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At Karolinska in Huddinge, an intensive care unit for covid patients has been put into operation. The influx of intensive care patients is now increasing and several hospitals in the Stockholm region are beginning to peak.
Now equipped to expand the number of Iva sites. But the tipping point is staffing, and it is now clear that the hospital is reintroducing long work shifts and scheduling staff into 12.5-hour shifts.
– We started with volunteering, but now we also need to assign employees to it. So of course we will do individual assessments and for example we will not force single parents to work 12.5 hour shifts, but otherwise it will sadly be normal for some time, says Björn Persson, manager of intensive care operations in Karolinska.
In Karolinska, the hospital has opened a new intensive care unit for covid patients in Huddinge with 18 seats, and now a new ward is being prepared to open in Solna. In total, this means that Karolinska, which now has 55 intensive care places at the end of the week, is gradually increasing by 25 places, to meet the growing need for covid care. As of Tuesday, the hospital had 108 inpatients with established covid-19, of which 15 were in the intensive care unit.
Intensive care nurse Katja Fogelberg describes that she is eager to start working again on the long shifts of covid care. “I am tired of the soul since last spring.”
Photo: Roger Turesson
Employees were informed on Tuesday that 12.5-hour shifts will be reintroduced. The difference with this spring is that it now takes place within normal weekly working hours and not with a 48-hour week as in the spring crisis situation agreement. One explanation is that intensive care has lost staff since last spring.
The intensive care nurse Katja Fogelberg, who worked in the covid intensive care unit this spring, took her first shifts in the covid intensive care unit in Huddinge on Monday.
– It is a lot of anxiety to work these long shifts in protective equipment. We’ve seen the apartment ready, but somehow we hoped we wouldn’t end up there again. Many fear this is just the beginning and is only escalating, says Katja Fogelberg.
When it became clear that everyone was forced to work long shifts, reactions were both resignation and anger. She says that she now has to work 34 hours a week, but describes that she herself, despite having had a vacation, does not feel rested after spring.
– It’s like I’m tired in the soul. What we experienced this spring was like waging a war and you are not ready for a new war.
At Karolinska in Solna, preparations are underway for the new intensive care units that will open during the week. Head of intensive care operations Björn Persson testifies to a pressure situation.
Photo: Barzan Dello
Björn Persson says that it feels important to clarify the panorama of the situation provided by the Public Health Agency and the National Health and Welfare Council, among others, that intensive care still has a large idle capacity. On Tuesday, the National Board of Health and Welfare announced at the joint press conference of the authorities that the capacity of places in the country is good and that there are 30 percent of vacant care places in intensive care. But Björn Persson says that the description does not correspond to reality, as intensive care units are partly spread across the country and partly that the burden of covid care is a reduction in the level of both intensive care and of the work environment.
– We are very concerned about how the situation will develop in the coming weeks. Even in normal situations, we often find it difficult to staff our 38 intensive care units in Karolinska.
He thinks it is difficult to compare the current situation with the spring.
– Then we were close to a state of war, and it is only possible to work like this for a limited time, says Björn Persson, adding that he is concerned about long-term intensive care staff.
“We were close to a state of war then, and it’s only possible to work like this for a limited time,” says Björn Persson, manager of intensive care operations at Karolinska, about the spring workload.
Photo: Barzan Dello
– I am concerned that my staff will consider whether they will want to continue working in intensive care if at some point they are ready to work under these conditions.
Björn Persson also says that the situation that now looms has to do with the authorities’ measures to reduce the spread of the infection, which, in their opinion, are late.
– They should have been taken several weeks ago, because it takes three to four weeks before the increase is visible in medical care from the moment the spread of infection increases.
Ingrid Allerstam, elected representative of Vårdförbundet, who is herself an intensive care nurse at Karolinska in Solna, says that Vårdförbundet has not reached an agreement with the employer about long work shifts, which is why Karolinska has so far concluded agreements one-on-one with nurses to partially work on the recently opened grand opening. at Karolinska in Huddinge for some compensation. To cope with the staffing, Solna’s nurses have moved there.
– And now others will also be ordered to work. We are very, very concerned about our members. The employer has a huge shortage of intensive care staff, but when it shows it now, we think it has been delayed in planning because it has had more time to plan than last spring, says Ingrid Allerstam.
She says that man from the employer’s point of view, it is unclear how many nurses are missing or what the long-term plan for staffing is.
Karolinska in Huddinge is preparing to expand the number of Iva places, but the critical point is the question of personnel.
Photo: Barzan Dello
Ingrid Allerstam describes a different situation than last spring. Over the past weekend, the intensive care unit in Solna was understaffed, despite the fact that Karolinska did not start performing covid care in that part of the hospital at the time.
– Hardly a day has gone by all fall without us getting a text message about the extra work to fill the staffing gaps. In many ways, it is more worrying now, because we are much more tired and less. And if now you go from being a volunteer to ordering, then people who do not have the strength of strength.
Director of Karolinska Hospital On Tuesday, Björn Zoëga held a meeting with the hospital’s operations managers and thematic managers when DN was present. There, the increasingly pressured situation with covid patients was addressed. In Karolinska, usual care is also affected and, starting this week, operations in both Huddinge and Solna will be canceled to free surgical personnel who can work in the intensive care unit.
During the meeting, Zoëga said she had produced her black book with notes taken at the start of the pandemic in March.
– What I said then still applies. We must remain calm, structured and based on facts.
Björn Zoëga tells DN who understands that these are feelings of discomfort and anxiety associated with the return to the care of seriously ill covid patients.
That twelve-hour shifts are a reality again, Zoëga comments the following:
– It is a difficult situation. Our staff can work fewer, but longer shifts than normal. We try to the extent possible to schedule work shifts so that employees’ working hours do not exceed the number of hours they work during a normal week. That is our goal. We must ensure that staff can cope with the entire pandemic.
