GHA eyes ‘mini-Nightingale’ if admissions persist

The Gibraltar Health Authority plans to open a ‘mini-Nightingale’ to aid the pressures caused by Covid-19, its acting Medical Director Dr Krishna Rawal said.
Dr Rawal told the Chronicle the mini-Nightingale would be at the rehabilitation clinic in St Bernard’s Hospital and would be for patients nearing the end of their recovery from Covid-19.
He explained the Nightingale at Europa Point Sports Complex presented logical issues, such as staff and resources being split between the sites.
The mini-Nightingale would provide care for those close to recovery who need some extra days of rest before being discharged.
This would provide a buffer, more beds and resources for patients who really need it in the Covid-19 Ward.
“This is something that we are working on now, it is not in operation yet but we will probably have it ready by the end of the week if we need it,” Dr Rawal said.
“But at the moment our reconfigurations are doing very well.”
There are also plans to expand the Covid-19 Ward, currently housed at the Victoria Ward, if hospital admissions continue to increase.
The John Mackintosh Ward has been eyed to provide for a second Covid-19 Ward if demand continues.
As cases continue to rise in Gibraltar, the GHA’s staff has been affected with 10-12% throughout all its services in isolation.
“Our services have stretched even that 90% of staff is now becoming more stretched because of the increase in the numbers of admissions that we have had,” Dr Rawal said.
On Tuesday the GHA saw the number of admissions into the Critical Care Unit increase by two and another three in the Covid-19 Ward.
Overall, there were eight patients in the CCU and 22 in the Covid-19 Ward.
The CCU has had to be split in two, CCU 1 for the Covid patients with 10 beds and CCU 2 now at the Day Surgery Unit for non-Covid patients with seven beds.
Dr Rawal confirmed there are more patients in the Covid CCU than the CCU 2, which is for all non-Covid related injuries.
He caveated that due to people being locked down less emergency injuries such as motor vehicle accidents have been taking place, resulting in fewer patients in CCU 2.
But urgent care, for example for cancer patients needing surgery, continues to take place at the CCU 2.
The GHA has had to take over much of the Rainbow Ward to provide for an acute admissions ward.
“The acute admissions ward is designed almost like an airlock,” Dr Rawal said.
“Any patient who comes in, until we can be absolutely certain of their Covid status, if they are not well enough to remain waiting in A&E for a swab result, we will bring them into the acute admission ward at Rainbow Ward so we can move them either to a clean or Covid area.”
Despite the extra space to deal with the sharp increase in cases, the GHA needs to have the staff ready to care for these critical patients.
One patient could need a team, all kitted out in PPE to avoid transmission of the virus.
Wearing PPE is not just uncomfortable, but means that the frontline worker must make the most of their time in this gear.
Once in PPE a frontline worker cannot take a break for the hours they are wearing the equipment.
“They’ve started this next wave already tired and just to put this in context we had workers in CCU working full shifts, but three hours at a time in full PPE,” he said.
“This is incredibly hot, incredibly cumbersome and difficult. In that time it is impossible for them to take a drink or have something to eat.”
“We are seeing staff members becoming exhausted, dehydrated and even to the point where we are allocating some of the offices which have been essentially left aside now because of course of our routine clinical activity has stepped down and we are putting beds in there so they can have an hour or so to rest before they can get back into the enormously demanding shifts.”
Dr Rawal praised GHA staff for working under these conditions, for their preparatory work throughout the past few months and their skills.
He encouraged the public to only attend Accident and Emergency or ring an ambulance when “absolutely necessary”.
This will help ease the pressure on the GHA while it deals with the pandemic.