This episode is dedicated to all the frontline health care professionals who have shown immense courage every day during the covid 19 pandemic. Despite tough times, they overcome extraordinary challenges and save lives.
On the podcast is Mette Find Andersen.
Mette is an ICU nurse at one of the largest intensive care units in Denmark. She has also been the hygiene coordinator in the ward for more than eight years. During the beginning of the pandemic, Mette's ICU department quickly became full of the most affected patients with COVID-19. It was a scenario most people could not have foreseen.
In this episode, you will gain insights from one of the many frontline healthcare heroes. These stories must be told so we can learn from the pandemic and prepare for the next.
On hygiene mentorship
The most important is that we, as hygiene coordinators are visible in the department.
On infection prevention in hospitals
Do proper hygiene, sanitize your hands, and take your mask off correctly to avoid contaminating yourself. It's been so important for us... take hygiene to the next level. It is the most important thing in a hospital ward. It is infection prevention.
Mette Find Andersen
Fri, 10/15 11:41AM • 19:03
patients, pandemic, icu, colleagues, icu nurse, nurse, hygiene, important, department, work, denmark, infection prevention, ward, relatives, coordinator, learn, families, wear, hospitals, talk
Dr. Marco Bo Hansen, Mette Find Andersen
Dr. Marco Bo Hansen 00:02
Hi, I'm Marco, and thanks for listening in. I'm a medical doctor and researcher, and my mission is to empower healthcare workers to prevent infectious diseases. Each episode is a short conversation with experts sharing their insights with us. This episode is dedicated to all the frontline health care professionals who have shown immense courage every day during the covid 19 pandemic. Despite tough times, they overcome extraordinary challenges and save lives. My guest today is medicine Anderson, an ICU nurse at one of the largest intensive care units in Denmark. She has also been the hygiene coordinator in the ward for more than eight years, during the beginning of the pandemic medicine ICU department quickly became full of the most affected patients with COVID-19. It was a scenario most people could not have foreseen In this episode, you will gain insight from one of the many frontline healthcare heroes these stories must be told so we can learn from the pandemic, and prepare for the next. So let's welcome today's guests. excited to have you.
Mette Find Andersen 01:11
Thank you very much.
Dr. Marco Bo Hansen 01:13
Can you tell us about yourself and your work?
Mette Find Andersen 01:15
Yeah, well, I can tell you, I'm 43 years old. And I've been working as a nurse for 19 years. And it has always been in my ICU department at my own hospital in my own town. For one year, I was at a children's ward just to see something else and try something new. But I knew I wanted to go back to the ICU department. So I've been there ever since.
Dr. Marco Bo Hansen 01:37
And what made you decide to become a nurse in the first place?
Well, actually, I wanted to be a police officer. That's my dream job. Okay, but here in Denmark, there are some height requirements for being a police officer. And I was too short. So I was thinking what would be the next best thing. And then I thought about nursing would be some of the same, you'll help people in some need of help just now in the healthcare system, except from help from the police.
Dr. Marco Bo Hansen 02:06
And you're definitely doing that as a nurse, but you also decided to become an ICU nurse. What do you like most about being an ICU nurse?
I think that we have a very important job in helping both our patients and their relatives in the most critical time of their lives when they are so critically ill. I think that's the most important job as an ICU nurse, you have both the patient but also all the relatives and families.
Dr. Marco Bo Hansen 02:33
Yeah, and what is the most difficult part then of being an ICU nurse,
we sometimes are in very difficult situations with example, young patients who are very ill, and some of them die. And it's hard sometimes when the patients are your same the same age as your children of the same age as your parents, and you have to comfort the families. But it's also very giving as a nurse to help the patients because a lot of patients do well and come out of the ICU. So I think it's a whole picture of the nursing. Also all the technical skills you have to learn at the ICU, all the machines and yeah, so I think it's just not one thing in the ICU department. It's many things that you do in your job that gives so much meaning.
