Nightingale expansion: consultant says shortage of staff could be major hurdle
AN intensive care consultant has warned expanding the Nightingale Hospital for more critically ill Covid-19 patients may prove a challenge due to a shortage of nurses.
Dr Raymond Mckee from the Faculty of Intensive Care Medicine said staff shortages — in particular adequately trained nurses — is the biggest hurdle in ensuring sufficient critical care capacity.
Dr Mckee said extensive planning has been carried out in preparation for the current surge, but he continued: “Expanding the Nightingale is going to be a stretch. When you think back to March or April time, the worry was actually about equipment ventilators, you can’t do it without that.
“The second thing people need is physical space — if you’re expanding your critical care capacity, you have to expand that into areas which normally don’t have critical care, so you expand into theatre recovery area or areas near critical care that are maybe available and not being used for anything else, some places have been using theatres. But the fact is we need nursing staff.
“I’ve never seen anything like this before, none of us have. We haven’t had any down time or returned to our baseline since the start of the pandemic and everyone is exhausted.”
Pat Cullen, director of the Royal College of Nursing (RCN) in Northern Ireland, said Dr Mckay’s comments echo the message she is hearing from nurses working on the frontline in critical care units across Northern Ireland.
“We have been keeping in close contact with members working in ICU environments and they are extremely concerned at the ability to open more beds in the Nightingale,” she said.
“It is a very difficult situation and we know that specialist ICU nurses are already under strain. They are concerned that if more beds are required there will not be the specialist nursing staff available to do this. It is worth remembering that it’s very hard for nurses — who may be very specialised in other areas — to go into an ICU department. It is a very different skillset and unless you are used to working in this environment it can be very daunting. The system is under enormous pressure, and nurses are under enormous pressure across every area of practice.
“We must do everything we can to ensure that the numbers of patients requiring intensive care treatment are kept as low as possible so that we can provide the level of safe and effective care that every patient in Northern Ireland deserves. Nursing staff are already doing everything they can, but it is not sustainable.”
Dr Mckee said capacity is currently sufficient to ensure rationing of ICU beds is not happening and staff will continue to ensure anyone who requires critical care and would benefit from treatment will receive the necessary care.
However, he asked the public to refrain from activities that may result in them sustaining an injury that would necessitate hospital treatment. He also said comments from Covid deniers are distressing for frontline staff dealing daily with the reality of the pandemic.
A spokeswoman from the Department of Health said increasing critical care beds by 15 requires 100 additional nurses. She said initiatives are under way to increase trained staff but urged the public to adhere to public health guidance.