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On the last day of August, there were 755 new COVID-19 cases out of just 6,943 tests performed. Another 43 deaths were reported from infection with the new coronavirus. 506 patients were admitted to intensive care, a record. However, forecasts show that, in a short time, if the trend continues, we will exceed 800 of cases in serious condition. However, Romania does not have enough medical personnel for such a scenario, and authorities at the highest level say that in ATI there is a risk of a blockade. How are doctors coping now and what are your biggest fears in a “Patient in Romania” campaign report?
“The only intensive care unit that can provide care for severe forms is here, and personally there are none.”
“I see a bleak future, because even when you come to the hospital … ambulances are always circulating in this city”
In the voices of the doctors Ploiești County Hospital they feel fear and despair. Not once did they think of the darkest scenario: no more intensive care facilities and so many patients that there are not enough staff to care for them. And I am not far from any option.
Romania has only a quarter of the need for intensive care physicians
For patients to receive adequate treatment, 3,000 intensive care doctors would be needed in Romania. But only a quarter remains. There are 850 more residents, but they need years of training.
“If someone gets sick from the staff, it will be almost impossible to do the work schedule and ensure the number of people, because I have one on the shift,” says Gabriela Nacu, head of the ATI department, with concern.
And this happened. We found two infected nurses in the intensive care unit. Doctors say that it is very difficult for them to see the colleagues with whom they fought against this virus in the hospital bed.
Patient: “I couldn’t breathe at all! The feeling was deadly “
– I came in a very serious condition and was very well cared for and I have all the respect for all the staff! I couldn’t breathe at all, but now I’m fine, says a patient. He talks quite loud and still needs extra oxygen.
– How did you feel when you were infected?
“Death death.” But I was lucky with the doctor and all the staff, who are superlatives, here is my second home and my family!
“We take care of all the patients, but when the patient becomes a man who has been with you for years, the situation seems to get a bit complicated. The emotional factor comes in, you really want it to be good and we do absolutely everything we can. It is always more difficult for the staff, they are like a family member, a family member ”, confesses Dr. Gabriela Nacu.
Doctor: “We are all exhausted, we are at the end of our strength!”
Faced with an unprecedented situation, overwhelmed by the excessive number of patients, the doctors at the Ploiești County Hospital needed help. Ioana is a resident and came from Iași to work in Ploiești. She is aware that it takes a lot of staff for patients to be really well cared for.
“It is quite difficult to attend to covid patients, auxiliary personnel, medium personnel, but also doctors in very few numbers, since this is not a university hospital, they do not have resident doctors, it is totally insufficient for a doctor to be on duty both in covid and in no covid, it’s impossible, it’s a huge amount of work. And you don’t really have time to care for patients like you should. The intensive care patient needs a lot of care, clinical and paraclinical, and you don’t have time to do them all, ”says Ioana, resident physician.
“I cannot describe the effort in words, all the patients are serious. Everyone needs latrines, food, mobilization, they must be made to breathe again on their stomachs at 4 o’clock. We are all exhausted, at the end of our faculties” , confesses Dr. Gabriela Nacu, head of the intensive care unit of the Ploiești Regional Hospital.
The “TIR” for intensive care, a machine in which working hours are not counted
Mobile intensive care units have been installed in hospitals that have become too small for patients in serious condition. So it is in Ploiești.
In this mobile hospital, a mobile unit installed near the covid section of ATI, the unit has 8 beds with a ventilator, oxygen and all other necessary devices.
“Here is a container where the personnel are decontaminated. The world must see the conditions. We have to go through the mud, through the rain, when it rains, and here you go in, leave your equipment at the door, you can shower, change your uniform and leave everything outside, to go to the clean sector ”- explains Dr. Nacu.
And even if this mobile unit brought extra beds, the staff is the same. That is insufficient.
“I have a nurse who takes care of the six patients and an orderly,” says the doctor.
“I’m here for 6 hours, in the intensive care truck. Covid patients, now we have 6 patients, we had 8 and 9, there were 11. At 6 hours a colleague from intensive care comes and changes me, I’m from the UPU. I undress and dress again to go to the COVID polyclinic, where we have other patients, ”explains Nicoleta Mariniță, Emergency Assistant.
12 hours in mono, no water, no bath, nothing
“I had situations where a nurse spent 12 hours in a suit with no water, no toilet, nothing. It is possible with an effort, I don’t know, superhuman. I sincerely admire my staff, because they all understood that we are necessary and that we have to do this, but I emphasize, I don’t know how much we can do this, ”says Dr. Gabriela Nacu.
COVID-19 patients need more oxygen than other critically ill patients. And its treatment becomes even more difficult in these conditions. In the mobile intensive care unit in Ploiești, there are 12 beds, but 12 patients cannot be treated there at the same time because the oxygenation system is not working.
“When we tried to put more patients in the mobile unit, all requiring ventilatory support and at that time we also had three patients who needed high-flow oxygen in the mask, there was a desaturation in absolutely all the patients. We had to transfer the patients to the hospital one by one. We limit ourselves to 8 beds with 8 patients who need ventilatory support ”, explains the doctor.
“We are robots, we have been working like this since March”
In Prahova County, the number of patients infected with the new coronavirus exceeded 3,000.
“We are robots, we have been working like this since March,” says assistant Nicoleta Mariniță.
“It’s hard for me to think about the next period, because the number of cases increases every day,” confesses Dr. Gabriela Nacu.
Web edition: Luana Păvălucă
