presented at an international conference, “which meant for me endorsement from the scientific community,” she says. Another endorsement soon followed; last year, she was one of 30 nurses – 10 from UCLA Heath – to be honored by the Simms/Mann Family Foundation’s Off the Chart program, which recognizes nurses for outstanding care.
By the program’s design, recipients embody “a bias toward action, capacity for self-direction, originality and creative instincts, courageous and bold thinking, and the potential to achieve even more.”
The honor came as a surprise to Dr. Obreja, as did the $10,000 award that came with it.
“Looking back, I feel like nursing is my passion, so I don’t feel like I worked for it,” she says. “It was a super surprise, but I’m proud of this award. It’s inspiring, reassuring me that I’m doing what I’m doing well.”
Dr. Obreja has found stepping outside her comfort zone in certain situations means accepting a challenge. That was her experience when she left Romania.
“Everybody recognizes that the first year of being an immigrant is the toughest,” she says. “It’s a cultural shock. It’s not having your friends and family for support. And I very much remember that what I missed the most was rain. Somebody told me, ‘Oh, this is homesickness.’ But we were determined to make it.”
She shared some stories of discomfort with students at UCLA School of Nursing, where she was a lecturer.
“It helps me to connect with the students,” she says. “They are scared about the program and all the deadlines and the requirements. So, I keep telling them that being uncomfortable is normal, like gaining a new skill, which with hard work will grow. I want to give them the confidence from the beginning that they made a great choice, whatever their interest will bring them in the future.”