Northern Ireland

Warning over reduction of ICU nurse/patient ratios at Nightingale

Concerns have been raised about the reduction in nurse/patient ratios at the Nightingale hospital during the second wave
Concerns have been raised about the reduction in nurse/patient ratios at the Nightingale hospital during the second wave Concerns have been raised about the reduction in nurse/patient ratios at the Nightingale hospital during the second wave

INTENSIVE care nurse ratios have reduced in Northern Ireland's Nightingale hospital due to staff shortages, The Irish News has learned.

The recommended one on one practice - whereby one ICU nurse cares for a single patient - has moved to one ICU nurse looking after two patients while assisted by support staff in the specialist Belfast facility.

Pat Cullen, who heads up the Royal College of Nursing (RCN), warned the change "absolutely went against the critical care guidelines for Northern Ireland".

The development comes a day after leaked photographs from inside the 11-storey Nightingale showed wards used for storage and a specialist Covid ward unopened since August.

A spokesman for the Belfast confirmed that it had "redeployed nursing and nursing support staff to critical care".

He said they have "one registered nurse caring for one patient at any time" - but did not clarify if they were ICU nurses.

"A fully trained and experienced ICU nurse closely supervises a maximum of two registered nurses at any time providing expert support and guidance. Intensive Care Clinicians and Allied Health Professionals provide additional support in a collective approach to delivering the highest standard of care for the most critically ill patients," he said.

Belfast trust say all staff redeployed to ICU have been appropriately trained to "ensure they can carry out their role safely".

"The Trust has developed training utilising the Critical Care Network for N. Ireland (CCaNNI) nursing practise skills framework for non-ICU nurses. Additional education resource materials, including an induction and orientation pack for the Nightingale Critical Care Unit, is provided to every staff member redeployed to the Nightingale."

But Ms Cullen said she had spoken to staff on the ground who felt that conditions were "unsafe" due to the level of supervision required in such a highly skilled area of nursing.

The RCN director aho pointed to the CCaNNI recommendations, which say there should be one ICU nurse to one patient in 'level 3 critical care' , which she said is Nightingale ICU.

Earlier this month The Irish News reported that 15 intensive care nurses had resigned from the Belfast trust over the past six months.

"They are struggling for nursing staff at the moment and the ICU ratio has reduced from one on one to one to two. The gaps are filled by support staff. The abnormal has become the normal for them," Ms Cullen said.

"We are aware the Nightingale is averaging about 20 critically ill Covid patients currently. That puts us into a crisis because we have no staff. Some ICU nurses have resigned to work for an agency or left the profession altogether.

"Sickness absences unrelated to coronavirus are also soaring. The result is that many elective surgeries are being cancelled and we're running Covid hospitals.

"This is all symptomatic of a health service that has left nurses behind."

Earlier this month Chief Medical Officer Dr Michael McBride said Nightingale, which is based at Belfast City Hospital, had capacity to treat more than 150 Covid patients.

Yesterday, the regional facility was caring for 17 critically ill patients on ventilators. Hundreds of operations carried out at the leading hospital pre-Covid, including gynae, dermatology and urology procedures, have been transferred to the Royal Victoria Hospital, with many affected by temporary suspensions.

Kidney transplants were also carried out at the City and have been "paused".

The trust spokesman said the pandemic has "understandably impacted on non-covid services".

"Service delivery in other areas has changed with many outpatients appointments being carried out remotely and some services delivering care in different locations. We appreciate the understanding our staff and patients have shown as we continue to meet this challenge."