Critical shortages of ICU staff mean bottlenecks and untrained nurses

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The SA Medical Association has expressed concern about inexperienced medical staff being deployed to ICUs, while KwaZulu-Natal Health says it cannot increase the number of high care beds because of the shortage of specialist nurses and doctors.

"What came to SAMA's attention is that in the ICU, which is a highly specialised unit, you cannot employ any nurse in an ICU ward – you need to be trained for that. "If you put staff in a unit they aren't trained for properly, you not only compromise the patient's care but you are also taking her dignity away from her because she (the nurse) doesn't know what to do and she is too afraid to say 'I don't know' because she might become a statistic of unemployment," SAMA chair Dr Angelique Coetzee is quoted in News24 as saying.

Coetzee added that it was also important that those who were in management positions in the health sector to have experience.

Coetzee said that there needed to be a probe into the abolishment of unfunded medical vacancies at hospitals – an attempt to make hospitals and provinces look "artificially better on paper" because there aren't any unfilled vacancies. "One of the indicators at the national department of health is your vacancy rate so if your vacancy rate is artificially being brought down to a level of 1-2%, by taking the unfunded posts and abolishing them, then you look great on paper. Then it seems there aren't a lot of posts that were put on a moratorium."

Another News24 report notes that KwaZulu-Natal Health has been unable to increase critical care and high care beds for COVID-19 patients because of a shortage of specialist nurses and doctors. The Times reports that this is according to Health MEC Nomagugu Simelane-Zulu, who, together with the head of department, Dr Sandile Tshabalala, appeared before the portfolio committee on health to give an update on health-care services in relation to COVID-19.

While the department has recorded an overall bed occupancy of 56.3%, the impact of the virus has been devastating on health-care workers, with 1,694 in isolation and 724 in quarantine. The Times reports that this has resulted in dire staff shortages.

The MEC told the committee that while the province learnt from the first wave and had made strides in its response plan, challenges remained. These included an inadequate supply of oxygen due to limited capacity for bulk storage, inadequate supply of oxygen cylinders and facility infrastructure. Another challenge was increased mortality due to delays in seeking medical care by COVID-19 positive patients.

According to The Times, the Health MEC said the provision of oxygen remained precarious, due to a shortage of cylinders from Afrox depots, the only supplier.

 

Full News24 report (Open access)

 

Full report in The Times (Open access)

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