Nine months ago, Boris Johnson praised staff at St Thomas’ for saving his life. Now, a senior intensive care nurse at the London hospital has warned that patient care is being compromised because of staff shortages and a failure to plan for the second Covid wave.
Dave Carr, an intensive care charge nurse, is one of many NHS workers desperate for the public to know what is going on inside their hospitals at a time when misinformation and scepticism about the virus are rife.
Outside St Thomas’ in the early hours of New Year’s Day, a crowd of Covid deniers gathered, without masks, shouting “Covid is a hoax”. Inside, Carr’s colleagues struggled to save the lives of a growing number of patients.
“The public needs to be aware of what’s happening. This is worse than the first wave; we have more patients than we had in the first wave and these patients are as sick as they were in the first wave. Obviously, we’ve got additional treatments that we can use now, but patients are still dying, and they will die,” said Carr.
As a representative for the union Unite, Carr feels emboldened to speak out. But across the NHS, many more staff claim they have been threatened with disciplinary action or even dismissal if they put their head above the parapet.
In Devon, one nurse working on a Covid ward said safety standards had slipped at her hospital, but she feared for her job if she was identified by name. “The infection control restrictions are more relaxed. Before, we had to use a separate entrance but now we don’t, and some doctors feel they don’t have to obey the infection control protocols and are still unsure of how to properly remove the PPE,” she said.
Staffing is a huge issue, she said, with 10 out of 25 nurses absent on a recent week because they were isolating. During the first wave, her hospital never had more than around 20 Covid patients. Now they have more than 40.
Claims circulating on social media that hospitals were empty had upset many staff. “People need to understand the problems we are having and the situations we are facing, rather than this ridiculous notion that we are all in empty hospitals learning TikTok dances, which couldn’t be further from the truth,” said an occupational therapist in Hampshire. “We’re being pressured into pretending everything is all right for the benefit of the popularity of the government. They are trying to underplay the situation so that people don’t look behind the curtain and see what’s happening.”
Carr, who has been an intensive care specialist for 21 years, said that while more lives were being saved at St Thomas’, those patients have to be in hospital for longer, leading to more pressure on hospitals, “because we can actually fix more patients than we could the first time round”.
He warned that St Thomas’ was now treating patients from other hospitals in the area that were near collapse.
Carr’s hospital has increased intensive care capacity and now has almost 100 beds, but struggles to find the nurses to staff them. He believes that the dire situation could have been avoided if hospitals had slowed non-urgent operations and care in recent months to concentrate on training nurses, but “what we heard was NHS England and the Department of Health just pressurised the hospital to do as much elective work as possible, and of course now we’ve got to deliver the vaccine.”
Carr said that the pandemic had hit following “chronic cutbacks in the NHS over 10 years”, with tens of thousands of nursing vacancies, and then the first wave had “shattered” staff.
“One of the things that really is not being grasped … we’re doing stuff now that compromises the care that we’ve been trying to give and that I’ve delivered all of my career. And for a lot of our nurses, it’s really upsetting for them not to be able to deliver the level of care that you’ve been trained to do,” he said.
The Hampshire occupational therapist said they were among the “huge majority of the staff feeling frustrated and feeling unable to put the word out under my own name and say what’s going on”.
Staffing was a major issue, they said: “We are losing staff hand over fist, either due to sickness or being redeployed to other areas. We are opening bed spaces anywhere we can find them and are being warned that we will need to use our already scarce therapy space to house patients, meaning rehabilitation will be gravely affected.
“Paradoxically, the first wave felt well organised by comparison to this one – there was an emergency plan from the government and we followed it. This time, the rise in number was initially insipid, and now it feels as though we have been caught on the hop by something we could have easily prepared for. Days are exhausting, and then being confronted by Covid deniers on social media leaves us feeling emotionally distraught at our loved experiences being denied.”