Posted 28 August 2020 - 13:14
Posted 28 August 2020 - 13:14
My job
Keeping redeployed staff connected and ready for further waves of COVID-19
How a trust’s scheme is ensuring nurses back in their usual roles are ready to work in ICU again
How a trust’s scheme is ensuring nurses back in their usual roles are prepared to work in ICU again
In March, we took a break from our roles with the General Medical Council (GMC) to take up volunteer staff nurse posts in the intensive care unit (ICU) at Ashford and St Peter’s Hospitals NHS Foundation Trust in Surrey.
Staff from across the trust had to be rapidly redeployed to ICU to help care for patients with COVID-19, and there was little time to prepare for the large influx of staff arriving every day from a variety of specialties, including recovery, ophthalmology, pain management, theatres, day surgery, and specialist nurses from the breast care and cardiac teams.
View our COVID-19 resource centreOther ICU-experienced nurses stepped forward to help and support workers, such as theatre technicians and healthcare assistants, also joined the redeployment.
Accommodating extra staff in ICU during the pandemic
Guidance from NHS England recommended that this expansion of the critical care nursing workforce should be undertaken in a phased response but, due to demand, this was impossible in the early stages of the pandemic.
Colleagues arrived on different mornings, anxious about where to go and with whom to report. This was further complicated when we had to move the handover room to a larger one to accommodate all the extra staff.
When the redeployed staff arrived, often looking scared, many faced a rapid induction to the unit.
Some of the early deployed and volunteer staff were proactive, assuming roles in support, guidance and well-being for subsequent staff, which helped take some of the pressure off the senior critical care staff.
Developing an induction course to prepare redeployed workers
A day’s induction course was quickly developed by ICU and education staff at the trust. This included the essentials of care for ICU practice, such as mouth and eye care, changing endotracheal tube tapes, maintaining hygiene needs and proning patients.
Those in redeployed roles were also responsible for restocking and cleaning bed spaces, and a checklist was soon put together to help with these tasks.
The induction was repeated every other day over a three-week period to capture as many staff as possible, with 140 staff members attending the course.
Donning and doffing personal protective equipment (PPE) was covered, and each new member of staff had to be fit-tested for their FFP3 masks. This all took time and was complicated to organise.
No one could take away the anxiety for these new members of the team, but often once they put on their PPE and entered the unit, they said they felt better. They were welcomed by other staff, some of whom were only a couple of days ahead of them with the ‘fear factor’.
At the end of their first shift, many said they felt this was the safest place to be in the hospital.
ICU staff had to learn how to delegate tasks to volunteers
An added impact of so many redeployed staff was the pressure on the already stretched critical care nurses. Not only did they need to take responsibility for very sick patients with COVID-19, but also they would often be allocated a redeployed nurse for the shift.
ICU nurses are often known as perfectionists, and the experienced, permanent critical care staff had to learn how to delegate some of the nursing care of their patients to redeployed staff and feel comfortable with this.
As we learned to work together as a new and different team, it was fascinating to hear what everyone normally did before COVID-19. We made time to share experiences and get to know each other, despite having to have conversations in full PPE.
Working in ICU has been beneficial for many new staff members
The COVID-19 pandemic has been a life-changing experience for everyone working in healthcare, and there have been benefits for some staff.
Critical care nursing is not for everyone, and some redeployed staff may never want to set foot in an ICU again. But some, who would never have contemplated a career in critical care, have been drawn to the environment and chosen not to leave, while others have joined the critical care bank and will continue to work in ICU in the future.
For others, redeployment was an opportunity to reflect on their careers and take stock. It has also provided staff with skills to take back to their own clinical areas, and has broken down some of the barriers that often exist between critical care staff and other clinical areas in the hospital.
Redeployed staff: stepping into an unfamiliar environment
Andrea Lewis, interim chief nurse, Ashford and St Peter’s Hospitals NHS Foundation Trust
‘We are hugely grateful to nurses such as Kim and Elizabeth who came forward and offered their services at such a difficult time.
‘I do not underestimate how nerve-racking it must have felt, stepping into the unfamiliar environment of intensive care at the start of the COVID-19 pandemic.
'It took huge courage and dedication and we are forever grateful to colleagues who volunteered to help’
‘It took huge courage and dedication and we are forever grateful to colleagues who volunteered to help. The flexibility shown has been eye-opening and made us think differently about how we use and develop our workforce.
‘The new intensive critical care programme is a great example of this, encouraging colleagues to develop and retain new skills while creating a workforce that is quickly able to adapt and mobilise in the event of further COVID “waves” or future emergencies.’
New critical care programme will ready staff for potential future waves of COVID-19
We now have a window of opportunity to prepare for any potential next wave of COVID-19, or even another pandemic. This pause will allow us to plan robust training for these redeployed staff who may be needed again in the future.
Ashford and St Peter’s Hospitals NHS Foundation Trust has designed an intensive week-long, level 1 critical care programme to better prepare deployed staff to support the critical care unit in any future pandemic or emergency.
Each member of redeployed staff has been offered a place on the programme, which includes a week of theory consolidated by a week in critical care. There is then a commitment to work two shifts a month on the unit for the next 18 months.
The programme – which we undertook in July – has been designed to consolidate the skills learned, correct any misconceptions and keep redeployed staff connected and interested in returning to critical care if the need arises.
This will have many benefits for the trust and patients, as redeployed staff inevitably take their newly acquired skills back to their clinical area.
We have now returned to our usual roles at the GMC but continue to undertake two shifts each month in ICU, in line with the critical care programme. This will help ensure we retain our critical care skills so that, if we are needed again in the future, we are ready to step up and help.
Kim Tolley is training and development manager at the General Medical Council and an ICU volunteer staff nurse at Ashford and St Peter’s Hospitals NHS Foundation Trust
Elizabeth Tysoe is employer liaison adviser at the General Medical Council and an ICU volunteer staff nurse at Ashford and St Peter’s Hospitals NHS Foundation Trust