Life at NNUH: inside the Critical Care Complex

Our teams approached the Covid-19 pandemic with togetherness and compassion in the most challenging of circumstances.

In the Critical Care Complex, staff had to adapt and treat an unprecedented number of patients with acute respiratory problems, with some needing ventilation.

During the pandemic they created two separate Intensive Therapy Units (ITU) and High Dependency Units (HDU) as part of the re-zoning of the hospital to isolate patients with Covid-19 from those with non-Covid illnesses and injuries.

The virus and the need to wear Personal Protective Equipment (PPE) changed the way we work and made communicating with colleagues and patients more of a challenge.

The team see a variety of patients who have come straight from the Emergency Department or emergency surgery as well as those who have had a major elective procedure who require close monitoring. The Critical Care Outreach team also brings ITU skills to the ward and provides extra support to patients on the wards.

Deborah Easby, Critical Care Consultant, said that one of the biggest challenges of Covid-19 has been not having relatives on the unit at their loved-ones bedsides.

“When it comes to the point where I can no longer save a patient, the thing I can do is be very kind and understanding and take time with their relatives to explain things to them and help them come to terms with it,” she said. “That’s very hard when that cannot be done face to face.

“Sometimes we have done everything for a patient and cannot keep them alive any longer, but we can give them a peaceful death and support the families to make sure they understand that and why we have come to that point, and that can make a huge difference to that family if they feel well supported, well cared for and well listened to.”

Working in ITU gives the nursing teams the opportunity to care on a one-to-one basis for their patients.

Claire Rice, Deputy Sister, said: “I’m very practical based and I love the patient care and the one-to-one care from admission to discharge. We have to make patients feel comfortable and safe and I love being that all-round nurse I wanted to be since I was 15.”

It’s also very rewarding to help rehabilitate someone who’s been on a ventilator.

Toni Bladon, Physiotherapist, said: “Patients here are at the most vulnerable they are ever going to be and we can make a huge difference. Someone’s physical function is key to who they are as a person. The earlier we can start their rehabilitation, the better their recovery.”

Charley Harris, Staff Nurse, said: ““I like the autonomy you get as a nurse and you get to learn everything about your patient and we get to work in a multi-disciplinary team. The senior team and the support from the clinical educators makes us feel well supported.”

Emma-Jane Oetterli, Critical Care Outreach Nurse, added: “I had been in critical care in London for seven years and I feel that outreach was the perfect role to bridge the gap between intensive care based practice and the wards. I am able to use the skills I have gained in ITU and bring them to the ward and develop more skills because of that practice on the ward.”