Cardiac Physiologists – Coping and Adapting as a Team during COVID-19

Over the weekend, I reflected on the effect, dynamics and response of our team of 16 Cardiac Physiologists to these unprecedented COVID weeks.

Anxiety, Communication and Self-care

Given we perform and report cardiac tests on patients, there has been anxiety of contracting or passing COVID to patients, particularly during cardiac ultrasound, a close contact procedure. 

There was the uncertainty of the situation, possible redeployment and how the health service would cope. There were also individual concerns regarding family, particularly older relatives.

We had an initial meeting where all concerns and thoughts were raised in an open way.  Questions were answered honestly, where information was available, but there were also a number of “I don’t knows”. 

We hold daily huddles, to update on rapidly changing work practices and set-up a COVID Info group in addition to our longstanding work WhatsApp group, so everyone had relevant information on their device.  Our team was directed to information sources, such as the WHO and HSE.  As a team, we feel these daily huddles reduced anxiety and improved communication.

Our mantra is to “get through this with our health and relationships intact”.  To aid this, infographics about stress management and self care from @whw_HR have been shared.  This weekend, I shared “Hold onto your red thread” an article from the BMJ – mine are cycling, home life and minding our team.

New Protocols

30% of COVID patients develop cardiac issues, with a number requiring cardiac ultrasounds. Protocols reflecting international guidance were rapidly adopted. Twitter has been great at keeping us updated on guidance and also showing how other centres and leaders in the field have been dealing with this. 

Within one week, we developed processes for safely treating patients with COVID, who were also suffering from heart attacks. This involved the 24/7/365 Heart Attack (CODESTEMI) team, nurses, doctors, radiographers and ourselves.

Although non-time critical diagnostics were cancelled, our long-standing use of remote monitoring technology, where implanted devices can be checked from patients’ homes, has allowed us to continue to provide follow-up for these patients. 

We have noticed over the last number of weeks, after cocooning was instituted, that phone calls with these patients takes longer as they seem to enjoy the chat.  We also observed that chatting with inpatients who require tests was even more important than usual. They are missing their visitors – the suggestion is to ask at least one non-clinical question. 

We also rapidly, with support of IT, integrated reports from all of our testing equipment onto the hospitals Electronic Health Record.

Split teams – challenges and benefits

Cardiology split into two teams, working different shifts on alternate weeks.  This was designed to protect the service from being wiped out by infection.  Within three days, through open discussion, we had managed to work out shifts which aligned to medical and nursing colleagues and provided extended hours diagnostics, six days a week, to support a non-COVID Emergency Department in the Acute Medicine Unit.

New extended hours are quite tiring for staff and people are missing colleagues who are not on their team. However, there have been a number of benefits; the smaller teams provide opportunity for staff to take on more responsibility and colleagues have got to know each other better. Both teams have tried to keep spirits up, lots of baking, some laughs, minding each other, and goodies being left for the team taking over.

I was concerned about not meeting the other team but am having a number of WhatsApp video calls to keep in touch, although I might benefit from them most.

Pride

There is a huge sense of pride in our own team, how they have adapted, grown, got stronger and minded each other.  Pride in our HSCP colleagues, Radiographers – performing tests on COVID patients, Med Lab Scientists – responding amazingly to ramp up testing in difficult global conditions, Medical Physics staff – procuring, commissioning and checking huge amounts of equipment to get us ready, Physiotherapists, Dieticians, Speech and Language Therapists, to mention a few – working in critical care areas and COVID wards. 

There is also pride in our leadership at national level; Simon Harris, Dr. Tony Holohan and his team and the Irish people whose adherence to restrictions has helped prevent the surge.

This Blog was written by Paul Nolan, Chief Cardiac Physiologist, University Hospital Galway. @pnolan99. paulg.nolan@hse.ie

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