Only a few weeks ago we were very able to say ‘business as usual’ in care and nursing homes across the country but alas no longer. There are somewhere between 42,000-48,000 nurses working in social care – most in nursing homes, some in non-nursing care homes and some in other roles. All of whom have had their work and lives transformed since the advent of the Covid-19 pandemic.
I am a mental health nurse, owner of two small care homes with outstanding CQC ratings in both and also have a lead role in Devon with the NHS Sustainability Transformation Partnership representing the care home sector in how our work is seen as partnering all that we are doing to address the response to the virus. Life has changed so much in such as short space of time. I have often said there is no ‘off button’ as a ‘hands on care home activist’ – it has never been more true than now
Since the advent of the virus we have redoubled our already stringent home policies, procedures and everyday practices following the rapidly changing evidence, advice and guidance from our government and experts. Our priority in my homes has been to maintain ordinary life for our 36 residents as much as possible seeking to not cause alarm or anxiety. Many of our dwellers live with advanced frailty and dementia and homely daily life is so important to them. We too, however, need to be gearing up for the probability of seeing the virus arrive and where we must escalate still further a robust systems of care.
Our relationships with our primary care colleagues have strong, well-established principles of shared care, reciprocal respect and an ‘in it together’ ethos – however, since the outbreak we have needed more regular conversations about safe visiting, restricted access for all – family loved ones and others, and reviewing basic care needs seeking to ‘skill up’ non-nursing care staff to be better able to manage, for example, some basic observations and care interventions not previously carried out thus reducing demand on NHS staff and also the risk of putting our residents into contact with potential exposure to the virus too. Using telemedicine and new communication systems with people remote working is also becoming the norm – a probable lasting legacy and positive bi-product of these turbulent times.
I have adapted the former NHS lead nurse, Jane Cummings 6Cs (care, compassion, competence, communication, courage and commitment) to shape and guide our approach to the essential aspects of dealing with the virus. These are:
We are also founding members of a long-established care provider-led collaborative supported by our local Academic Health Science Network, The ‘South West Care Collaborative’. We have always subscribed to the need for ‘share to learn’. In respect of how we are facing Covid-19, this has meant us all uniting against the common enemy – being reflective on our own work and policies and sharing these fully and openly.
Contingency planning is not easy when things are changing so much – our top tips for nurses have also included – keeping up to date, being prepared, being role models and leaders and retaining a sense of purpose and focus on safe practices. Though often forgotten – nurses and care staff in care homes can be missed when headlines are shared and speeches of thanks are made. Our role in caring for many of the most vulnerable must not be ignored or underplayed. It’s worth noting there are significantly more beds in care and nursing homes than in hospitals dealing with more of our older people.
One of the longer-term positive outcomes when we are through this coronavirus crisis, I am sure, will be a strengthening of the bond between health and care, with the broad church of nursing leading the trend with elevated status for us all.