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Health Minister Nicholas Steele – the line minister responsible for tackling the coronavirus

Nurses Were Not Fully Prepared to Fight Covid-19

THE NEW TODAY has been in direct contact with some nurses at the St. George’s General Hospital who complained that they were not adequately and properly prepared by the authorities to deal with the deadly coronavirus.

The nurses spoke with this newspaper on the grounds that their names will not be disclosed for fear of victimisation by their bosses at the hospital.

According to one of the nurses who worked in a very sensitive section of the hospital she was happy that none of the 23 Covid-19 patients needed to come into her section for urgent medical treatment as the unit was not prepared to deal with them.

She said that the nurses working alongside her were not taken through the necessary precautionary measures that are needed to deal with COVID-19 patients.

The nurse stated that she did her own research on the virus to prepare herself personally since she was not adequately prepared by the Management Team in place at the hospital.

“We had nurses on my level, we had conversations on it (dealing with COVID-19 patients) at the unit and even though we know what we had to do if we got into contact with it but as a directive or clear cut guidelines from management, we did not,” she said.

The nurse pointed directly at some of her colleagues who were working on the 4th Floor of the hospital where the Operating Theatre, Recovery Room and Intensive Care Unit (ICU) are located and might have had to handle suspected COVID-19 patients who had to be sent there for urgent or emergency surgical care.

She said the nurses there were not sufficiently trained in the proper use of Personal Protective Equipment (PPE) in terms of how to put them on, at what stage, when to take them off, where to take them off, and the proper disposal of the gears after dealing with a suspected virus case.

“There were no clear directives for that. There were some discussions, there were some suggestions but out of these suggestions there were major loopholes – how to put it (PPE) on, where to take it off. If you are dealing with a known or suspected COVID case and the person has to be treated – where do you put on the PPE?

“You need clear cut disposal units as to where do you dispose of the PPEs. You can’t put them in regular black bags, you have to put that in a special bin when you know that you come in direct contact with a known or suspected case.

She went on: “These things were not clearly defined. I did my shift for the entire period and I wasn’t told about it clearly”.

According to the nurse, there are special procedures for regular patients entering the Operating Room for treatment but it would have had to be different for those who were suspected or known to be affected by coronavirus.

She spoke of there being no clearly defined policy put in place and shared with all the nurses on the 4th Floor.

She noted that it was always a nurse and not the doctor who had the first direct contact with the patient especially as he/she enters on the Floor of the Operating Room and again the Nurse was the last person to receive the patient after the surgical procedure is completed.

“Where do you put on the PPE (to handle the patient)?” asked the nurse.

She also said: “After the suspected COVID patient would have had the surgery, recovered from the surgery, recovered from the anesthesia – where do you remove it (PPE)? So somebody had to bring the patient to you or you had to collect the patient and when you done, somebody had to send the patient back down to wherever they needed to go”.

The nurse acknowledged that the General Hospital was prepared for housing patients with COVID-19 but such a patient who needed surgery brought into serious question the inadequate preparedness of the facility.

She said the procedures to be followed for surgical operation and recovery from the surgical treatment of suspected COVID-19 patients were not “clear cut and thank God we didn’t have any cases as such”.

She also cited a lack of preparedness by nurses in a situation in which one of the COVID-19 patients could have been pregnant and needed caesarian section to deliver the baby.

The nurse said that the patient would have had to be taken from the Obstetric ward on the First Floor and brought to the 4th Floor for treatment.

She stated that the major question in the minds of many nurses on duty was how that suspected COVID-19 patient would be transferred to the Operating Theatre on the 4th Floor and how does the individual leave up there and go back to where they have to take them.

“These are things for nurses to know, you had to know it before hand, not know it only when you have to deal with it when facing something for the first time – you might tend to make mistakes more than if you knew it beforehand.

“We were dealing with something new – something that we never experienced before. This is not like TB. TB is very different – similar in some ways but very different.

According to the nurse, she only really started to worry about COVID-19 when the first set of patients were taken in at the Isolation Unit at the General Hospital for medical treatment.

She said it was then that she started in earnest to prepare herself and needed to know from the Management if they had PPEs for the nurses given the sensitive positions that some of them were occupying at the hospital.

“I started to ask myself, let me lock myself down, let me see what I have to do – where is my PPE, where is my suit, where is my shield, where I’m putting this thing on, where I’m taking this thing off, how am I dealing with this?

She said that she started to look at her own preparedness and the readiness of the ward to deal with the pandemic.

According to the nurse, some PPE’s were eventually given to her department for use but those were not sufficient for them.

The nurse said that despite the problems concerning a lack of preparation throughout the hospital system, Grenada did well in terms of containing the spread of the virus but “we could have done better”.

“I think we missed the opportunity to test, test, and test”, she remarked.

According to another nurse, the Hospital Management took the questionable decision to only test persons who were showing symptoms of COVID-19 and not everyone who were exposed to the virus.

She made specific mention of a situation in which a person who had contracted the disease was “unknowingly” admitted on the Medical Ward where there were other patients receiving treatment for their conditions.

“As soon as they realised that they admitted a COVID case they moved and corrected it. And then all these nurses, all these health care workers and auxiliary staff would have gone home on a bus and you would have mixed with other staff on a different ward and they did not even test those nurses.

The nurses pointed out that there is always intermingling of hospital staff on duty and both doctors and nurses would have been exposed to those who came in contact with this particular COVID-19 patient.

“What I thought that they should have done at that point, they should have tested all hospital staff and doctors whether or not they came in contact with him. These same staff would have gone home on the staff bus and laughed and mixed with their friends,” she said.

“Seeing the fact that they admitted the COVID case unknowingly and that they know about silent healthy carriers, they should have tested all staff in the hospital. They should have done it especially nurses and doctors who (are) always in the front with the patients,” she added.

In addition, THE NEW TODAY was also told about another concern of nurses with the staff bus since it was never sanitised throughout the day and night as it transported them from work and back to their home during the many shifts.

The nurse said that the hands of staff were also not sanitised to enter the bus and this was lacking.

According to the hospital employee, all nurses, orderlies and maids work hand in hand at the institution and were provided only with masks and gloves even before COVID and during the pandemic.

“To deal with COVID you need much more than a mask and a glove. You need the body suit, eye coverage, shields, eye glasses – the whole suit,” she said.

“We didn’t get the entire package only part of the package was provided. We weren’t given everything we needed,” she added.

The problems highlighted by the nurses differed from the glowing picture painted by Health Minister Nickolas Steele a week ago when he boasted that Grenada had beaten the first wave of COVID-19.

“…We have actively been building capacity within our health system in the last few months. While we will never be fully ready to meet the demands of an outbreak … we are much better positioned in terms of our processes, to be able to successfully fight this disease,” he told Grenadians.

Minister Steele said that Grenada is making successes in its efforts to procure more equipment such as Tests and Personal Protective Equipment (PPE) and strengthening contact tracing efforts by building capacity and ensuring rigorous training of team members in the battle against COVID-19.