WITH 1,949 people in hospital with Covid-19 and more than 200 in our ICUs, hospitals and their staff are again under immense pressure. 

Bernie Waterhouse, Clinical Nurse Manager at St James’ Hospital in Dublin, said 2020 was the “most challenging year of my career” and she and her colleagues are now battling another surge that is growing every day. 

She has been working on a Covid ward for the last ten months, having been redeployed from the surgical area of the hospital.

Waterhouse was the first healthcare worker to be vaccinated and has now received both doses of the Pfizer vaccine.

Speaking at today’s HSE briefing, she said one of the most upsetting aspects of the first surge last year was that the hospital could not allow visitors in to spend time with dying relatives. 

At that stage, she said, it was not clear how much protection PPE would provide and there were concerns that family members could catch Covid-19 if they spent time in the hospital. 

“It was a really difficult and stressful situation. A lot of patients as a result, died on their own,” she said.

In the first phase particularly, nurses were the last people to see the patients before they died. Unfortunately they couldn’t always be with them because of the lack of PPE and the question of whether it was protecting staff, we had to reduce staff exposure to 15 minutes. It was really difficult and a lot of the time patients did die on their own.

“We did a lot of Whatsapp calls and Zoom calls with relatives before they died, but also unfortunately we had to do it after. A lot of patients’ families would ask us to send photographs after they had died because they wouldn’t see them.

We would get families to bring in clothes so that we could dress them in their clothes before we sent them off to the mortuary. All of these patients unfortunately had to go into a body bag which isn’t really very nice at all.

In this phase families can visit for short periods of time to be with their relatives when they are dying. She said the hospital has also improved its communication with families, contacting them daily to provide updates and arranging video calls with patients.

“We’ve also secured a Spotify account for dying patients who can play their music when their families aren’t there,” she said. 

‘Hugely stressful’

On Christmas week, the hospital had just six Covid patients. Now there are 102 patients with Covid-19 in the hospital, with 22 of them in ICU.

“We’ve had days that have been hugely stressful for our staff, where we’ve had maybe a couple of deaths and also a couple of patients that have gone to ICU on the same day,” Waterhouse said.

“So that’s really difficult to manage and unfortunately sometimes care has been omitted because you just physically can’t provide the care that’s needed for these patients, a lot of these patients required one-to-one nursing care, which we can’t provide.”

While the hospital is dealing with increased pressure on its resources, it is also faced with staff shortages as healthcare workers contract the virus. Waterhouse said some staff have been out for the majority of the pandemic due to longterm effects of Covid-19. 

She said even staff in their 20s and 30s are still suffering from the effects months later and are unable to return to work.

Waterhouse said the is anxiety among staff working in Covid areas as they have been isolated from their home life, with limited social contacts for the entire pandemic.

“Particularly on a Covid ward they’re always concerned about whether they’ll transmit the virus if they’re asymptomatic carriers to vulnerable relatives.,” she said.

We’ve had some nurses living with their parents but unable to meet in the house because their parents might be concerned about them transmitting the virus. They feel very isolated as a result of that and this has gone on for a number of months because they’re working in a Covid area.

Waterhouse said the last year has been a huge learning curve and nursing teams have “adapted greatly to a hugely changing environment.”

“They’re very committed to their work and we’re very proud of them. We’ve learned a huge amount from this pandemic, it’s the most I’ve ever learned in my whole career in the last year.”