Dr. Marco Bo Hansen 03:20
Exactly. And thank you for sharing that. As mentioned, you have many years of experience being a nurse and an ICU nurse. So thinking back, what do you consider your biggest accomplishment in nursing?
I think that I now at my ICU department is considered an expert, you can say that with my many years of experience. And that has also led to that I train almost all of my new colleagues, who will begin in our ICU department and seeing how they develop as ICU nurses from my training. I think that's so nice. And it's very giving to me as well to teach all the things I have learned and know, on to my new colleagues.
Dr. Marco Bo Hansen 04:01
And that also leads me to think about at the moment, there has been a lot of talk about the increased pressure in the hospitals and yeah, on nurses in particular. Have you experienced this situation at a time for training and education? What are your thoughts on this?
We take the time to train our new colleagues. It's very important. They have a period of three months when they are under the guidance of me or some of my other experienced colleagues. But we also had the same problem as many other wards in Denmark now. We need more nurses.
Dr. Marco Bo Hansen 04:35
Exactly. And perhaps we can talk more about that later also, but let's talk about COVID-19. Yeah, because you have been the hygiene coordinator for the ICU department during the pandemic. And please take us through when you first heard about COVID-19 until you started treating the first patient in your hospitals. Yeah, did you think
it was both a exciting time and we were a little anxious because no one knew of this illness or disease, not even our doctors. So everything was new for all of us. But it was very important for me as the hygiene coordinator to get the guidelines out to my colleagues and get them to read them and understand them. And then we made this school, we could say, for our colleagues, where we taught them how to put on the protective gears in the right order, and how to take them off at the right order. So we didn't contaminate ourselves with the disease.
Dr. Marco Bo Hansen 05:32
Exactly. Was that your role as a hygiene coordinator to do that? And what are the tasks as the hygiene coordinator? do you have?
Yeah, that was part of my job. And then just, the guidelines were changed almost every day because of this new pandemic. And we printed them out. And we hung them up different places at the board. And I was very busy trying to teach how to disinfect our hands almost all the time and disinfect the environment, and how to clean the rooms after a patient has been there with the COVID-19. So I didn't notice a lot of the patients just there because I had a lot of other things to do all of the practical things,
Dr. Marco Bo Hansen 06:14
what would you say was your most important task as a hygiene coordinator during the pandemic,
to make sure that my colleagues understood the guidelines and work correctly after them?
Dr. Marco Bo Hansen 06:25
Okay, and how did you then face these challenges with the shifting guidelines and requirements? How did you tackle that? And do you have any suggestions for how we can prepare for that in the future,
I think this was very hard for everyone, because it was so new. So every day, something new would come that we should, how to take care of them, and what to wear and what not to wear and what not to do. So I don't think that we could have done anything different at that time. But maybe now we have learned from this. And now we know a lot about the hygiene as well and taking care of these isolation patients. So I think that maybe if there comes a new pandemic, we will be ready in another level, because we've been through this,
Dr. Marco Bo Hansen 07:08
and what are the challenges that you face. And they make in the ward,
we had a lot, not a lot, but some of our colleagues who was very frightened about this disease, very anxious about it, and some of them so bad that we had to move them to another department, because they just couldn't work in our department because of this COVID-19.
Dr. Marco Bo Hansen 07:29
Okay, and how did you tackle this mental health issue and challenges? Was it information? What did you do?
It was a lot of information, and reassuring my colleagues that we did it in the right way. We had the protective gear that we should use, and it was okay. And then it was very important for us also to not let let us yeah, we were to say all the things that were going on in the media as well, showing pictures from other countries. But when it was really bad, so they don't have to be afraid to work in my ICU department because we knew how to do it. Exactly. And
Dr. Marco Bo Hansen 08:10
what is your thought on the media's role in all this? Because as you mentioned, there were different news and people could be very scared. How did you tackle that?
Well, especially with the protective gears, we saw a lot of different ways how to wear them. And in many countries, they wore a lot of more than we did. So my colleagues were often in doubt about what I have told them was the correct way. And none of my colleagues were infected.
