Caring for patients with COVID-19 was a challenge unlike any other of recent times. To look after more critically ill patients, our hospitals were reconfigured in a matter of weeks and staff asked to embrace new ways of working.
Stepping up to care for COVID-19 patients
Transformative and innovative change was acutely evident on Elizabeth ward at Royal Brompton where nurses learned vital new skills so they could look after patients with COVID-19 who needed advanced intensive care.
Previously a high dependency unit providing specialist care for adults with different medical and surgical conditions, the ward became an intensive care unit looking after 26 COVID-19 ventilated patients.
The nursing team, led by senior sister Denise Breen, ensured the right equipment was in place and undertook intense training sessions to ensure everyone had the necessary skills and knowledge to look after patients requiring such complex care. Denise said: “It was a huge challenge to ensure that patients on ventilators had the advanced level of care they needed, but the team took learning new skills in their stride. Everyone stepped up and moved seamlessly to provide this new level of critical care. I am in awe of all of them, and very proud to be part of this team.”
Moving from caring for child to adult patients
Royal Brompton’s paediatric intensive care unit (PICU) transitioned from a paediatric to an adult intensive care unit (AICU), with most child patients transferred to other hospitals.
To prepare for the transition, PICU became an “education machine” says senior nurse and service manager in paediatrics, Lizzie Biggart, with the entire team quickly learning many new skills, including how to operate equipment and administer medication to adult patients in a completely different environment.
Lizzie said: “Everything was different for our PICU team. Few of the paediatric nurses had ever looked after adults and they had to contend with entirely new parameters of care – which they did absolutely brilliantly.
“Our nurses are proud they are PICU nurses. They are taught to question, enquire and learn in order to provide excellent, exquisite care for patients who sometimes weigh less than one kilo. To be asked to look after very sick adult COVID-19 patients in a completely different environment was a massive ask, but one which they accepted with their usual professionalism, courage and commitment.”
Transforming Harefield’s cardiac care unit
The Adult Cardiac Care Unit (ACCU) at Harefield Hospital, which includes two wards and is normally home to patients with heart failure or those recovering from heart procedures, was transformed into a facility to care for patients with COVID-19.
Peter Doyle, divisional lead nurse and associate general manager at Harefield, said: “To turn this around in just a few weeks was phenomenal. Everyone came together so well – the estates team built new partitions and installed sinks to keep the areas safe, the IT team implemented new systems for the clinical teams and many other staff across the hospital stepped up to deliver what was needed.”
Matron Mandy Brown, who leads the nursing team on ACCU, added: “Our nurses had to learn lots of new skills, use different systems and work with different clinicians. Each and every one of them went far above and beyond their usual roles and we are immensely proud of them.”
Healthcare assistants
Healthcare assistants (HCAs) across the Trust upskilled to help colleagues put on and take off personal protective equipment (PPE) – so-called donning and doffing.
Putting on and taking off PPE correctly is a critical process that requires training and involves significant care. Properly fitted PPE protects staff from catching COVID-19. Careful removal and disposal of PPE that has been exposed to COVID-19 is particularly important to prevent transmission of the disease.
In areas where the highest level of PPE was required, hundreds of staff had to don and doff gowns, masks, gloves and face shields every day – sometimes more than once.
The HCAs worked long hours to make sure that colleagues would always have someone available to help them get carefully in and out of their PPE.
Aude Taittinger, practice educator for HCAs, said: “The HCAs worked tirelessly on the donning and doffing stations, playing a crucial role in the COVID-19 operation at the Trust. They all exhibited such fantastic team spirit and kept smiling all the way through. Their positivity, resilience and adaptability has been a real asset for us in these challenging times and we are all so proud to be supported by them.”
Read some stories from the frontline:
- From the frontline: Beccy Lytton, paediatric intensive care matron, redeployed to adult intensive care >
- From the frontline: Laura Davis, clinical nurse specialist, redeployed to intensive care
- From the frontline: Louise Croft, Macmillan lung nurse specialist, redeployed to help look after COVID-19 patients
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