“When DORSCON Orange came into effect on Friday, 7 February 2020, our team immediately set up an Extended Screening Area (ESA) outside the KKH Children’s Emergency (CE) in anticipation of a surge in patients. The ESA was a separate extension for ‘intermediate risk’ patients as per MOH criteria. ‘Low risk’ patients would be directed into the main CE building and ‘high risk’ patients to an isolation annexe off the main CE building. This arrangement was guided by experience from the H1N1 influenza outbreak in 2009, when an ESA was effective in managing the situation.
The ESA began operations that same weekend. As nursing supervisor, I began my shift there by briefing the nursing team on the new workflow. The first patient arrived at 8am, and by about 9am the waiting area in the ESA was full. Patients continued streaming in, and some had to stand as there were not enough seats. Frustrations arose and maintaining safe distancing between families became harder. The situation could turn chaotic.
Under layers of Personal Protective Equipment, I could literally feel my body burning and perspiration pooling as our team worked quickly to manage the patient load. Thankfully, the situation in the ESA was closely monitored, and additional nursing and medical staff were swiftly deployed to assist.
Exiting the ESA drenched in sweat, I updated my head of department of the situation. We saw that, unlike the H1N1 outbreak, the majority of patients at CE this time were those classified as ‘intermediate risk’; while the numbers of ‘low risk’ patients were extremely low. Hence the smaller ESA was flooded with patients while the larger main CE building had fewer patients.
It did not take long for the team to decide to switch the intermediate-risk and low-risk areas of the Children’s Emergency – and the patient flow. The space crunch in the ESA was immediately eased, with effective distribution of patients into the three main areas of the CE – a workflow which currently remains in place.
As a nurse, my duty is to uphold the safety and well-being of not just my patients, but also my teammates. I am proud to work with a responsive and dedicated team. Upon realising that what worked for H1N1 did not apply for COVID-19, our team quickly found a solution and kept everyone safe.
Some colleagues personally thanked me for helping to suggest the change in patient flow – which made it safer for both patients and healthcare staff. These simple gestures of appreciation make me feel that the work that we do, is all worth it!”
Ms Huang Weili is a Nurse Clinician at the KKH Children’s Emergency Department, and is involved in COVID-19 disease outbreak operations, including caring for children with suspected COVID-19.
Source: KKH Facebook
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