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In particular, hospitals depend on foreign experience in intensive care units. But the pandemic that has paralyzed much of our neighboring countries means that expertise is needed there.
– It’s almost impossible to get substitutes, says leader Lill Sverresdatter Larsen of the Norwegian Nurses Association to Dagbladet.
Norwegian intensive care nurses should be their own surrogates, he says.
– They are working their way to death. It is a very extreme workload.
– Not allowed
Sverresdatter Larsen has received comments about people who work 14 hours a day in the intensive care unit for ten days in a row.
– It’s 140 hours in ten days. In an intensive care unit, you are with patients at all times. In addition, there are extremely complex patients. It looks like a cabin in there, and then you have to be vigilant and attentive.
A shift can, for example, start at 6 p.m. and last until 8 a.m. the next morning.
– This workload is not allowed, but they are not people, so they live it as they should. The alternative is to stop emergency operations and functions.
On duty for 16-17 hours
Markus Pikkarainen is a union steward in the intensive care unit of the University Hospital of Northern Norway (UNN). Talk about major issues in daily operations.
– We are severely understaffed and completely dependent on hiring substitutes from Sweden, Denmark, Finland, and abroad in general, to keep normal operations running. We now have a severe shortage of foreign substitutes and we don’t even dare to think about the pandemic. We have enough trouble with daily operations, he says.
To make it circulate, the daily operation is based on extra shifts, hiring and work shifts.
– On the shift, it is common with eight to ten hours of workday, but there are constantly text messages about extra needs. Especially on the weekends. Experienced intensive care nurses are primarily needed on all shifts.
Pikkarainen says that overtime is needed several times a week and it is surprising that there is no message about the need for additional shifts this weekend.
FHI: Fears continue that corona pandemic will spiral out of control
– It is not uncommon for people to work, for example, both day and night, and up to 16-17 hours at a time. It is not planned for that, but unforeseen events always happen, so people stretch a lot. Without that flexibility, things would not have worked out.
– It causes extremely heavy wear and tear on intensive care nurses, and we are extremely concerned that the pandemic will hit as hard as this spring. Because where do we go to look for the people that we don’t even have enough for ordinary operations? he asks.
– Really desperate
During his 25 years in the profession, there has always been a shortage of intensive care nurses, Pikkarainen says.
– This crisis has been announced so many times. Now, in these times of pandemic, I am very concerned that the warnings have not been heeded before.
– We are really desperate to know how to deal with this if the worst case scenario occurs.
Department head Birgith Nerskogen, from UNN’s Awakening and Intensive Care department, tells Dagbladet that she understands that intensive care nurses are frustrated with the situation.
– Unfortunately, the challenges the shop stewards describe are not unique to the UNN, but are recognizable in various intensive care units in Norway.
– At the local level, we maintain a close dialogue with our union delegates to find solutions. We try to find measures within strict staff and budget limits, but we have a strong full-time culture at UNN and framework agreements on work which means that the calculation does not work.
Change the rules
On Monday, the government changed the rules so that personnel in critical social functions, such as health personnel, can enter Norway even if they do not have documentation of a negative coronary test.
– The changes are necessary for staff from abroad who will deal with critical social functions to enter the country, says Health Minister Bent Høie.
The regional health authorities have expressed great concern to the Ministry of Health and Care Services about the requirement of the test, because it has been demanding that critical personnel be obtained as incentive personnel.
– Critical deficiency
The shortage situation applies across the country, says Sverresdatter Larsen. Also places with little infection. She describes the situation as “particularly dire”.
– We have an intensive capacity similar to what we had on March 12. Maybe even worse. People are so tired. They have not had a normal vacation, they have worked every other weekend and long shifts, says Sverresdatter Larsen.
In the revised budget for 2020, the government has allocated 250 new study slots for a bachelor’s degree in nursing. 200 new study places have also been assigned for the continuous training of nurses.
– But additional intensive care education takes two years, so it can only be part of the package. Nurses should also be paid a salary that makes them choose to stay, even if it’s difficult.
NSF has warned of a critical shortage of intensive care nurses for ten years, he says.
– However, we do not have the intensive capacity that we should have had. Much could have been done, but has not been done.
– Nurses will be traumatized
Many quit
According to Sverresdatter Larsen, 1 in 5 stopped working as a nurse during the first ten years in the profession. He fears that the pressure the nurses have been under for several months will result in more dropouts.
– Based on all the inquiries I have received this year, I believe and believe that they will stop longer than usual.
Pikkarainen also believes that the leak of nurses is too great.
Inside the corona rooms: – Not a virus you can get rid of
– Overall better
Secretary of State Frøydis Høyem from the Ministry of Health and Care Services tells Dagbladet that more than 3,000 health service employees have completed in-house training in intensive care for corona patients.
– I am aware that internal training does not replace the competence of an intensive care nurse, but in general, the competence of intensive care is better now than in March / April, he says.
– Now you have changed the entry rules, but NSF thinks it will be a problem to bring in personnel anyway. what do you think about it?
– We are working long term with this. Among other things, work is underway to train more staff with intensive competence, says Høyem.
It also notes that the government, in addition to additional study places in the 2020 budget, launched a plan the previous year for 80 new specialized nurses a year.
Alarms: – Service neglect
– But why hasn’t this problem been addressed before?
– The government has dealt with the challenges associated with recruiting, developing, and retaining nurses over time. In the Storting National Health and Hospitals Plan 2020-2023 report, which was launched last year, nurses and health professionals identify the staff groups they will focus on in the future. The corona pandemic has shown us even more clearly how important this is, says Høyem.