Health Minister Terrence Deyalsingh said his ministry is doing its best to assist health-care workers in both the traditional and parallel health-care systems but it needs the assistance of the public to ease the stress on them.
Speaking at the ministry’s media briefing on Wednesday, Deyalsingh said health-care workers have been under the gun since March 2020.
“We employed several strategies, including psychological support. However, mental scars don’t heal like a physical scar. We employed strategies like transportation, meals, time off, and other strategies to ease the strain, but as this virus bites more and more and the unvaccinated demand more and more health care, we have always been concerned with physical and mental wellbeing of our health-care workers.”
Head of the Registered Nurses' Association Idi Stuart is concerned that the traditional health-care system is being stressed by the rise in covid19 cases.
Stuart was responding to questions from Newsday on Tuesday following a one-man protest by San Fernando General Hospital (SFGHward manager Ricardo Goolcharan) on Monday.
Stuart said he was concerned about the implications it could have for the quality of health care being provided to patients, as it was long known that staff, particularly nursing staff, were burnt out.
He said new measures had been implemented by the regional health authorities (RHAs) starting this week without consultations being held between the RHAs and representatives from the nursing and health-care workers.
“Some of the new measures increase the duration of working hours, whereas the normal work day in the public service is eight hours, the RHAs are demanding nurses work 12-hour shifts. Some RHAs are demanding nurses work 48 hours-plus, when they are not required to work anything beyond 40 hours by statutory requirements.”
Stuart explained the need to follow safe staffing requirements, saying, “This is the acceptable standard for patient care to be delivered safely by nursing personnel. When one goes above these safe staffing levels, the data and evidence has shown it compromises patient care.”
He said Intensive Care Unit (ICU) care means one nurse to one patient, where the patient is expected to be given one-on-one care by a nurse.
“From the minute you move away from one-on-one care, you begin to impact on the quality of care that patient gets. The ICU in the core health care system has been compromised, since some nurses have been reassigned to the parallel health-care ICU. With the increase in covid19 cases in the month of November, they have further decreased the already decreased staff in the parallel health care system, so they further weakened and pulled nurses from the parallel ICUs into other ICUs that they (ministry) created recently.”
He said the mobile hospital at the Hasely Crawford Stadium in Port of Spain has been reopened, and ICU staff has been pulled from the Port of Spain General Hospital to now service three areas.
“It is not a matter if nursing personnel could provide quality care, it is just by sheer numbers they cannot do it because they just do not have the numbers. It is our (association's) point of view, the mechanism where the Government has tried to spread their resources as far and wide as possible to give everyone care is actually doing no one a benefit.”
Deyalsingh said while under normal circumstances one-on-one care would be the normal, TT is in an emergency.
“Since last year, to make up for the human deficit we actioned, at Couva especially and doing it at St James and the other hospitals, electronic monitoring of patients. The screens set up in the cold zones have alarm bells and whistles, which automatically track the patient’s SpO2 levels, cardiac rhythms, pulse rate, and one other parameter, and whenever something amiss happens, an alarm goes off in that electronic monitoring system. That way important resources can be sent to that patient, and that is one way in a pandemic when things are not ideal you still maintain optimal level of care.”
He said since last year 200 nurses had been trained in ICU management, with 25 ICU nurses being brought in from Cuba. He said less experienced nurses are paired with more experienced ones to take care of patients.
Deyalsingh said with the addition of 13 new ventilators and associated equipment last week, there would be 102 ventilators available by the end of the week. He said no patient has been denied access to an ICU at this point in time.