The next seven days will test the National Health Service in an unprecedented way. Coronavirus Patients in need of critical care are beginning to approach unsustainable levels-the number of patients is expected to double every few days.
Hospitals across the country expect 33,000 additional beds in an ad hoc ward made of old clinic spaces, offices and operating rooms. NHS Required capacity.
The death toll in the United Kingdom has exceeded 1,000 and an additional 260 have been victims of the plague. The increase in outbreaks from 759 to 1,019 was the largest daily increase in deaths since the outbreak began.
NHS director Steven Powys told a press conference on Downing Street that all deaths were a tragedy, but for Britain less than 20,000 people would do well. “We should not be satisfied with it,” he added. “It’s a good result, but it only happens if you stop the transmission of the virus.”
There is growing concern between NHS leaders and seniors. nurse,Said Independent There is a great risk in safely placing extra beds and treating patients in need of breathing assistance, and there are concerns that many staff members may get sick on their own.
A chief nurse at a Midland hospital said Independent What is currently being considered Intensive care “It would not normally have been possible. This would push staff who are not used to emergency treatment of this kind of patient to the limit.”
Nicky Credland, Chairman of the British Association of Critical Care Nurses (BACCN), added: “We’re doing everything we can, but there’s a shortage of intensive care nurses. We have to admit that we can’t save everyone.”
London is expected to be hit the worst in the next 10 days, followed by other parts of the country within the first few weeks of April.
On Friday NHS England The hospital confirmed that there were 6,300 Covid-19 patients, at least half of whom were considered hospitalized in London. Cabinet Minister Michael Gove said on Friday that the number of cases has doubled every few days, suggesting that London would be overwhelmed without the additional 4,000 beds opened at London’s ExCel center.
But mail to NHS staff at London Hospital IndependentVolunteers who volunteered to work at the newly named NHS Nightingale Hospital are expected to live effectively on site. Volunteer staff working at the hospital said they needed to “prepare to live while the field hospital was open.”
St. John ambulance volunteers are also being asked to help hospital staff, but some are trained only a few days before the hospital opens.
In the coming weeks, more field hospitals will be opened at NEC and Manchester Central Conference Center to ease pressure on local hospitals.
But as the number of patients increases relentlessly, the plans that NHS bosses have rushed over the past few weeks have been strained to quickly become a national emergency.
NHS guidance issued to hospitals on Thursday focuses on hospital-wide staff, including non-nurses such as care assistants, therapists and pharmacists, who are expected to oversee a “ caregiver team ” across several regions Treating nurses has revealed that they may have to be used to care for patients.
In general, intensive care units operate on a ratio of one nurse to one patient.
According to documents, the NHS is heading for a crisis, with 10% of the posts vacant, and normal operations are maintained through the use of agency nurses. That said: “Surge and opening additional beds is a challenge to staffing abilities.”
The normal rules for training nurses stated that they need to be relaxed to “conserve life using all available resources.”
“It is recognized that the duration of a pandemic, such as a coronavirus, imposes pressures and challenges on providing safe, effective and quality care to critically ill patients.”
“We are pleased to announce that BACCN’s Credland has helped to agree to the guidelines. “What we need to do is think about how to place staff that are not traditionally involved in intensive care, such as theaters and outpatient nurses.
“It’s not perfect. We do our best we can for most people we can.
“We know that the situation in London is terrible and we will see it spread across the country, and you will tell people that they are emergency nurses in days or weeks You can’t just teach it. “
She warned that nurses and other staff could suffer severe mental health effects from the next few months: “Staff see many patients dying in one shift, and they Will not be able to provide the level of care they are used to. The risk of post-traumatic stress is absolutely astronomical. “
Nursing is only one aspect of the staffing level of emergency care beds. A doctor at Royal London Hospital in Whitechapel explained: “It’s all creating extra space and extra ventilation, but is there enough staff in those areas? Physio, runners like healthcare support workers, pharmacists, administrative staff, security, cleaners? Is required. “
Addition: “All Covid areas, 4 bed bays, each side room requires an outside runner. Usually ITU [intensive treatment unit] Nurses went to the shed one billion times per shift, obtained small pieces and new medicines, asked doctors and received prescriptions. Now it all has to be done by runners. There are not enough phones to contact a doctor. “
They also said that patients needed at least a team of five to get angry and lay the patient prone, and indeed can help their lungs cope with the infection.
Researchers and clinicians at King’s College London and South London, and the Morsley NHS Trust have also warned that NHS staff will face what they call “moral injuries” from decisions taken in times of crisis.
Professor Neil Greenberg stated that psychological distress could be due to someone’s behavior or lack of behavior that violates moral or ethical standards. In the article British Medical Journal, He wrote: “During the outbreak of Covid-19, many healthcare workers encounter grief-relative relatives in a situation they cannot say,” We did everything we could. ” That was not enough. “It’s a moral seed. It will do harm unless you start preparing and supporting staff who need to face this problem.
Professor Alison Leary, Chairman of Healthcare and Workforce Modeling at London South Bank University, said that the NHS needs to “ take the principle of slow-moving big incidents, ” saying the second, third, and first wave Said that we need to consider how to deal with it. crisis.
“It is necessary to understand that many staff work beyond their reach and ability. We go beyond the risk envelope that we usually accept as healthcare professionals and as society. Must accept that it is working. “
She said that the longer term mental health of pandemic staff and patients is likely to last for years to come.
Helen Buckingham, Head of Strategy at Naffield Trust, also considers social care and nursing homes that could undermine NHS response if patients need to be sent to hospital or cannot accept new patients Said you need to. “We need to keep in mind that there are about 1.5 million more people working in social care than the NHS,” she said.
But Buckingham added that the NHS is “as ready as possible in the circumstances,” he added. “It’s clear from the modeling that the numbers will rise significantly in the coming days. We only know later if that is enough.”
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