As Ireland’s health service prepares to deal with the full force of the Coronavirus pandemic, nurse Jo Tully shares her fears and key demands for the period ahead.
COVID-19 cases are increasing in Ireland, and whilst are measures in place to slow transmission of the virus, what measures have been put in place to prepare hospitals to prepare for the coming outbreak?
It is hard to say anything about how this is going to pan out because no one knows. It is really difficult. Obviously looking at Italy there is fear, but the surge of COVID-19 patients hasn’t really started yet in Ireland. I think there is one person in our hospital in isolation on a ventilator.
As you probably know, our bed capacity, but particularly our ICU capacity is way below the European average. In fact, it is less than half the European average. It is this capacity crisis that could potentially create absolute disaster.
We are all in a bit of a waiting game. The hospitals have cancelled all non-emergency appointments and surgeries. It will probably be next week before we see numbers of patients coming into hospital with Covid-19. We have learned the practice of donning and doffing, as it is called, personal protective equipment in order to ensure that you do not contaminate yourself. We are learning how to do it and do it correctly. But, by and large, there is not that much being done in terms of the training of staff.
We have been informed that when the virus hits, our 18 bed ICU will become a Covid-19 isolation unit, where any ventilated patients will be placed. And while we can postpone elective surgeries, reducing the number of patients will need ICU beds, we cannot prepare for a non-COVID-19 patient requiring the ICU, because of a heart attack or something of that nature. There will be ICU facilities needed, so other places in the hospital will have to become makeshift ICU wards, even if they don’t have all the facilities of a proper ICU.
Overall there are 50 beds with ventilators. The problem is that some of these beds are outside the ICU area, which carries its own risks, increasing morbidity and mortality. They won’t be in the unit that is dedicated for COVID-19, and most likely those patients will not be cared for by nurses who are specialists in ventilation. That will be a problem. But if it is only that problem, it is probably attainable. The real problem is if it goes beyond that and that will be a profound crisis. There just won’t be enough beds.
Has the Irish Nurses and Midwives Organisation, your union, played an active role in the face of this crisis?
No, not really. A big issue is the shortage of personal protective equipment (PPE) to keep health care workers safe. While there are some, we don’t know how long they will last for – and that depends on how big the crisis will be here.
But generally, the unions have been pretty non-active. They should be arguing that anyone who is getting laid off because of this crisis should be getting fully paid. For the public sector, where I work, that is going to happen, but in the private sector it is going to be a major issue. In the public sector, all of the sick time that people have to take for either self-isolation or if they test positive, will not be deducted from their sick leave. That has been dealt with. But there is much more besides that.
With schools, colleges and nurseries closed, what options are there for nurses with children?
It’s in the lap of the gods, really. There are no facilities open and no plans put in place around that. It is for people themselves to make those arrangements and for the most part it is a disaster zone. At least one parent will have to be home from work. For single parents in the health service, that creates a huge problem which is yet to be addressed.
As nurses and other frontline health workers ready themselves for caring for the sick, what should be the demands immediately on the state to make your job easier, and hopefully prevent more deaths?
Testing for staff in hospitals needs to be fairly regular. It is essential and that isn’t happening yet. That should be a key demand.
In Ireland they are talking about using private hospitals to expand resources. However, what they have done in Spain, is a very different thing. They have essentially nationalised the private medical system. That is something that we should be doing obviously. And that might mean that this crisis could produce more good than bad if we could get rid of the private health system. The very idea that they can do it is not being covered in the press, but certainly if Spain can do it, so can Ireland. The fact that they have done it, means it can absolutely be a reasonable demand here.
You know workers are just so amazing. And certainly, in the health service. There is no question that anyone has done a debunking or has even thought about going AWOL in this crisis. People have just bitten the bullet. There is fear about, but we are just holding our breath and hoping for the best. People are incredibly loyal and ethical around what they feel their duties are. Which is really quite incredible given the level of fear that the coronavirus is bringing. People are doing their best and the big issue is how are workers in the health service going to be protected while doing their best in a crisis that is bringing enormous fear. That is the government’s job – we’re doing ours.