Impatient doctors and nurses are calling for the government’s measures to build up a sound intensive capacity.
OSLO / TROMSØ (Nettavisen): – It is not the coronavirus that is to blame for the intensive care capacity now being poor, says Rita Paulsen, group leader for the intensive care nurses at the University Hospital of Northern Norway in Tromsø.
– The intensive capacity has not been at its peak for many years, she says.
Also read: Guldvog: – The uncertainty is greater than in March 2020
Paulsen says that many are tired in the hospitals after a long period of great work pressure and lack of professionals.
– It is interesting when they talk about increasing intensive capacity. For UNN’s part, it has never really been developed, Paulsen says to Nettavisen.
– We got a new department three years ago. We have the equipment, we have the physical space, but not the number of positions to meet the need.
Paulsen says that the hospital was admittedly given some nursing positions in order to be able to take so-called intermediate patients, patients who require more follow-up than regular bed care, but are not fully intensive care patients. But even this does not give the capacity increase they are calling for, she points out.
Also read: Intensive care nurses in Tromsø: – Terrible to see people struggling like that to get enough air
– No goodwill
– A month ago you went out and said that the politicians come late on the field and that this is something they have known for a long time. Have you received any signals that there is a change?
– I do not see that work is being done to increase the capacity of the intensive care units. There is no goodwill in the government, which must come up with much more if it is to thrive. There are an awful lot of tired nurses now. This embraces far and wide. It’s not just in the intensive care units. It’s on regular bed posts, it’s in psychiatry, in home care. The doctors are also struggling. They are also not many enough.
– The government must deliver
The experienced intensive care nurse says intensive care capacity is about physical space, equipment and personnel:
– The flight from the profession must be stopped. The solution, I think, is that the load must go down and pay up! Then we may be able to keep those we educate and draw someone back to the profession. And there the government must deliver! Do not just refer to the parties in the wage negotiations, she says.
– Now the omikron variant creates new uncertainty, and new national infection control measures have been introduced. What do you think about the situation in the hospitals this winter?
– I am excited about whether the measures will work. People are tired and bored. I understand well that this is broken for business. There are fears of leave and bankruptcy. The question is whether we are willing to choose who will receive hospital treatment and who will not. My job is to do everything I can to give people the treatment they need. I hope we do not have to be in a situation where we have to choose. It’s my worst case scenario, that we have to start selecting.
The Norwegian Directorate of Health: – Very demanding
Retrieved from the Norwegian Directorate of Health’s recommendation to the Ministry on 7 December 2021:
The Directorate considers that a relative shortage of qualified health personnel is now the most limiting factor for the hospitals to be able to maintain or increase their capacity in the future. It is very demanding that the lack applies to critical key personnel to treat seriously ill adults and children who are difficult to replace with others. Plans have been made for further expansion of capacity and to ensure sufficient competence in patient treatment, but it will be uncertain whether these will be possible to realize in a situation with high sickness absence.
The health personnel have been in the pandemic for a long time. This entails wear and tear both physically and mentally, which must be taken into account when assessing capacity challenges in the future.
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Discusses moving patients
Paulsen says that the hospitals are already in full swing to prepare for the increase in patients that the Norwegian Directorate of Health warns may come, but that the room for maneuver is limited:
– The hospitals are looking at who has the capacity and whether it is possible to move patients, but the problem is that everyone is in the same situation. The staff in the intensive care units is adapted to a steady influx of patients, despite the fact that we are an emergency department.
Expect increased demand
Laila Furulund Strøm, section leader at the intensive care unit at UNN in Tromsø, says that they must expect an increased influx of patients in the future, even though the omicron variant will not make patients any sicker.
– If we get more people who are infected with the omicron variant, it will probably mean that even more people will be admitted to intensive care. This is because even though the omicron variant will not make patients any sicker, we must expect that patients will come to the intensive care units also with this variant of covid. Together with the delta variant that we have had so far, it will contribute to a total of more inpatients because there are more who are infected, because the omicron variant is more easily infected.
The latest figures from UNN show a total of 8 inpatient covid patients, all in Tromsø. A month ago, the number was around 20.
The figures do not give the whole picture, Strøm points out:
– The figures for the number of admitted covid patients referred to are for those who are isolated. The covid patients can lie for a long time and be seriously ill long after they have come out of isolation, and this means that the intensive care units are full, so there are more covid patients than it seems.
– Can contribute to better control
Strøm says that there are important measures that the authorities are now imposing on us to reduce the number of close contacts.
– Another important means of avoiding becoming seriously ill is that everyone gets vaccinated. Both of these measures together can contribute to us gaining better control and a reduction in the spread of infection and that it in turn can reduce admissions to the intensive care units, she tells Nettavisen.
At the same time, she asks key politicians to think long-term:
– For a long-term improvement, it is important that the government takes action and increases intensive preparedness in Norway. This is so that it does not affect all patients who need help and that, for example, you do not have to postpone planned operations.
The online newspaper has asked for an answer from the Ministry of Health and Care Services to the proposal from Rita Paulsen and Laila Furulund Strøm.
Hospital director: – The employees have really stood up
Anita Schumacher, CEO of UNN, praises the employees and confirms that intensive capacity has long been a challenge:
– Even before the pandemic, intensive capacity was at times a challenge for us, and during the pandemic this has become extra demanding. We have had many patients admitted to our intensive care units due to covid-19, especially this autumn. And although this number has declined somewhat in recent weeks, we still have many other patients who need intensive care. The employees have really worked to make this go around, both those who work in these departments on a daily basis, and other employees who have been relocated, says Schumacher in an e-mail to Nettavisen.
She says this about the prospects ahead of the omikron winter:
– We are excited about how the winter will be. Local measures in Tromsø seem to have helped the number of admissions, but if the omikron variant leads to many hospital admissions, this could create challenges for operations. It is very difficult to get substitutes, and even though extra cohorts are now being trained with intensive care nurses, it will take time before they can work fully with us.
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This is the intensive debate
On Tuesday, the number of covid patients in Norwegian hospitals reached a preliminary peak; 320 patients. This is the highest number in the entire pandemic so far.
On Wednesday, the number was 307 admitted with covid-19, 95 of them in the intensive care unit and 48 in the respirator.
Covid patients make up 30 percent of hospitalizations in Norway now, but seize large resources. On average, each covid patient has a length of stay of 8 days.
Criticism of the intensive capacity comes from several quarters. Jon Henrik Laake, chief physician at the intensive care unit at Rikshospitalet and leader of the Norwegian Anesthesiology Association, claimed NRK Dagsnytt 18 Tuesday 7 Decemberr that the intensive care capacity at Norwegian hospitals has not been upgraded in 15 years and that it is at the same level now as when the pandemic started on 12 March 2020.
– Our opinion is that you have wasted opportunities every single day. One could take action when the pandemic was a fact, but preferably long before that, Laake stated according to NRK.
In its professional recommendation to the Ministry of Health and Care Services on 7 December, the Norwegian Directorate of Health writes that a relative lack of qualified health personnel is the most limiting factor for hospitals to be able to maintain or increase their capacity in the future. possible to realize. (See separate fact box).
-We can handle a huge amount of covid patients over a short period of time, but not over a long period of time. Then the hospitals must prioritize other groups, said health director Bjørn Guldvog in The debate on NRK on Tuesday 7 December, after the government presented new national austerity measures.
– Already now, they have begun to prioritize groups for elective treatment. The more people in intensive care, the more people will have to wait for treatment, Guldvog said.
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