'We cannot do miracles' - Yorkshire nurse's fears for colleagues as health service is pushed to the brink
Joan Pons Laplana, a Digital Senior Charge Nurse at Sheffield Teaching Hospitals, was trained in delivering the coronavirus vaccine on December 1 last year, and has been picking up shifts in his “spare time” to administer it.
But he said he feared for already overworked colleagues, who were now being asked to deliver the vaccine while seeing a new wave of coronavirus heading towards Yorkshire, combined with the usual winter pressures piled on the health service.
Mr Laplana, who was named Britain's nurse of the year in 2018 - in part for his role in ensuring hospital staff in Norfolk had ther flu vaccine - said: “On top of having the usual January craziness, plus Covid, Mr Johnson wants us to vaccinate two million people a week,” he said.
“I’ve had my vaccine training and the plan is to go to the Sheffield arena quite soon but the problem is, where are the staff going to come from? We’re still needed at the hospital because if not, we cannot guarantee the safety of patients. In London they’ve started diluting the ratio in ICUs and I have colleagues telling me they have three, four, sometimes five patients to care for in ICU, that is dangerous when the ratio has always been one-to-one and it’s one-to-one for a reason, having triple the amount of work is dangerous.”
And he said the health service was faced with an impossible choice.
“What do you do? Do you reduce the number of staff at the hospital and put patients there at risk? But then if you don’t do that, then the risk is the pandemic will never finish because we’ll never vaccinate enough people to control the virus.
“We have a very difficult situation and I feel sometimes the Government thinks we are magicians like David Copperfield, we cannot do miracles.”
Mr Laplana said: “People do their own job and then they are willing to give these vaccinations because otherwise nothing will happen but people are tired, levels of sickness are high like everywhere in the country.”
He added: “It’s a lot of pressure on the people who are here.”
Prime Minister Boris Johnson has aknowleded the targets he has set for vaccinations are a challenge.
On Thursday, he said people had a right to know how quickly jabs could be rolled out and stressed the NHS was ready to administer vaccines as quickly as they could be supplied by manufacturers.
The Prime Minister said there would likely be “difficulties” in the rollout of the vaccine and there would be some “lumpiness and bumpiness”.
“Let’s be clear, this is a national challenge on a scale like nothing we’ve seen before and it will require an unprecedented national effort,” he said.
“Of course, there will be difficulties, appointments will be changed but… the Army is working hand in glove with the NHS and local councils to set up our vaccine network and using battle preparation techniques to help us keep up the pace.”
Mr Johnson said that the most vulnerable groups which the Government plans to have vaccinated by mid-February accounted for 88% of all those who have died in the UK during the pandemic.
He said “if all goes well” then hundreds of thousands of vaccines can be administered per day by January 15 and “it is our plan that everyone should have a vaccination available within a radius of 10 miles”.
He added: “It follows from that that the limits will not be on our distributional power but on the supply of vaccines, and I have no doubt that we have enough supply to vaccinate these four groups by the February 15 deadline.
“We also have the distributional network to do it and to continue an expanding programme down the priority list.”
While NHS England chief executive Sir Simon Stevens said there will be a “huge acceleration” in the vaccination programme over the coming weeks.
Sir Simon said there were 39 days left to meet the target set by the Prime Minister to vaccinate the most vulnerable.
“We need a huge acceleration if we are, over the next five weeks, going to vaccinate more people than we typically vaccinate over five months during a winter flu programme,” he said.
He said the “bulk” of the vaccinations would be carried out at GP surgeries and pharmacies, but that the number of hospital hubs and large-scale vaccination centres were also being increased.
But Mr Laplana, who describes himself as a “nurse activist” and previously stood to be an MEP for The Independent Group for Change, said: “When the vaccine came out we were all excited, I was in tears when I held the vaccine and it was quite emotional delivering it to old ladies and I just wanted to hug them and kiss them, but I was one of the ones saying we should not have lifted things for Christmas and here we are in January 2021, watching a tsunami coming, and we can do nothing to avoid it because it’s too late, always too late, and that’s basically an example of what has happened with the Government - too little, too late.
“I want to believe we are capable of getting to two million doses a week, but the question comes with the resources and how long is a piece of string?”
“I don’t think we’ll get there [vaccinating 13m vulnerable people] in six weeks, I think it will be longer because January and February are always busy for the NHS, that’s my prediction, because it’s impossible otherwise, how can you make a workforce which is already very thin even thinner and spread it even more? It’s impossible, we can’t work seven days a week 24/7.”
But he said the people of Yorkshire had been steadfast in following the rules.
“I want to thank Yorkshire because we are one of the places that has managed to control the virus and so far, we have not been overwhelmed in our hospital,” he said.
“And Yorkshire has taken seriously the recommendations and as a nurse I want to thank the public and I want them to carry on because the worst is still to come but if we all play a role and we all carry on doing what we need to do, stay at home, follow the rules, then I think by April we’ll have thing under control - and we’ll be able to have a festival of happiness in Yorkshire where everyone can hug each other, we need a good celebration.”
In London, the epicentre of the new variant of coronavirus, staff have also spoken of the pressure they are under.
At St George’s Hospital in Tooting in the capital Dr Mark Haden, an emergency department consultant, said: “We make it look like business as usual but it’s very much not – it’s very different to our usual pattern of work.
“Everyone’s stress levels are higher than usual. Everyone is working to the limit, to the threshold of what they’re able to.
“The hospital bed occupancy is very, very high, it has lots of Covid patients as inpatients at the moment. It’s very stressful for staff and that is starting to show.”
St George’s has had to expand the number of intensive care beds for the critically sick from 60 to 120, the vast majority of which are for coronavirus patients.
The rest are for those recovering from other serious trauma such as heart attacks or road traffic accidents.
But the expansion has had a real impact on both the staff and patients’ treatment.
Nurses who would usually be assigned to one patient are now having to deal with up to four casualties at one time.
And they are doing so while wearing uncomfortable personal protective equipment (PPE).
Such is the demand on the intensive care unit that staff from other departments are being drafted in to help – despite not being trained to do so.
ICU consultant Dr Mohamed Ahmed, 40, said: “When a nurse has care of one patient, there’s that ratio for a reason – every detail needs to be looked at.
“When they need to look after three or four patients, their standards are lowered.
“They feel they have to do their best but they come away feeling demotivated and demoralised. That’s really apparent. They clearly want to do the best they can.”
Matron Lindsey Izard said pressures on the service were immense.
“It’s not just about Covid,” she said.
“If you go up a ladder this weekend and fall off it, there’s a chance you won’t get an ICU bed.
“People are still getting run over, they’re still self-harming, they’re still beating each other up.”
Ms Izard said staff were so exhausted that she feared “a large number” would quit once the pandemic was over.
She said: “I really do think a lot of people have thought, ‘This is the writing on the wall for me as a nurse, I’m not sure I want to do this again’.”
Sara Gorton from Unison, which represents hundreds of thousands of health workers, said: “The NHS is under unbelievable strain, with many hospitals now struggling to cope. The pressure on staff is overwhelming and their own health and wellbeing is a major concern.
“With more and more health workers off ill, those who are on duty are being asked to give even more.
“It’s clear people are now going beyond burnout and this could have lasting consequences on not only them but the safety of services we all rely on.”