Heather Murphy, Northern Ireland
COVID-19 and the impact of temporary Neonatal Unit Closure
COVID-19 has presented many challenges nationally and resulted in the formation of the Paediatric surge plan within Northern Ireland to ensure the safety and security of both neonatal and paediatric services during a worldwide pandemic. To preserve these services a five step plan was created by the Department of Health, step one of this plan was initiated via the temporary closure of three paediatric inpatient wards, reallocation of intrapartum care in one hospital and the closure of one Neonatal Unit.
The temporary closure allowed local evaluation of the impact on maternity and paediatric services and considered the predicted increased demand in these services alongside the unknown timescale of service disruption, consequently the Neonatal nurse support role was developed. The role involved approximately half of the permanent Neonatal nursing team remaining on site to work collaboratively with maternity and paediatric services, to provide support for midwifery staff to reduce the incidence of infants requiring Neonatal Unit level care, stabilisation and subsequent transfer of infants requiring Neonatal Unit admission. To facilitate this service need throughout the paediatric surge plans, the creation of this role alongside collaborative working, medical and nursing education and staff support were paramount to ensure the safe and effective care of patients requiring stabilisation for ongoing neonatal care who are both non COVID-19 & suspected/ confirmed COVID-19.
The remaining nursing team were redeployed to the hospitals sister Neonatal Unit located one hour and twenty minutes from the temporarily closed unit. Challenges were presented through additional travel time combined with a shift work rota and orientation to a new Neonatal Unit, however redeployment offered the opportunity to work at a busy Neonatal Unit, care for infants requiring a higher care level than commissioned within their home unit and offered additional experience in another Neonatal Unit. Furthermore collaboration with the sister unit can assist cross sector working within the hospital trust, opportunity to undertake additional competencies which are infrequently undertaken in the home unit and temporarily work within a new multidisciplinary team.
Post paediatric surge plans have involved planned reopening of the closed Neonatal Unit which prior to reopening offered the opportunity for ward based reorganisation which would otherwise be highly difficult during normal service, whilst also acknowledging the impact of change projects following the surge plans. Additionally ensuring staff engagement to provide support and evaluate the Neonatal nurse support role following reopening of services.
COVID-19 has directly impacted neonatal nursing staff work life on both hospital sites alongside disruption in staff personal life due the pandemic. Despite the ongoing pressures within neonatal nursing combined with the impact of the paediatric surge plans have highlighted staff resilience throughout an unprecedented time within our speciality. The surge plans have allowed us to continue to provide safe and sustainable care for infants within the Northern Ireland Neonatal Network and collaboratively work with our maternity and paediatric colleagues to provide high quality care.
Following the reopening of the Neonatal Unit there is now focus on maintaining collaborative working within the home unit site, reflection of the continued positive working relationship with the sister Neonatal Unit and supporting staff following the impact of the paediatric surge plans but also remaining aware COVID-19 is ongoing and preparing for a potential second wave and further impact on our infants, families and staff.