CUMH employing a patient-centred approach even in the face of Covid-19 adversity

In a world where human is limited and normal hospital procedures required major changes, staff at Cork University Maternity Hospital (CUMH) worked hard to ensure that people in labour could still savour the magical moments of childbirth, even as the chaos caused by the pandemic raged on.

When the COVID-19 pandemic reached Ireland’s shores, hospitals began cancelling activities that were not of the emergency or acute nature.

While many elective procedures and appointments were postponed, childbirth was one aspect that could not wait.

Staff at CUMH were quick to adapt to the new normal, erecting tents outside the hospital to check patients’ temperatures and symptoms before entry, and becoming adept at donning personal protective equipment for labour.

Sadbh Creed, a nurse at Cork University Maternity Hospital (CUMH), explained that once the pandemic arrived in Ireland, healthcare staff became “ aware of the added threat and danger in work”.

“We were dealing with this added stress at both work and home, and we were trying to make sure our patients didn’t feel that,” she said.

“That’s hugely important, especially in the maternity hospital where we are not usually taking care of sick people but people who are experiencing this fantastic moment in their lives and we want to ensure they fully experience it.

“For us, the focus was ensuring people were safe but that they could still experience that little bit of magic even as the world around them was in chaos.” Sadbh explained that effective screening processes outside the hospital ensured that not all patients had to be seen in full PPE, but that CUMH staff became adept at using it while still providing quality care to patients.

“CUMH was on top of things quickly,” she said.

“Very early on, we started checking people outside the hospital.

“We had tents outside where people were getting their temperatures checked - we had the screening processes in place,” she added.

“That meant that not everyone was seen in full PPE.” In cases where PPE was required, Sadbh itted it felt “alien” to begin with but that both staff and patients became used to it.

“Usually, we wear protective gowns and things like that but for there to be such a physical barrier between us when it’s such a personal form of care was definitely very strange for us,” she said.

“What was also particularly difficult for us was seeing those on wards who were not in labour spend a lot of time on their own.

“When people are critical or in labour, they’re surrounded by people but those who weren’t critical or weren’t in labour spent a lot of time on their own,” she added.

“They couldn’t have visitors because of the restrictions and we didn’t have the staffing to stay with time so they spent a lot of time bored and lonely.

“That’s very difficult for us because midwifery and nursing is not just about medical care and treatment - it’s much more personal than that.

“We get to know our patients, spend time with them, chat to them - it’s one way of being able to tell their condition - we can see if they’re improving or deteriorating quicker that way.

“There’s a lot more than just handing out medication and checking temperatures.

“While the PPE didn’t stop us caring for patients, it certainly brought it home to patients, particularly at the start, that there is a pandemic out there and I think it might have startled them a little.

“For some people it was frightening and we worked hard to make them feel comfortable and safe.” Staff at CUMH have been praised by GPs in Cork in recent months for their patient-centered approach even in the face of such adversity.

Looking to the future, Sadbh highlighted the need for hospitals to be able to continue offering outpatient and elective appointments as well as screening programmes, even in the event of a possible second wave and busy winter flu season.

Sadbh said staff at CUMH have worked hard to reduce appointment waiting lists.

“We managed the first wave of coronavirus well but lots of other aspects had to be put on hold to enable us to do that,” she said.

“We need to find that balance between continuing with the normal workings of a hospital and dealing with a possible second coronavirus wave along with a busy winter flu period.”