Dr. Marco Bo Hansen 08:38
You mentioned that media also plays a role. But of course, you have seen so many patients, and treated many patients with COVID-19. Can you mention a particular patient story that affected you and what we can learn from it?
Yeah, we had a male 70 years old, he and his wife were on a cruise ship in Italy. And they were both infected with the COVID-19 onboard the ship. And when they finally came to Denmark, it was very difficult for them because no harbour would take them. But when they came to Denmark, the mail was very ill from his COVID-19. He was actually one of our first patients in my ward with COVID-19. He ended up staying at our Ward for 100 days. But he Yeah, yeah. But he survived the COVID-19. And as we know today, he's healthy. Yeah, he was very sick of it and also sedated, intubated, in prone position for many days and, but he came through it. What we learned from that experience was that under the COVID-19, there was no relatives allowed around war, he developed a severe case of delirium. So we made an exceptional room for his wife so she could come one hour a day and
Dr. Marco Bo Hansen 09:51
not know what delirium is. Can you quickly explain what it is?
Yeah, he was very uncomfortable and couldn't lie. Still a bit confused? Yeah, very confused. And yeah, couldn't sleep at night? Yeah, so yeah, it was very bad for him. But then his wife came to visit him one hour day, and there's no doubt about that, that made him come through his sickness and his illness was COVID-19, it was so good for him. It made a world of difference that you could be with him.
Dr. Marco Bo Hansen 10:24
And I guess that that is really an important learning, because yeah, in the beginning, I guess, and for how long no relatives were allowed, as visitors in the hospitals,
we still have no visitors. For COVID-19 patients, there still are no visitors allowed. Okay, but all of us nurses are very, we don't agree with that. But unfortunately, we don't have the last thing and that it has been the most difficult thing for us. Because we are used to having relatives and families visiting all day, we have no visiting hours, they can come as they please. So from one day to another, to go from always having some relatives or family members of our patients, to suddenly none visitors, it was very hard for us nurses, because we use the relatives to get to know our patients, and they are a big resource for the patients. So that was a difficult for us to take in and still is.
Dr. Marco Bo Hansen 11:18
And I think your example is a great way of thinking how important family friends, visitors are also in the treatment of the patients and the conditions in general. So thank you for sharing that. If you think about COVID-19, and also about infection prevention in general, then what do you consider the most important aspects of infection prevention management,
the most important is that we as hygiene coordinators are visible in the department. People know who we are, and that we know the guidelines at firsthand and then that all of the colleagues can come and ask us but the miscibility of us and the work we do that is very important. And to put the focus on how important the infection prevention is,
Dr. Marco Bo Hansen 12:03
what are typical questions from your colleagues you receive?
Yeah, we have had a lot of not mistrust, but doubts about the PP mask, for example, how many hours is allowed to wear it, that has caused a lot of discussion among my colleagues. Because in the beginning of the pandemic, the rule of three hours were made to eight hours. And not all of my colleagues could understand that. And they thought that it was just so we could take care of the patients and be with them for a long time. So we had a lot of trust issues that I had to work with my colleagues and tell them that it was okay to wear the mask for longer than three hours. And it was not made just to harmless it was made, because we can have it on for more hours than this three hours. But that was kind of an issue and actually still is among some of my colleagues.
Dr. Marco Bo Hansen 12:54
Yeah. And how to work with this mistrust. You can see communication or
what is a lot of communication. And we actually make this flow chart schedule. So it's nothing to be in doubt on when you have to wear the mask or when you just can wear an ordinary mask. Yeah, so there's no doubt about when to wear the one or the other. We have made the very visible clear and made a big posted about it.
