Updated: Apr 6
The government has turned into Oprah.
It is a well known fact we do not have enough intensive care beds in the UK to care for the potentially thousands of patients that will require a ventilator. NHS Nightingale plans to help solve this. It will soon open its doors, initially providing 500 beds to patients with coronavirus. Based at the Excel Centre, it has the capacity to house up to 4,000. Wow! No one can say that's not impressive (in scale at least).
I feel however it is important to highlight, this is not a normal hospital. These are not normal intensive care beds. A intensive care bed is not merely a bed and a ventilator. Intensive care is so much more than that. Intensive care beds are for the sickest of the sick. Not only do we provide that much talked about respiratory support (support with breathing), we provide support for multiple organs such as people's heart and kidneys . We find the right balance of sedation and pain relief so people are comfortable. We make sure people are getting not only the right amount of sleep but the right type of sleep. We ensure they are getting enough nutrients and energy. We keep patients moving to prevent complications of staying still too long. We provide psychological support for both the patient and the family. And that's not even all of it. All of this care is provided by a team of people, from nurses to doctors, from pharmacists to dietitians, and from psychologists to physiotherapists, to name but a few.
Intensive care nurses remain at the patient's beside for up to twelve hours at a time, coordinating all this care and advocating what is best for their patient. There is a reason we normally provide one to one nursing care. Intensive care nurses are highly specialised and trained. Not only do you need to complete a three year nursing degree, you need to work in an intensive care unit (ICU) for at least another two years. In that time you need to complete further university course in intensive care nursing and then you are a fully qualified intensive care nurse. A course I am currently completing at the moment (great timing eh?); it allows us to gain much needed knowledge in ventilation, specialist medications, the use of highly complex equipment, and all of what is mentioned above.
What I am trying to say is, we should not be downgrading what an intensive care bed is and the role of the intensive care nurse. Like I said before, it is so much more than a bed and a ventilator. As you can see there is a huge specialised team behind one patient. To put it simply, we can have all the beds and the ventilators in the world but if there is not the staff to provide the specialist care needed, we are going to come across some difficulties.
So we have to adapt. Which is what we are doing. We have to dilute out the specialist staff. We are already seeing this at my hospital, with ward nurses looking after ventilated patients and an intensive care nurse overseeing two, sometimes three of them at a time. If numbers get as high as we think they might, we might be overseeing up to six ventilated patients.
It is a daunting prospect. But these are, dare I say it, "unprecedented" times and this is the real life problem we have been dealt . A lack of specialised staff, resources and equipment is a challenge many healthcare workers face across the world, now but also before in poverty stricken and war-torn places. We as healthcare professionals have no choice but to adapt our plan of care to meet the demand and save as many as possible.
I would be lying if I said I wasn't scared. Scared for my patients, scared for my colleagues, and scared for myself. Nursing across the board is having to change, with many taking on roles they never expected to in their careers. However I know this is temporary. I know this will pass. I know my colleagues and I will support each other, and with the huge support from the public we will get through this. And will be working our hardest to do so.