Community and social care nurses fear worsening staff shortages as they prepare to take on patients hospitals cannot accommodate because of the escalating coronavirus crisis.
The community workforce is likely to be reduced as personal protective equipment supply problems make it more likely colleagues will become ill, nurses – who wished to remain anonymous – have told Nursing in Practice.
Alice, a district nurse team lead working in Somerset, told Nursing in Practice said she had to split just 25 masks between her team of 20 last week, adding that ‘the lack of PPE is very concerning’.
Social care is already burdened with vacancies – and Alice said some of her team were ‘self-isolating and some may be taken ill, which means we have fewer staff to see patients’, creating shortages.
She said that they were currently seeing fewer patients with lists having been reduced by around a quarter as non-essential visits were scrapped.
But, she added, they were preparing to look after patients with long-term conditions who cannot be admitted hospital or have been discharged early due to the lack of beds.
‘We will be treating some patients at home who would usually be in hospital, which is going to be tough,’ she explained.
Alice also pointed out district nurses might be redeployed to other areas of the health service, such as to a hospital if they have experience of ventilating patients.
Caroline, a trainee health visitor, has been redeployed to a paediatric ward during the outbreak, which was her previous place of work.
She said: ‘I totally appreciate why they’ve done it, but it was gutting to be taken away from my placement and put that on hold.’
Rebecca, a nurse working in a care home, said that supplies of ‘vital’ PPE remained insufficient at her care home last week.
She added that that there is a ‘palpable anxiety’ among staff about managing the pandemic.
Rebecca continued: ‘Staff are incredibly worried about if or when the virus gets in our home. They worry for the residents but also if they get it.’
Chief executive of the Queen’s Nursing Institute Dr Crystal Oldman has tweeted that community nurses are ‘admitting huge numbers to caseloads’ after early discharge.
@bbchealth please remember to mention all the fabulous nurses in the community working to keep people safe, admitting huge numbers to caseloads after early discharge & proving highly skilled nursing care to all #COVID19 @SamSherrington @kathevans2015 @HilaryGarratt @WinnMatthew
— Dr Crystal Oldman CBE EdD RN RHV (@CrystalOldman) March 28, 2020
Ms Oldman also told Nursing in Practice that ‘lack of PPE remains a challenge in all settings’.
She continued: ‘While we have seen reported improvements in the supply of some key items such as face masks, as the virus spreads globally there is a greater demand on the international supply chain of vital equipment.
‘As nearly all equipment is disposable and cannot be reused, there is a constant need to resupply.’
The QNI is in constant contact with central government over supplying adequate PPE to the community and social care workforce, Dr Oldman added.
Royal College of Nursing professional lead for community and end of life care Carolyn Doyle said nurses must be able to work ‘safe in the knowledge they are protected’.
‘We need to see the appropriate personal protective equipment delivered to all those working across the health and care system.’
A department of health and social care spokesperson told Nursing in Practice that the Government is ‘working round the clock’ to provide PPE.
They continued: ‘In the past two weeks the NHS Supply Chain have delivered over 390 million pieces of PPE.
‘The full weight of the Government is behind this effort and we are working closely with industry, social care providers, the NHS, NHS Supply Chain and the army so all our NHS and care staff have the protection they deserve.’
There are 29,474 confirmed cases of coronavirus in the UK as of today. Of those hospitalised who tested positive for coronavirus, 2,352 have died as of yesterday.
Earlier this week, the RCN warned the lack of PPE for NHS and social care staff is ‘unacceptable’.
The names of all the nurses in this story have been changed.