Into the Future

Posted on 8 June 2021

A global pandemic and unprecedented public health crisis has left our operational systems and frontline staff stronger than ever.

For the past year, hospitals across the world have fought to manage the effects of a life-threatening and clinically mysterious disease.

Here in South Africa, sudden waves of positive COVID-19 patients have tested Mediclinic’s operational capacity and taught us a great deal about our fundamental responsibility to offer expert care, even amid a global pandemic.

The good news: our staff and our systems have grown stronger than ever.

Mediclinic’s value system has always been sound, says Dr Gerrit de Villiers, Chief Clinical Officer: Mediclinic Southern Africa. “But in a crisis? A state of disaster? We had to rally. We have had to be agile, and resilient. We’ve had to work harder, longer hours, as a team, using a science based approach outside of our comfort zone. We’ve had to evolve.”

At the forefront of that value-based evolution, of course, is the division’s team of nursing staff. Dr Estelle Coustas has close to 40 years experience in various nursing management roles. In her position as Nursing Executive: Mediclinic Southern Africa, she’s been assisting staff at the frontline of the COVID-19 pandemic, strategising and managing the nursing teams’ response to sudden influxes of positive patients.

“I’ve been involved in supervising the development of the Mediclinic nursing protocols for a long, long time,” she explains, “and over the years that detail has changed frequently. We regularly adapt our processes to improve in many areas, as the need or new evidence arises. COVID-19 presented us with a challenge like no other”.

When the coronavirus disease outbreak was declared a pandemic in March 2020, Mediclinic reallocated and trained teams of nurses to work in the dedicated COVID-19 units, where they were responsible for treating COVID-19-positive patients.

At  first, Dr Coustas says, the nurses were excited about acquiring new skills. “Nursing is a profession that naturally puts patients first. Remember, nurses are in many ways a patient’s primary contact in any treatment journey – we are at their side every step of the way, from admission right through to discharge. So when the pandemic hit us, the teams were passionate about being part of the solution.”

Then the stress set in. Nurses who had worked for years or decades in specialised units were unaccustomed to the unique challenges of treating critically ill patients. They were also placed under severe strain by the sudden rise in patient volumes. “Nurses were placed in a tough position,” Dr Coustas says, “providing care to patients with an infectious disease, while trying to avoid becoming infected themselves – and that takes its toll. The fear is very real”.

The work is also energy-intensive and emotionally draining. Many of the patients need to be turned onto their stomachs while sedated, in order to distribute oxygen more evenly throughout the lungs and improve overall oxygenation. That may sound like a simple enough procedure, but proning a patient on a ventilator takes up to 10 nurses at a time – and it needs to happen multiple times a day, per patient.

What happened next?

“We learnt, and quickly,” Dr Coustas says. “Our organisation has traditionally been slow in effecting change, preferring to search for evidence and consult widely before decisions are taken. This pandemic has taught us the value of agility.”

Mediclinic adapted by supporting, empowering and upskilling staff and sourcing high-quality personal protective equipment (PPE) in a matter of days. We also designated counsellors at hospitals as a contact point for all hospital staff to turn to, in group and individual sessions, day and night. Hospitals were kept up to date on new clinical best practices as evidence about the disease emerged.

These adaptations are designed to help mitigate the effects of further surges. They empower staff to stay abreast of developments and tailor their care appropriately, patient by patient. “Making and changing plans, adapting to new surges and new variants, hasn’t been easy,” says Dr de Villiers, “but it has brought us together. Today, our nurses are tired, it’s true. But they are hopeful about the state’s vaccine rollout programme. The work they’ve done is exemplary. We are proud of them”.

Mediclinic staff are working long hours in sometimes unfamiliar roles. These are dedicated professionals fighting the effects of an unpredictable disease. In the face of all that, they remain committed to providing compassionate, clinical care – now, and in the future.