What changes have we made in our ICU ward to help nurses working with Coronavirus patients?

"It is still uncertain exactly how Covid-19 can be spread."

Now several weeks into the Covid-19 pandemic, ICU Deputy Charge Nurse, Suzanne Armstrong, details how ICU Nurses are coping, and what effect the changes to procedure are having.

Topics covered in this article

Introduction

Personal protective equipment (P.P.E)

Changing the way we communicate

Isolation, segregation or containment of infection

Looking after each other and supporting each other

Introduction

The simple answer is everything we can.

There has been a large number of changes to the way we run and operate within our ICU’s due to the outbreak of Covid-19.

Many of the changes are preventive measures intended to minimise the spread of infection and risk to our ICU staff.

Now more than ever, we need our experienced staff fighting fit.

Personal protective equipment (P.P.E)

The obvious step is of course PPE, personal protective equipment, which has been increased and must be strictly adhered to at all times.

This includes plastic overalls / gowns, face mask and visor, shoe covers and gloves.

This is the first and arguably most crucial step in protecting our nursing staff.

ICU care is very hands-on and happens at close quarters.

It can be intrusive and messy, contact with bodily fluids is common and should be expected.

As a result, it is incredibly important to be wearing adequate PPE at all times.

Some countries have gone even further than we currently have and are outfitting their nursing staff in sealed full body suits.

It is still uncertain exactly how Covid-19 can be spread.

This makes it quite challenging to take specific action to protect against infection.

A “cover all” approach must be taken and precautionary measures put in place in the hope they are effective.

The rule of thumb at the moment is take no chances.

Changing the way we communicate

Many changes to how our ICU’s are run have been made to help protect our staff.

Many of these are simple and obvious but very effective in limiting the risk of and spread of infection.

For instance, communication methods between treatment teams and colleagues have changed significantly over the last months.

Thankfully these changes and restrictions are easily handled with the help of modern communication technology.

Phone systems, walkie talkies and even social media have been utilised to help keep everyone up to date and on the same page.

Face to face meetings and interactions have been minimised or discouraged between staff unless absolutely necessary.

Clear and concise communication is a fundamental element to effective team work and crisis management, we are doing our best to keep the flow of information to our staff open and reliable while reducing risk.

Modern communication technology also plays a vital role for the relatives and loved ones of our patients during this crisis.

Visiting a relative in an ICU can be a very emotional and overwhelming experience, sadly for some people it is the last chance to say goodbye to a loved one.

With the new isolation and infection control measures in place it is not possible for relatives to have the same face to face or physical contact they would have under normal circumstances.

This must be very difficult for people to understand and deal with during an incredibly emotional time.

Modern communication technology helps bridge the gap between our temporary measures and the needs of our patients and their relatives.

It can allow relatives to spend time with their loved one without the risk of traveling or coming onto the ICU unit itself.

Isolation, segregation or containment of infection

Isolation, segregation or containment of infection is another vital step in safeguarding our vital NHS staff during this outbreak.

Intensive care units tend to be split into several smaller units.

Isolating units which are treating Covid-19 patients; restricting movement between units and properly managing staff rotation are all critical measures in reducing the spread and impact of the virus outbreak between ICU units, workers and patients.

The huge increase in patient numbers has forced intensive care units to expand out into other areas and take control of staff and equipment not normally under ICU control.

This is a necessity but brings with it new challenges in regards to containment of infection.

It is important to remember that there are still many non-Covid-19 patients that need ICU treatment and care.

Every patient has an equal right to proper treatment no matter the circumstance.

Many of us, myself included, are making sacrifices or changes to our routines and daily lives to try and help combat the Covid-19 crisis.

These could be small and seemingly insignificant changes that may add up to a big difference in the spread of infection.

Little things like taking an alternative or less populated route to and from work, limiting the amount of time spent in public places such as supermarkets or parks, and strict social distancing measures.

It’s important to do what you can right now.

Looking after each other and supporting each other

Looking after each other and supporting each other through these hard times is paramount.

Checking on your colleagues, just asking how they are, can be the lift someone needs.

Colleagues that live alone are particularly vulnerable to increasing feelings of isolation and emotional fatigue, help them any way you can.

We will all have low and sad days, It doesn’t mean we are bad nurses, it means we are human.

What we are feeling is the reality of the situation and the very sad events we are dealing with everyday.

If we felt nothing at all, we would not be a capable nurse.

I have been very kindly offered to stay with a colleague during my shift patterns.

This allows me to dramatically reduce the amount of travelling needed during work days, lowering the risks of infection for myself and others, and helps safeguard my family and anyone I may normally come into contact with during my commute to and from work.

I am hugely grateful for this very kind and considerate accommodation.

Although this change has impacted my routine and family life significantly, putting additional strain on my home life and responsibilities as a parent, it is a worthy sacrifice under the circumstances.

So much generosity, concern and support is flowing between everyone in our ICU’s during these difficult and dark times.

It is truly aweing and inspirational to see our family of staff coming together in complete unison.

You could say that this is the real first line of protection our nurses have, the protection and support of our colleagues.