Dr. Marco Bo Hansen 13:19
And I think that's interesting information visibility. Yeah, a lot of communication. That's really important. So thinking back on the pandemic, how has it reshaped the way healthcare professionals work or how you work in general,
I think that we now stand more together, if you can say that, we work as a team. And we decided to solve this as a team and together help each other. Because of my department very quickly, being full of the COVID-19 patients, we did a lot of cohort isolation and work more in teams. So not everyone was in with the patients at all times somewhere else on a break. And then other colleagues could go in and take care of two or three patients at the same time. And then we could do this, we could help each other in that way. So we work one to one, we have only one patient, but under the COVID-19 you don't have your own patient, you help with all of the patients.
Dr. Marco Bo Hansen 14:14
Okay, so the team spirit and yeah, connection with your colleagues has improved. Yeah, become stronger. Yes, yeah. And then also what are your most important learning from the pandemic?
I think that it has been very exciting to try some new illness or disease that no one knew of, and seeing how everyone stood together and try to solve all the issues, the COVID-19 patients, they were very much alike, the patients, they had only one organ failure, the respiratory, somewhere in dialysis, but not all of them. So they were very much alike. So we could help each other and solve some of the problems we had with one patient that would also come with the next patient. So it was all about standing together. And we have worked very much in teamwork. And I think we do that now as well. Great insights.
Dr. Marco Bo Hansen 15:06
Let's hope that this continues. This is so important. We have a question from a listener. Yeah, was asking how do you think that we as healthcare practitioners best prepare for the next pandemic?
Yeah, I could say knowledge. But we don't have that if it's a new one. So I think it's just to prepare for something like this maybe could happen again, I just think we have to not go with the flow. But we did that. And I think it went very well. So I don't know if you can prepare for another pandemic. But now you know, how it's like to be in the middle of a pandemic. And so maybe just because of that, we are better prepared the next time.
Dr. Marco Bo Hansen 15:45
Let's hope Let's hope that and let's talk about time prioritisation, because I read an interesting study. And it says that nurses on average spent 78 minutes per patient on activities in the patient room? And how do you manage your time? And what do you consider your priorities when you are with the patient?
Well, actually, my hospital has a motto that says the patient first, I think we always work like that. In my ICU department, every patient has only one nurse for every shift. So we do all with our patients, we wash them, we mobilise them. We talk to the families and the relatives. We work with the doctor, we give them medication. So I think it's very giving that you have the privilege to be only one nurse to one patient and an ICU ward.
Dr. Marco Bo Hansen 16:39
Exactly. And not everyone has that privilege. But no, I know. But I think that it's an important point that you can you spend your time with the patient as much as needed. But I also guess that working in the ICU, you are faced with many ethical decisions, both in terms of the patient, the visitors, relatives community, how very often Yes, yeah, exactly. And how do you prioritise making the right decisions for the betterment of those that you serve?
I think it's always, again, a team work with doctors and us as the nurses, we see the patients 24, seven, and our doctors maybe just three times 10 minutes a day. So I think we work as a team in my department. We don't consider the doctors higher than us. We are colleagues, all of us, and they listen to us. And we are always with the discussions about our patients. Should we go on? Could we do this? Could we do this? So I think it's very equal teamwork in our department.
Dr. Marco Bo Hansen 17:43
I'm very pleased to hear that it sounds like it's a cultural thing that you have what we call a lot of psychological safety. So you are not afraid of speaking up if you see something is wrong, and you are allowed to ask questions because you work on equal terms. Yes, sir. The hierarchy. That's great to hear. Okay, so let's end the podcast with one final question, which is really important also. So our listeners include healthcare professionals across the world, which advice would you give to them based on your learnings in the ICU and as a hygiene coordinator during the pandemic,
I would say that it's so important that the hygiene, sanitise your hands, take your gas off in the correct way so you don't contaminate yourself. It's been so important for us. So really take the hygiene to the next level. It really is the most important thing in a hospital ward. It is the infection prevention.
Dr. Marco Bo Hansen 18:40
Thank you, Mary, for taking your time to join us today.
Dr. Marco Bo Hansen 18:44
It was very fun. And thank you to our listeners. Please be safe and remember to clean your hands.