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Croom staff praised for 'embracing the unknown' during pandemic

STAFF at Croom Orthopaedic Hospital have worked through the most dramatic changes in service delivery in the Mid-West during the pandemic, temporarily transitioning from elective surgical to medical care for the first time in almost 70 years, while also preparing for the future, with the rapid construction of state of the art hospital bed facilities on site.

Assistant Director of Nursing in Croom, Katie Sheehan, applauds the positive attitude and ‘can-do’ spirit of staff in the hospital for “embracing the unknown” and engaging with the kinds of changes that enabled Croom Orthopaedic Hospital to play such an important strategic role in UL Hospitals Group’s battle against Covid-19.

Initially, theatre staff at Croom were redeployed to University Hospital Limerick to support the anticipated surge in Covid-19 patients requiring intensive care. When the surge instead manifested as a significant swell in non-Covid-19 admissions, the staff were returned to their base in the county, and the Orthopaedic Hospital began accepting non-Covid medical patients under the governance of Consultant Rheumatologist, Dr Sandy Fraser.

Katie is acutely aware of the scale of the challenge facing staff in Croom during the pandemic. She started out her nursing career in the hospital in 1981 and, although she has been in “a million and one places since then”, returned to Croom in 2016. Because of the well established patterns of care in a surgical hospital, Katie admits to being taken aback by how readily and enthusiastically hospital staff embraced their changed circumstances.

“There is a massive difference between medical care and surgical care. Surgical patients are ‘well’ but something has happened to them. There is a pattern: they come in, we treat them according to a plan, and they go home. Medical patients are ‘sick’. They can be very complex, with multiple co-morbidities and lots of different issues. So it’s very different to what we’ve been accustomed to.”

Dr Sandy Fraser said he was delighted to step up and offer clinical coverage for medical patients in Croom, and emphasised the team effort and willingness to help, at local hospital and Group level, as the key to the success of the initiative.

“I was delighted to help. Everyone wanted to do something to help, and there was an amazing group effort. I really have to pay tribute to the nurses. These are world class orthopaedic theatre nurses being asked to do something they hadn’t done in 30 years, which is to look after medical patients on wards. And there was no reduction in quality of care received by any patient when they were being looked after here. Throughout the hospital, it was all hands on deck. The patients were looked after brilliantly throughout – it was a fantastic group effort, and it was a great pleasure to be part of it,” Dr Fraser said.

“Across the board, our staff were astounding,” Katie Sheehan said. Some of the nurses would have worked in theatre for many years, and they have really stepped up to the plate. Not once did they say, ‘I can’t do that.’ Instead, they’ve been driving this. They’ve come to me, and they’ve said, ‘Listen, we have this patient who has an issue, and can we get the training for that?’ and UHL have been with us on this journey every step of the way, unfailingly providing us with any training and support we’ve needed,” she explained.

Katie has observed a blurring of lines between staff in different areas of the hospital. “Theatre, for example, is very separate, and the staff are in scrubs and working beyond the red line. But now, they’ve been on the wards and have gained an appreciation for the work of their nursing colleagues, porters and other staff in the hospital. Many of them have told me how they have loved the patient contact on the wards, and I think it will prove to be a big game-changer in the way we work here.”

Allied Health Services also played a crucial role in the care of patients in the temporarily reconfigured hospital. At a time when Musculoskeletal Clinical Specialist Physiotherapists were unable to continue face-to-face outpatient work, staff were involved in treatment of patients on wards either in Croom or Nenagh.

“The team in UHL was able to facilitate occupational therapy for patients in Croom, allowing for the provision of appropriate treatments for patients, and for easier discharge planning,” said Fiona Steed, UL Hospitals Group Lead for Allied Health. “With the ongoing expansion of telemedicine and the phased return to outpatient work, physiotherapy staff are now reverting to their regular roles.”

As the Covid-19 curve continues to flatten, here in the Mid-West, the focus is on the future. Work is well advanced on the infrastructural work that grew out of the original vision for Croom Orthopaedic Hospital as the regional centre of excellence for orthopaedics and rheumatology.

A brand new 24-bed single room en-suite unit is scheduled for completion at the end of the summer, which will initially cater for overflow of patients from UHL requiring isolation. In addition, the new building can be expanded upwards to include, ultimately and pending funding, the development of four new theatres, the hospital’s Sterile Services Department and a new Day Ward.

“What has happened is that many of the key elements of our vision are now in place, and that, along with our experiences of retraining and upskilling during the pandemic, has left us very confident about the future. There is a buoyant feeling; a feeling that we’ve stepped up to the plate in Croom; that we’ve delivered. And we will harness that energy now as we face into the future,” Katie said.

Paying tribute to the local community, Katie said: “The hospital is such a landmark in the local community. Many of our staff live in Croom, they walk into work. And because it was once the County Hospital (opened in 1924), many people throughout the Mid-West will have ancestors who were born here, so that heritage lives on in people’s memories. We have had enormous support and generosity from the local community here and throughout the region during this public health emergency, and we continue to serve them with deep gratitude,” she said.