How has Coronavirus changed our ICU operations?
Firstly, from the initial outbreak to present, our ICU has undergone a whole transformation where its demand has pushed the need for all nursing and medical support.
Our ICU has spread to a whole encompassing area of other wards converted to ICUs for COVID-19 patients and a small unit for “regular ICU” patients.
It has stretched the capacity for work but reduced the capabilities for some nurses to continue working as they too became susceptible to the infection.
The good thing about COVID-19 it has brought out good leadership qualities and strengthened the bonds of the team.
We’ve all had to recognise that our safety and well-being is in the hands of our colleagues.
What changes have we made within our ICU?
COMMUNICATIONS
Our emails and intranet are not enough to reach everyone fast enough and timely.
We need to have formal and informal discussions and updates.
Unfortunately, with the unit split and spread wide we have to use a pyramid structure of message dissemination.
- Communication messages and updates through safe group chats
- Frequency of team huddles and updates of the unit developments by team leaders or POD Leaders
- Passwords for accessing confidential information
- Daily managers meetings and weekly or daily staff updates from our clinical matrons to have everyone on board
SAFETY IN NURSING CARE
- Reinforcement of safe nursing practice guides among all staff both returning to support and currently practicing
- Using notice boards or flip cards or in safety briefings
- Daily testing measures to capture the trending growth or control of this disease within our affected patients
- Safeguarding our patient’s privacy and dignity has become paramount with us. We must ensure patients and relatives maintain some contact
- Safeguarding against the media hype - know and report on current conditions
- Use of patient password is now required
- Increased frequency of training of patient management of a ventilated patient to all ICU staff
SUPPORTING OUR STAFF WELL BEING
- Greater support and communication from our health for work team to look after our own mental wellbeing
- Praises for jobs well done and continuing to support the essential departments
- Emails communications on the spread across all trust sites
- Meals from our staff canteen
What we are doing to protect ourselves from the virus in ICU?
PPE is worn as per protocol and no one is allowed to leave their unit to visit another non-Covid unit to reduce risk of spread.
Hand hygiene, Clinell and cleaning your surroundings is essential in minimising the spread.
Slots of work are done in clusters to minimise exposure risk and to give yourself and patient breaks between treatment activities.
Patients require less breaks between ventilatory care, but we must try and do all the essential VAP (ventilatory assisted patient care) within expected times and get a lot accomplished in a shorter period.
Time and work duties are done strategically.
Aerosol treatments are done as per guidelines released for ventilated patients.
Team nursing for high risk procedures are done during safe time to have maximum medical and nursing support.
Enjoying our time away from work.
Getting plenty rest and rehydrating yourselves during and off shift.
Exercise is essential as we need to keep our physical and mental health on top of this pandemic.
Get your hobby kit out and rejuvenate your mind and body.
How are we coping emotionally while working as ICU nurses against Coronavirus?
Most of my family are based in the US luckily - on the east coast and in the Caribbean.
I miss their support, but I do have great friends here in England who call and give me support.
Our ICU team of nurses are plodding through this.
We always try to support and encourage others. Family time has become important and most are enjoying the day off with loved ones.
Making jokes and having a good laugh helps take the stress down.
People must continue to practice safe nursing care at all times.
You can only do what is within your scope of your own competencies.
We have felt the loss of patients young and old and they went without any family present.
We have come on shift to hear the one we thought was going to make it has passed on.
Deputy Nurses are resilient and we pray a lot.
Rest, teamwork and looking after your health.
Some of our team have started bringing a special dish on shift to keep food ready and available for everyone.
It’s helped during our breaks and built great team spirit.
Not everyone can do a dish but, some doctors, they would order pizza for the staff and we would support and enjoy.
Having adequate breaks between patient care is essential.
It helps fight against staff burnout and reduces the risk for errors.
Please remember nursing is universal throughout and you can only do what your competencies have developed you to do within your scope of practice.
"Making jokes and having a good laugh helps take the stress down."
About this contributor
Intensive Care Nurse
Hi All, I am Vera, an Intensive Care Nurse based in South England. I have been working at my NHS Trust surgical ICU for the last 6 months following my move out of private sector management nursing for the last 9 years. I have been ICU trained for the past 15 years with my experience based in cardiac management.
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