Hospitals are forced to postpone heart and cancer operations due to overflowing ICs
This is evident from a tour of hospitals and IC heads. There are now nearly 800 corona patients on the IC, the highest number since the first wave. To this are added the hundreds of regular IC patients. On Friday, the National Acute Care Network decided to further scale up the total number of IC beds, from 1,450 to 1,550 beds.
This is at the expense of other care. Until now, hospitals mainly postponed operations for problems that do not pose an acute health risk to the patient, such as knee and hip operations. Annoying enough, says Diederik Gommers, IC doctor and foreman of the Dutch Association for Intensive Care. Having to go on for months with a bad hip means living with pain for months longer.
“But we said we don’t want to scale down operations that you really can’t postpone for more than six weeks, such as open-heart surgery or some cancer treatments,” he says. ‘We are now at the point where we can no longer live up to that.’
Class 3 care
The Radboudumc in Nijmegen, among others, is out of necessity to scale this so-called class 3 care. ‘The operational teams check every morning what is possible, whether there is room on the ic for an operator,’ said a spokesperson. “But they also have to look at what is not possible.”
The situation is similar in UMC Amsterdam, says Armand Girbes, head of intensive care. Operations are being postponed, IC nurses have to divide their attention over more and more patients. ‘Every time we go a step further, while you actually think: that’s not possible.’
The root of the problem is not the number of beds available for the ICs. Breathing and monitoring equipment is also readily available, says Diederik Gommers. There is simply a lack of staff.
This is partly due to the high level of absenteeism due to illness. Some of the healthcare workers dropped out because they themselves contracted covid-19 and have not yet recovered from it.
But there is also a lot of fatigue and psychological problems, the hospitals say. Doctors have to treat more patients at the same time than usual and nurses who normally stand in places where they rarely see people die are put on the IC. ‘The rack is out,’ says Gommers. ‘In some hospitals the absenteeism rate is above 10 percent.’
‘There are nurses who have only been off for a few days since the summer vacation. Or who worked extremely many night shifts in recent weeks, ‘explains Peter de Jager, ic head of the Jeroen Bosch Hospital in Den Bosch. Here too, class 3 care is now being scaled down.
The atmosphere between colleagues is also good, he emphasizes. ‘But it is becoming a war of attrition. When is the end in sight? ‘
Here comes the emotional weight of working on the ICs, under greater pressure than usual. Employees have trouble sleeping and are unable to concentrate, says Girbes of UMC Amsterdam. The university called in professional help from the start, he says, including a psychologist who assisted next of kin after the MH17 disaster. ‘He knows how to handle trauma relief. But it has not prevented people from dropping out. ‘
In addition, there is unrest within the hospitals because only a small part of the healthcare staff has been vaccinated, says a spokesman for the Bernhoven hospital in Uden, among others.
This weekend, the healthcare organizations published a call to the cabinet to use a larger proportion of the available vaccines available to healthcare personnel. According to the call 17 percent of healthcare workers who provide direct patient care in hospitals have been vaccinated.
The staff at the ICs and the nursing wards with covid patients have often had an injection. “But the cardiologist who is called to perform CPR can also come into contact with a covid patient,” said Bernhoven’s spokesman. ‘We always have to explain to everyone who is next and when. So that is added: how do we keep the staff together to get the job done? ‘
It is now really important that the number of IC patients will decrease, says Diederik Gommers. He thinks 1,600 beds is the absolute maximum. “The 1,550 we have to go to now is dangerously close to that.” If more beds turn out to be needed, according to him, code black threatens; a lack of ic beds. Then hard choices have to be made about who can and who does not have a place on the ic.
Still, he wants to emphasize how important he considers perspective to the rest of society. For example, he warmly welcomes the experiments with quick tests to see whether you can safely organize activities with them. ‘As long as it doesn’t lead to an increase in infections. People should not get the idea that things are now all going well. We have never had it so hard within the walls of the hospitals. ‘