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On Tuesday this week, the hospital director, Øystein Mæland, told NTB that Akershus University Hospital had no capacity problems.
Days before this was declared, Ahus sent several patients to other hospitals because his intensive care unit was full, Ahus union steward and chief physician Ståle Clementsen tells Dagbladet.
On Friday afternoon, Ahus called a press conference, where Mæland acknowledged that they have had several episodes with a pressured intensive care situation.
– When I say that we have no capacity problems, it means that we have a capacity that we can take on if we do what we have done now, said Mæland.
CAPACITY: The hospital director, Mæland, meets with the press to report on the hospital’s intensive capacity. Photo: Hans Arne Vedlog / Dagbladet
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– Terribly bad
It was on Thursday afternoon that VG was able to report that the Oslo University Hospital (OUS) had taken care of severely ill crown patients from Ahus in the past 24 hours because the progress was too great.
Jon Henrik Laake, head of the Norwegian Association of Anesthesiology and Rikshospitalet’s chief physician, is taking a hard line against Mæland. Describes Ahus’s intensive care capacity as terribly poor.
– Here you see a man who has not done his job, writes Laake on Twitter and attaches a screenshot of the VG case with a photo of the director of the hospital.
For Dagbladet, make:
– The intensive capacity at Ahus is terribly poor compared to the population base for which they are supposed to be responsible. None of the other large hospitals has such poor capacity relative to population. This means that company management has consistently downgraded intensive capacity relative to other activities.
AHUS: On Thursday it emerged that the capacity of the intensive care unit at Akershus University Hospital had exploded. On Friday, the hospital director reported that three more corona patients were transferred from Ahus. Photo: Ørn E. Borgen / NTB
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– on knees
Laake notes that a year has passed since the pandemic hit Norway.
– This spring, the doctors and nurses in Ahus’s intensive care unit managed to mobilize, thus tripling their capacity. When they have now approached the hospital to try to maintain emergency services, considering that there could be new waves, they have encountered a coldness. Now we see the result, he says.
As of Thursday, Ahus had 28 corona patients, eleven of whom were in the intensive care unit, according to VG.
– 11 patients, in a hospital in charge of 600,000, is what it takes to bring the hospital to its knees, says Laake.
Zero new intensive care units: – Incomprehensible
He states that CEO Mæland has been absent from the aforementioned discussions on emergency preparedness.
– They have mostly been happening at the level below him. You have to go further down to find those who have really been and done the work. When they have tried to point out that additional preparation is needed, they have not been greeted with understanding. This is because the hospital is trying to make up for lost time this spring, when many planned operations had to be postponed.
– Completely wrong
According to Laake, Ahus has ten places for ordinary operations in the intensive care unit. The average capacity in Norway is 5.4 beds per 100,000 inhabitants.
– For Ahus with responsibility for 600,000 inhabitants, this means 32-33 intensive care beds. The average for OECD countries is 12 beds per 100,000 inhabitants, so we have a long way to go, he says, adding:
– But the capacity in Ahus is like in a poor country in Eastern Europe.
– Fortunately, it is completely incorrect and an unreasonable way to discuss this question, says the director of the Mæland hospital about Laake’s claim.
After the press conference, Mæland tells Dagbladet that they now have a higher capacity, in line with the burden of infection and that the number of hospitalized patients has increased.
– We have implemented measures to deal with this on an ongoing basis. We have gone to a yellow emergency and we have closed the planned surgery to mobilize personnel from those areas to our intensive monitoring areas.
You want to build capacity
Mæland emphasizes that he believes the hospital has done its job every day during the pandemic.
– It applies not only to me, but to everyone who worked in this hospital to handle a demanding situation. So we can discuss what is the correct level of intensive capacity under normal circumstances, but we must take that discussion when the pandemic is behind us, he says and continues:
– So I have a strong desire that we strengthen our intensive capacity in relation to what we have today.
He believes that this is not the discussion now, that it is more about how the hospital is mobilized to attend to “the acute burden and what can still be a burden for the summer.”
– The infection is increasing in Oslo. What would you do if Oslo also runs out of capacity?
– When you have been afraid of it, you have introduced very strict social measures. If we were to move into a situation that goes in that direction again, I am sure that we will once again have strict social measures that can help lower this peak. Even though we have plans, no one wants to be aware of those plans, because then we will all get pretty hurt, says Mæland.
Oslo infection: – It’s heavy.
Low capacity
– For a long time, we have had very little capacity. We have a small number of intensive care beds compared to the population base, says Ståle Clementsen, union steward for Ahus and chief physician at the Orthopedic Clinic.
When COVID-19 arrived in Norway this spring, the hospital opened space for more intensive care beds and provided rapid intensive care training to other health personnel. Describes qualified personnel as a vulnerable resource.
– The capacity we had this spring has been reduced this summer. Ahus has had many corona patients since the second wave started over the summer, but as the only hospital it has not been on hold until now. It has been almost normal operation. It’s about us going beyond the regular schedule, but it has meant that the staff that was brought into the intensive care unit this spring have not been available.
He says there is no doubt that intensive care unit employees for years have thought that capacity has been too poor, without the hospital doing anything about it.
– You will meet very few employees who work with patients at Ahus who disagree.
The hospital has believed they have been in control, according to Clementsen. According to him, the reason they are not hiring again now is that there is nothing else to collect.
– A paradox
– For a long time there has been an infection on the rise in the Oslo area. What do you think about employees not being heard?
– It is very frustrating for employees to have to resort to hindsight. In such a situation, it begins to become precarious not to be heard. I and many others have long believed that intensive staffing should be strengthened. But of course it is difficult, eliminate elective surgery, it will go beyond patients who have less acute conditions that also need treatment.
– Laake points to CEO Mæland and thinks he hasn’t done his job. what do you think about it?
– A few days ago, Mæland told NTB that we have no capacity problems, but that in a critical situation we will be able to obtain assistance from other hospitals. In the days leading up to this, Ahus sent several patients to other hospitals because our intensive care unit was full. The director thus acknowledged that the crisis plan had already been implemented, at the same time stating that there were no capacity problems at Ahus. It seems to me a paradox.
Towards total closure at Ullensaker
Not applicable to intensify
Mæland explained at the press conference that the hospital has the opportunity to mobilize the staff they need if the pressure increases, but that would mean they have to stop doing anything else.
The hospital director also explained that if a hospital experiences particularly high demand, other hospitals in Health South-East will help to receive patients.
Cathrine M. Lofthus, CEO of Helse sør-øst RHF, says in a press release that it will not be relevant for Ahus to delve into emergency preparedness before the capacity of other health trusts and hospitals has been used.
– Regular meetings are held under the auspices of the Oslo University Hospital, which will help to ensure that the full capacity of intensive care is used in the best possible way and so that the burden of the pandemic is distributed between departments and hospitals, it says Deputy General Manager Jan Frich at Salud Sureste.
