What happens when the hospitals reach capacity?

[rainytreeleaves]

Just reading about NI nearly reaching bed capacity and a few places in the north as well. Hospital in Londonderry saying they are in a worse state than in the spring.

The hospital that I work in has been on black alert all week. The covid ward is full, no other wards can be repurposed as everywhere is full and (from tracing they believe) community transmission and via asymptomatic staff, there is a mass outbreak on our care of the elderly ward. Lots of staff self isolating so unsafe shifts and lots of patients infected. Also those elderly patients aren't now leaving to free beds up and no elderly patients can be admitted there for specialist input. It's a total mess.

Our local nightingale can't open as they don't have anyone to staff it. They are literally begging people throughout our region to go on the bank to staff it but there's not enough trained staff available.

I'm just not sure what will happen next....we are worse now than the spring. Slightly less covid so far but much greater bed need in general and more general transmission throughout making working really difficult.

"Big problem for the government at the moment is the conflict between the libertarian /right wing voices who want to let market forces and the virus run through society, and the reality which needs central command and control to avoid some very grim scenes.
It would be great if I felt they had the competence to manage this. "

Same.

@MiniTheMinx

Why does lockdown need the approval of everyone? why are we being held to ransom by the conspiracy nuts and deniers? in politics the people get what the people deserve......an inept government. We have a bunch of idiots looking to see what the other bunch of idiots desire.

I suspect that by the last week of October the feeble minded deniers will be looking to Bojo to save them.

We have elected leaders they should lead.

As for conscription, its a national crisis, yes, but I think instead we should be looking to stamp down hard on rates of transmission. Whilst I agree that the NHS should be there to support society and not the other way around, we don't have reliable treatments that will substantially make a difference to survival. Far better to not increase capacity but to decrease transmission at this time. That means putting protecting lives before protecting the economy. If it can be done in times of war it can be done now, and with no need to conscript people.

I can cope with lockdown. I'm not remotely in the vulnerable category, neither do I have friends or family who are particularly vulnerable, and I'm in the South East. But I am more than happy to sacrifice my social life to protect the lives of others. I'm not at all sympathetic to people winging about theme parks and parties, or even whining about having their own children to educate. I get sick of people saying how hard it is to work without childcare, just imagine how hard it might be for a child who loses their parent this winter, or knows their teacher got sick in school and died, or their gran died at home because the hospital was too short of beds.

Nah, we don't need the approval of deniers and nuts to have a lockdown. We just need a government of leaders who will put life above saving this bloody system that supports their own privilege. Its sickening that they have awarded themselves a pay rise, awarded contracts to their friends and ignored their own guidance, given conflicting messages, sent millions into unsafe schools, condemned thousands in care homes to death, and done absolutely nada about improving the pay of health and social care workers. I mean, who the fuck are you StatisticalSense to demand nurses work longer hours? it may well be that many are scared, some traumatised, others themselves vulnerable, or perhaps they are lone parents to children who wholly rely upon them. What are you doing and what are you sacrificing for society? or are you one of those mad keen little worker bees parroting "save the economy at all costs" just because you are not yourself vulnerable to anything much other than boredom (probably....you do post a lot on here) or redundancy?

Absolutely. So much sense in this post.

@StatisticalSense Here is an idea, you go and take an on line course for a few hours so you can work in a care home or in the community and that will free up a more experienced carer who can work in a hospital..... its your civic duty to do so.

Or are you just happy to send others to do the dirty work?

Things that happened last time where I work:

Lots of hospital departments closes, planned operations and procedures were cancelled, and staff were redeployed to wards and ICU. As a result a lot of patients will become sick/die from none covid causes, and waiting lists will become even more ridiculous.

Criteria for ICU admission became stricter. Older patients might not be considered.

Theatres turned into makeshift ICUs.

Extra beds put into store cupboards etc on wards to increase capacity (happens every winter even without covid).

1 ICU nurse looked after 6 ICU patients, rather than the usual 1 to 1 care, with help from redeployed staff with previous or no ICU experience.

Annual leave cancelled for NHS staff.

Student nurses were asked if they want to rush through the final bit of their training and qualify early.

[quote jasjas1973]@StatisticalSense Here is an idea, you go and take an on line course for a few hours so you can work in a care home or in the community and that will free up a more experienced carer who can work in a hospital..... its your civic duty to do so.

Or are you just happy to send others to do the dirty work?[/quote]
That's an excellent idea.
She, and others like her, could help staff the nightingales. They'll need plenty of healthcare assistants.

Personally I hope conscription does actually happen, but just for people who don't currently work in healthcare like @StatisticalSense. Only joking, they sound like they would be a nightmare to work with. Maybe something like national service for all 18 - 21 year olds who are low risk of becoming seriously sick themselves. Need a lot of hands on deck.

Maybe something like national service for all 18 - 21 year olds who are low risk of becoming seriously sick themselves. Need a lot of hands on deck

Didn't 10s of 1000s of year 2 and 3 HC students volunteer to assist in our hospitals in the spring, only to be told to fuck off we don't need you and we wont pay you either? and that they were more trouble than they were worth.

I don't think you'll get them again.

Its a shame Johnson can't seem to get to grips with testing, track n trace, so much for the private sector.

@jasjas1973

Yep, I'm a nurse and students were indeed treated pretty shit, a nice introduction to working for the NHS. My trust did honour their contracts and pay them, which was the least the trust could do really.

With the national service idea, I meant literally any 18 - 21 year olds, train them up for a few weeks and then all hands on deck for say 3 or 6 months at a time. This is not a serious suggestion that I think would actually work, but if hospitals are overrun with patients we will need extra help from somewhere.

I'm not that age however I put my name down to help as a volunteer but they are unable to accept me at present. It's a shame but I understand it might be more trouble to have people in who have no nursing background.

Does anyone know....
When they say the number in ventilated beds, does that mean in ICU but not necessarily on a ventilator? I know they try not to ventilate people now but the reason I ask is I have been avoiding the news for months now but I switched over to sky news after boris last night. They had one of their awful ICU special reports on but it was very different to the ones they had earlier in the year where patients were unconscious, lying on their fronts and ventilated. They were sitting up, awake, talking and on CPAP machines. I know it's just one report but is this more representative of what's happening now?

@StatisticalSense

Well if it's staffing issues it looks like it's time for the government to conscript nonworking and part time nurses and doctors of working age to work full time (or make up their hours to full time) in the nightingale hospitals at usual rates of pay.

😝😝😝 and how exactly will they afford childcare? They can’t force people! As the other poster said.... everyone has a price. If conscription was a potential most people wouldn’t sign up for those careers!

A North West hospital had less than 5 patients in Summer and at one point, none in ICU. It now has 57 patients and 9 in Intensive care. That is within a 6 week period. This is why they are worried but the new measures don’t go far enough.

As I understand it "ventilated" means needing help breathing - be that CPAP or intubated. Not sure if it includes "just" being given oxygen like some people with copd fi.

I thought ventilated meant being in a ventilator - not CPAP (though you might be in ICU on CPAP)

Yes the people on CPAP were in ICU. It just seemed very different to the images from earlier in the year.

@Jrobhatch29

When they say the number in ventilated beds, does that mean in ICU but not necessarily on a ventilator?

The statistics that are updated daily are for "patients in mechanical ventilation beds", so asleep in ICU on a ventilator, rather than on a CPAP machine. At my hospital patients on CPAP are usually on a medical ward rather than ICU.