Date of release: 11 February 2021
For this week’s blog I want to focus on how we have trained consultants to work in nursing roles to address the increased demand for intensive care beds in the third wave of the COVID-19 pandemic.
With the Integrated Critical Care Unit (ICCU) at capacity and demand still rising, we had to quickly find a solution to increase the number of beds available to enable more patients to receive urgent care. To help to resolve this we decided to turn to our doctors and consultants. Email invites were circulated by the Deputy Medical Directors asking their colleagues to train as intensive care (ITU) nurses to increase bed capacity.
Around 150 consultants, along with some registrars, undertook a basic fundamental theory session in critical care nursing to prepare them to help existing ITU nurses and redeployed staff. As a result we doubled the size of our ICCU from 22 beds to 47 – this is a huge accomplishment for all.
The training was a combination of theory and practical instruction, incorporating interactive videos and demonstrations to familiarise the consultants with the bed spaces in ICCU along with the equipment, such as that used for airway management, ventilators and infusion pumps. Simulation training on ventilators was also provided.
Initially, some of the consultants were surprised at the Trust’s invitation for them to receive this education, but they were aware of the shortage of ICCU nurses on the unit and were only too willing to help, due to the acute surge in coronavirus cases. Some consultants admitted feeling out of their comfort zone, but they all commented on the delivery and content of the training and how well prepared they felt. All of the consultants were very engaged and the sessions prompted many questions around the nurse’s role in an ITU setting. Some said they were quite excited to be part of such an amazing team.
Consultants are used to working with acutely ill patients but seeing such a large amount of patients on ventilators was a new experience for many of them. However, they were hugely grateful for the support of the existing ITU staff, who in turn were pleased at how many consultants helped and supported them.
Other feedback I have had is that consultants have been impressed by the incredible stamina of the ITU nurses – seeing them working 12-hour shifts in such a challenging environment – but also in the knowledge that so many have been doing this since the pandemic started a year ago.
There have been many examples of real teamwork and unity between consultants and nurses. Doctors have been able to assist with the completion of clinical observations, documentation, drawing up drugs and the personal care a patient requires, allowing the ITU-trained staff to concentrate on their specialist skills. This has been a truly engaging, interesting, educational and enlightening experience for many consultants, who have an enhanced appreciation of what their nursing colleagues do.
All of this would not have been possible without the help and assistance from various departments of the RWT family. We have been indebted to the help of our Nurse Education team, Education and Training (E&T) team and Medical Illustrations department. Medical Illustrations prioritised their workloads to film the teaching and E&T converted it into a medics ICCU reservist theory e-learning training package that could be accessed via the ICCU reservists training page on our intranet. This meant the Nurse Education team had a record when staff completed their training, plus the information was made accessible for all who couldn’t attend on the day.
The Nurse Education team also created innovative supplementary e-learning packages for nurses and doctors to enable the upskilling of the consultants as quickly and as effectively as possible given the urgency of the situation, and have set up a simulation area on ICCU for redeployed staff to be competency assessed on these skills. Training was delivered through a combination of face-to-face learning in the Wolverhampton Medical Institute (WMI) lecture theatre and over Microsoft (MS) Teams.
I believe this is another positive way the Trust has innovated, adapted and shared skills during the pandemic, for the benefit of staff and patients.