In light of the global pandemic, hospitals in Northern Ireland had to adopt certain changes as a necessity rather than a preference, according to the region’s former Chief Nursing Officer (CNO), Professor Charlotte McArdle. These changes, particularly restricting hospital visits, were characterized as ‘the least worst option’. This challenging approach was necessitated by the exceptionally high vacancy levels in nursing that Northern Ireland was grappling with at the onset of the pandemic, according to Professor McArdle.
A crucial pivot in that strategy was the focus on ‘person-centred’ restriction, a distinguishing feature of Northern Ireland’s response. As the pandemic evolved, the region tweaked the visitor restrictions accordingly, while constantly focusing on a humane approach. Exceptions were made for women in active labour, palliative care patients, children, and people with special needs.
The fluid situation called for agility and it is on this premise that changes followed the surges in infections. Efforts were made to ensure that decisions were based heavily on the computed risk from implementing virus control measures. The need for such modifications was advised and executed by professionals including the CNO’s office, health ministers, senior civil servants, and other well-informed officials of respective integrated health and social care trusts of Northern Ireland.
The situation during the peak of the first wave in April 2020 was so dire that hospital visiting in intensive care units and general hospitals had to be terminated. The circumstances were equally challenging for the staff as well as the administration, as each intensive care bed required stringent protocols, optimal space, and workforce availability. However, since the peak, the restrictions were reconsidered, with particular concern for the emotional toll on families and for end-of-life patients.
The effort and capacity shown by the staff was commendable, but it does not deflect from the fact that it was a stressful and difficult time for all involved. There were inconsistencies and complexities in the implementation of visitor guidelines, owing to the local transmission rates which caused confusion and distress for families. Additionally, the stress on the healthcare sector was amplified by a 20-25% non-availability of the nursing workforce during the pandemic’s first wave and a pre-pandemic vacancy rate of 11%. This was linked back to workforce planning around undergraduate commissions between 2009-2012. However, the application to augment the nursing workforce from England, Scotland, Wales, and the Republic of Ireland in October 2020, unfortunately, did not succeed.
Despite these challenges, the objective remained ensuring the delivery of excellent care without compromising on the experiences of the patients and the staff.