HSE chiefs defend use of non-critical care staff in hospital ICUs
THE HSE has defended the use of non-critical care nurses in intensive care units (ICUs), saying it is “better than the alternative”.
Ireland’s ICUs are coming under huge pressure due to the surge in admissions of patients with Covid-19.
Last night there were 169 people in ICU as well as around 210 patients in ordinary wards who require non-invasive advanced respiratory support.
The Irish Independent yesterday reported on the concerns of senior ICU medics that non-specialist staff were being deployed to help the most critically ill patients.
Dr Enda O’Connor, director of ICU in St James’s Hospital, said he was happy to have the staff – who have been given training in the core aspects of ICU care – but they were “working outside their comfort zones”.
At the Mater Hospital in Dublin, nurses who trained in critical care up to a decade ago – and later went into other specialties – are being “pulled back in” to deal with the crisis.
Serena O’Brien, clinical nurse manager in critical care at the hospital, said the situation was “scary”.
She spoke of how critical care nursing is a highly skilled profession and said: “You are asking a nurse to come in and look after a ventilator. They have never seen one. They haven’t a clue... How would they? They have a different skillset out on the ward.”
At a HSE press conference, the organisation’s chief clinical officer, Dr Colm Henry, was asked whether he was concerned about the situation. He said the core ICU capacity was 286 beds and there were up to 350 available to cater for a surge in admissions.
He said the HSE believed the same quality of care could be provided if the full 350 capacity was used, but that was reliant on redeploying staff from other services.
Dr Henry added: “Clearly we would be in a better position... if we never had to expand intensive care capacity to go into surge with Covid-19.”
But he said the development of that capacity with redeployed staff “enables us to provide care”.
“As things stand, we’re now beginning to go into that surge,” Dr Henry said, adding that permanent ICU staff were supervising the care in ICUs.
“It’s better than the alternative,” he said.
HSE chief executive Paul Reid said he had spoken to ICU consultants and nursing managers and “they are taking all precautions”. He said 1,600 people trained for the ICU surge and some of those staff were being used.
Mr Reid said there was a “kind of buddy system” where they were teamed up with experienced ICU nurses and that he had “got very strong feedback about how people have mobilised together to support demands in some hospitals”. Earlier, Mr Reid outlined the difficulties facing the health service given the increase in virus cases. He called the situation “volatile” and “one of the greatest challenges that we’ve experienced”. He praised health staff as a “team of champions” but also said “it’s quite grim at the moment” and “it’s going to continue to get worse”. Mr Reid said hospital staff had never seen a situation where 169 people are being treated in ICU for the same illness.
He said it was “unprecedented” and “in all senses a race to save lives in all our hospitals today... Unfortunately on many occasions our teams may not succeed”.
Mr Reid urged the wider community to “stick with” public health actions in the days and weeks ahead, saying: “It does make a big difference.”
He insisted that despite the serious situation “we are keeping the hospital system and health care system in general within the required levels of control.”