University Hospital Kerry is braced for a nightmare scenario as medical staff levels plummet at a time when higher numbers of Covid cases than ever are swamping UHK.
NMO heads say staffing levels in Ireland’s health service are now in ‘free-fall’, the result of inevitable close contact by frontline workers racing to treat escalating numbers of Covid-positive patients.
Projections in Kerry make for grim reading, where the county rate of incidence for the 14 days up until Friday last, a period in which 1,366 cases were confirmed, was riding at 924.8 per 100,000; representing in just two weeks nearly half of all the 2,774 infected in Kerry, at that point, since the pandemic arrived here.
1,064 were hospitalised nationally with Covid in the fortnight up until Thursday, with 61 admissions to ICU in the same period – bringing to 119 the numbers in ICU by Friday.
And the numbers in ICU that have trebled in UHK since Friday when two were in critical care. As of Tuesday this week there were six patients receiving critical care at the hospital, with 23 Covid patients in all.
The projections for the coming days and weeks are stark, leading to a heightened sense of dread among the frontline staff of UHK, where the ‘free-fall’ as reported by the INMO is being felt as keenly as in the majority of the State’s other hospitals.
And it’s unlike the initial wave of the virus earlier last year when the A & E department was faced with little other than the worst Covid cases as fear gripped the population. This time around, in the depths of an icy winter, doctors and nurses are not alone dealing with escalating Covid cases but with the ordinary stuff of daily emergency too. Thursday and Friday witnessed numerous limb injuries as a result of the ice presenting to UHK in tandem with rising Covid cases.
“It’s not even the rising Covid that is the major thing for us at the moment in the hospital, but the lack of staff,” one nurse, speaking on condition of anonymity, told The Kerryman this week.
Working on a busy frontline ward, they said the rate of attrition among nurses was significant ever before the Christmas wave of Covid hit. ‘Burnout’ among those left to man the frontlines is consequently severe.
“We are all feeling burnt out now. You’d feel written-off by the time you get home, fit only to collapse,” a nurse said.
Tight as infection control at UHK is, there are inevitable close contacts in the frenzied environment of emergency healthcare – particularly as up until last Monday week nursing staff were not required to undergo the cumbersome task of donning full PPE dealing with non Covid-suspect cases.
Asymptomatic Covid-positive patients presenting with non Covid complaints invariably resulted in numerous medical workers being forced home as close contacts (treatment can only take place at close quarters). One estimate a fortnight ago suggested as many as 45 staff were out as close contacts at a given time. All but one of the nurses on Covid-related leave from one ward were as a result of in-hospital close contact, it’s understood.
“Our biggest thing losing staff is that, before, there was always a bank of agency nurses but they’re gone because they all got hired elsewhere. There has also been a mass exodus of senior nurses leaving the hospital in the last few months. I heard the figure of 17 left in one month. That’s due to retirement to some degree, but a lot of people are after leaving sick of the pressures they are being put under. Many left to work in the community sector because it’s a better environment. And that wasn’t to do with Covid, but with the pressures in the hospital,” a nurse told The Kerryman.
“Staffing is the big thing, but where management are going to get them at this stage we have no idea. We know management is in a predicament as well. They are constantly looking for nurses and can’t get them but they just keep pulling from various areas to redeploy elsewhere. And it feels like we’re not providing the service we should be anymore.”
Some sense of relief attended the roll-out of vaccinations at the hospital last week, but it’s one thing for the healer to have protection. “There’s a small sense of relief with the vaccinations, but the way the country is going is frightening. Give it two weeks and the daily figures nationally could be up on 12,000 to 15,000.”
With the virus threatening to swamp the hospital, the mood is extremely grim among staff:
“We would like to think we are braced for a bad month, but we don’t know how it will function if we keep losing staff.”
The rampant transmission of a virus so insidious for jumping from one host to the next without symptoms to such a great degree is already seeing many non Covid-related presentations ultimately testing positive.
It was a phenomenon first witnessed in worrying numbers by UHK staff around Christmas week, as more and more non-Covid cases came back positive prior to moving upstairs for surgeries and other treatment (each patient coming in on the ‘clean’ channel at A&E has to be swabbed for Covid before they are moved onto wards).
The positive cases are immediately moved to the Covid ward. However, where it has happened that they were given a bed in a non-Covid ward that room had to be closed until all other patients within the room, consequently deemed close contacts, were discharged – a scenario that has not happened often but which has led to greater bed pressures when it did. As the virus surged two weeks ago the hospital found itself struggling to keep up with – on one day – an eight-hour wait for some ambulances before patients could be admitted. Staff say the delay was due in part to the processing of Covid tests in the scramble to identify how many admissions were positive, and the PPE requirements slowing down the rate of turnaround in A&E.
Nurses speak to one positive difference between the current surge and the initial wave in March – the Covid-related illnesses seem milder now than then and fewer patients with Covid, proportionately, require intubation in critical care. They appeal to the public to follow the guidelines now to alleviate the pressure on UHK.