How Royal Preston Hospital life has adapted to Covid care

Three months ago at the height of the coronavirus 2019 pandemic in the UK, I wrote a piece on how it was affecting staff in Royal Preston Hospital’s Intensive Care Unit.

At that time, not much was known about the virus and our the dedication, commitment, innovation and expertise, including working as an efficient team to ensure our patients survive in the midst of very minimal scientific data on the virus, was explored.

Today, though not yet out of the woods with reports of recent spikes in coronavirus, we are in a much better position in terms of medical and scientific data and are better suited to attend to our patients than four months ago.

Various trials and studies have been published since and suggested good outcomes among coronavirus patients with some medications, and these currently guide our treatment of Covid-19 patients better.

These data were obtained mostly from those who have suffered from the illness, for which significant number ultimately did not survive and we remain grateful to them and their family for agreeing to participate in these very essential trials and studies.

This will serve to both reassure people and to encourage them to continue to follow government recommendations, including social distancing and use of face mask as required.

The new phase of re-opening the economy with an attempt to return to normality has introduced some expected issues in patient management in hospitals and led to introduction of measures to keep all people safe and prevent cross infection as more elective and outpatient visits are gradually resumed.

Hospitals will not be the same for a while as measures to ensure safe health care delivery is ramped up and exposure of people to the virus prevented. In our own hospital, routine visits of family members to their loved as previously is still not allowed except under well established circumstances. Outpatient clinics are done with an emphasis on social distancing and use of face masks in addition to encouragement of regular hand washing of patients and staff.

Preparations for elective surgeries now include some safeguards, including self-isolation by patients for a while before surgeries can go ahead. To help protect staff and patients from the illness and prevent cross infection, the rule on face masks by all staff is being rigorously enforced. All these are deviations from what we were used to prior to the pandemic and which we presume will continue for a while till we are able to have an effective vaccine for the virus.

Another key factor brought in to make hospitals safe and prevent infection from Covid-19 patients to non- Covid-19 patients, is the effort to clearly delineate and demarcate specific areas within and in between hospital wards in an effort to keep potential positive patients apart.

The unintended consequences of the above is the administrative challenges it creates for all involved which comes with efforts to create a safer hospital environment for both staff and patients. In our intensive care unit, we make use of our hospital’s colour code system categorising patients into groups in relation to their Covid infection and likelihood of being infected.

We then designate appropriate areas and beds to take care of all these different groups as we efficiently treat them. These new processes usually present logistical and administrative nightmares for all members of the health care team; consultants, junior doctors, nurses, health care assistants, porters, technicians, HR staffs, clerical managers, etc.

Keeping in touch with relatives to inform them of the movement of their loved ones around the different areas of the unit also adds another layer of work for the health team, but as exemplified with previous challenges a few months ago, the team has been able to do this with great efficiency and in good spirit.

Of joy to us in our unit is that during this period, we moved to the first part of our multi-million pound modern and sophisticated unit which gave us more space and more equipment to work with. However, as the second part of the unit is still a few months from completion, we have had to continue making use another total arm of the unit on a different floor dedicated mainly to non-Covid patients.

This has added to the logistical challenge of coordinating and efficiently managing the patients. It also means a good balance of staff mixture must be present across all the areas and the different components (arms) of the unit at all times, requiring extended hours and essentially more potentially inflexible shift patterns for staff as we all work to ensure our patients get better.

Despite all these, the staff remains committed, has shown a remarkable level of resilience, a great display of dedication, an unparalleled professionalism, unrivalled team work and admirable mutual respect.

On a lighter note, as I got into trouble for not name checking all my friends in the previous article, I am going to run away from specifically mentioning anybody’s name and end by highlighting to every member of staff in the hospital and beyond that they are (and will remain) highly appreciated.

In particular, to all my lovely colleagues and members of team ICU of Royal Preston Hospital, please continue to hang on there and know that you are sincerely appreciated and valued.

Let’s keep up the good work!

Dr Samuel Ikenga is a registrar in the Intensive Care Unit at Royal Preston Hospital