Staff crisis as hospitals are stretched to the limit
Intensive care nurse speaks out as traumatised colleagues are taken sick or quit altogether
EXHAUSTED nurses are quitting as they are “stretched to capacity and beyond”, a veteran intensive care nurse has said.
Some have been forced to take sick leave due to stress while others have left to work for private organisations, said Amanda Smith, an ICU nurse of 12 years experience.
Under-pressure trusts have already issued calls for staff not on duty to come in and help.
Amanda said the surge could mean up to 149 Covid patients in ICU — 28 more beds than now available — meaning tough decisions over who gets treated.
“It does fill you with dread,” she said.
AN ICU nurse has described in harrowing detail the devastating pressures being experienced by staff caring for some of the sickest people here.
Amanda Smith, who has worked as an ICU nurse for 12 years, warned there are not going to be enough intensive care beds to cope with the number of critically ill patients in Northern Ireland in a matter of weeks.
She has warned the situation is going to become so severe that intensive care will be rationed to those most likely to recover — with some patients taken off ventilators to make way for patients with a better chance of survival.
She described the tough conditions ICU nurses face.
“The PPE isn’t as warm at the moment because of the time of year but you do get very dehydrated and the masks are very uncomfortable,” she said.
“It’s important after two or three hours that you get a break, it can get to the stage where you get so hot that the mask starts sliding off your face.
“There are nurses who have gone off sick because of the stress and there are ICU nurses who have left to go and work for private organisations, we’ve lost nurses from ICU and recovery.
“There are others who have left nursing completely, there are nurses who didn’t have to retire but they decided it was time to go.”
Describing the challenges of nursing Covid-19 patients at the end of their lives, Amanda said one of the most difficult experi
ences comes when families say their goodbyes to their loved ones over the internet.
“The doctor organises a Zoom call when the patient isn’t going to make it and it’s absolutely heartbreaking to hear what the families have to say, it’s very, very difficult to listen to,” she said.
“Often when the treatment is withdrawn, the patient is so sick and they have fought the illness for so long and they can’t fight any more that they die very quickly, their bodies have given up. It must be horrendous for those families because they might not have seen their loved one for 50 plus days and they can’t even see the body, it must leave a huge gap that is very difficult for them to get their heads around.”
She also revealed that modelling data has suggested there could be 149 Covid patients in
ICU in the coming weeks — 28 more beds than are currently available. This does not include other patients who require intensive one-to-one care, such as cardiac, stroke and trauma patients.
While health bosses are working to upscale intensive care capacity, Amanda said it is likely that one intensive care nurse may be responsible for four — or even eight — patients at any one time due to the expected surge in critically ill Covid patients.
And she said the already overstretched ICU nursing workforce is being depleted further as exhausted staff give up their jobs as they are so traumatised by the demands of the job.
“We are definitely going to be stretched to capacity and beyond,” she said. “There will be situations where doctors are having to look at someone’s past medical history and the benefit of treatment and then basically work out who’s going to benefit from treatment because they won’t have enough beds.
“At this moment, we have people who have been in ICU for 50 days plus, so in the situation where we have too many patients, we will have to limit the number of days patients can stay in ICU. It will be about getting the maximum results for the most number of people.
“We were very lucky in the first wave because the numbers came down quickly but this time we’ve been told there could be up to 149 ICU patients with Covid. It does fill you with dread.
“They’re in the process of expanding bed numbers and a lot of staff are being redeployed to work in the ICUS, but I suppose there is a finite number of staff. The number of patients we’re going to be dealing with is very high, it’s an enormous stretch for the health service.
“Ideally we would work with one ICU nurse for every patient but at the moment, we’re working with one ICU nurse and support staff looking after two patients. As patient numbers start to go up, we will have one ICU nurse looking after three or even four patients.
“We h a ve support staff brought in from other areas who have received some training and there are a lot of things they can do, like observations and fluid balance, but there are specialist things they can’t do, like dialysis.
“If it gets to the point where you have one ICU nurse looking after four patients, those patients will be together in a bay, but then what happens with breaks? You could have one ICU nurse caring for eight patients for a period of time.”
‘Staff who didn’t have to retire have decided to leave’