– I sleep worse at night – VG

– It’s full of battery.

This is what nurse Hege Gundersen tells intensive care nurse Kari Bue, who addresses patients with severe coronary heart disease in the Rikshospitalet Emergency Department in Oslo.

To do your work with the corona patients in the room, you must have a clean air supply through a hose. It is this machine that has a full battery.

You must have it to function on the job you need to do. Bue can stay inside patients for many hours before he can take a break.

He does so with an infection coat, a hood with a covering in front of his face, and gloves. Access to infection control equipment is better than it was when it was at its worst this spring.

On Tuesday, there are ten corona-infected patients at Oslo University Hospital, of which Rikshospitalet is a part. Three of them are receiving intensive care and one of them is on a ventilator.

A total of 53 corona-infected patients are in Norwegian hospitals. This is a significant increase from the lower level on July 23, when only three crown patients were admitted.

New top

Employees of the Emergency Department have already begun to notice the increase in pressure.

– I’m worried, because I don’t know what the top will be like and when it will arrive. We can’t learn that from time to time. If we do not handle the infection situation, we will have to pay for it with patients who remain in the intensive care unit for up to six weeks, says clinic manager Øyvind Skraastad.

– In the spring, I thought that many of those we had would die because they had been lying for so long. Usually it is a sign that we are not getting them back, he continues.

Skraastad describes the sickest corona patients as very resource-intensive for employees, both because it requires full infection control to care for them, a lot of advanced treatment, and because they often stay around for a long time.

This should be handled at the same time as staff caring for the other seriously ill patients who are admitted.

– It is this balance that is difficult for us now. We have a capacity that is not too wide. We typically have about 90 percent coverage here in the intensive care unit, but daily management gives us the ability to turn around, he continues.

The fear is that the infection that is in the eastern Norwegian population will reach hospital employees, potentially infecting many more at work.

– If I have to solve what is more difficult, then there is a great element of infection among the employees and they feel that it is risky to go to work, he says.

Difficult decisions

He talks about how his department this spring had to adjust planned activities to be able to receive the sickest patients. For that reason, they have a delay that they must make up for. Now they are preparing for it to happen again.

– Covid patients need very advanced and immediate help. We must be at the forefront all the time, he says.

So both employees and facilities must be prepared to receive more coronary patients. In the Emergency Department, this means that so-called cohorts are established where the sickest corona-infected are treated together, making it easier for employees with a full infection control kit.

It’s everyday life for chief physician Bjørn Löwhagen and intensive care nurse Hilde Nyrud.

– It really is the same as this spring. Now the numbers are starting to rise and we are preparing for a cohort. But this time we know what we’re looking for, says Nyrud.

– We reached a point where we are very pressured. We may be on our way there, says Löwhagen.

Pain threshold

Now Skraastad fears that the four intensive care patients will double daily in the future. If they reach about ten coronary patients in intensive care, they will most likely have to start downplaying parts of other hospital operations.

– It is my job to make sure that we do not take the risk with what we expose.

– If there is a wave like the one there was in some European countries this spring, we will be able to drive in a way that we do not fully understand in its extent, says chief physician Löwhagen.

On Tuesday, more than 18,300 people were infected in Norway, an increase of 434 from the previous day.

– I am concerned about these infection rates, says Skraastad.

– Do you have a pain threshold?

– Yes, we do, answer.

– The horror scenario is having to choose between patients, who should get a respirator. What I fear least this time is that we will run out of infection control equipment, says intensive care nurse Nyrud.

In light of rising infection rates in Norway and the second wave sweeping across Europe, Skraastad describes the hospital as being in a continuing emergency situation.

– It affects us all. As a leader, I am more present and sleep less at night, he says.