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Hornsby team reflects on overcoming COVID-19 emergency

It was a Saturday afternoon and Beda Andrews was enjoying her day off from Hornsby Ku-ring-gai Hospital’s Emergency Department when the acting Nurse Unit Manger received a phone call to say there was an incident at work. She immediately returned to work, where she joined Acting Director of ED, Dr Andrew (Andy) Brown, and together the pair swung into action to face one of the department’s toughest challenges.

The incident was a staff member diagnosed with COVID-19 and the pair’s immediate priority was the welfare of their colleagues. They needed to quickly identify staff who had been in contact with the affected team member and have them isolate at home. Immediately the ED lost about 18 staff working that day as they quarantined at home. Andy and Beda then needed to find staff to cover their shifts.

What followed over the course of the next 24-48 hours was hundreds of phone calls to affected staff, welfare checks and working with their ED colleagues to ensure the department continued to run smoothly and be able to care for patients.

They also needed to identify patients who had been in contact with the COVID positive staff member and assist the NSLHD Public Health Unit to start contact tracing.

"It was a race against time because our priority was the welfare of our staff. We wanted to tell them first-hand about what had happened before it was made public," Beda said.

"I remember calling staff to tell them (they needed to isolate) and there was a lot of shock."

Setting up an incident control centre away from the main ED floor, the pair worked the phones while they were supported on the floor by Clinical Nurse Manager Tristan Miller and Dr Stephen Kearney who managed the department. Dr Felicia Kwok began to oversee the rostering logistics, ED Clerical Supervisor Justine McMahon supported the team, while COVID After Hours Nurse Manager Carolyn Opie and After Hours hospital executive Adrienne Stern assisted the ED in the crucial first few hours.

"My focus had always been on responding to a patient who had COVID and the influx of patients so it was a lot of a shock when it was a colleague,’’ Beda said.

It was so good to see all of our disaster training come into effect and the whole team just pulled together.
Beda Andrews, Hornsby Hospital ED Acting Nurse Unit Manger

"But it was so good to see all of our disaster training come into effect and the whole team just pulled together."

What was unsurprising to Andy and Beda was the overwhelming support from their fellow ED colleagues, other hospital and district staff throwing their hands up to help.

Doctors and nurses volunteered to perform double shifts, nurses moved to 12 hour shifts, colleagues from other departments came to work in ED and colleagues from other hospitals in the district, including Mona Vale, Royal North Shore and the Northern Beaches, volunteered to help man the department to cover staffing shortfalls.

"We are like one big family and everyone just pulled together," Andy said.

"Everyone was doing it tough in different ways. We had those who were working really hard and worried about the quarantined staff and those at home self-isolating concerned about their colleagues who were working.

"Initially we needed to work out what was needed for the first 48 hours and then the next two weeks. Because of the unpredictability of COVID, we didn’t know how many staff would have to isolate. We lost an entirety of three shifts of staff. A third of the medical workforce and about 40 per cent of the nursing staff."

Immediate quarantining, use of Protective Personal Equipment (PPE) and following strict hand hygiene and social distancing protocols were effective in managing the spread of COVID in ED.

Fortunately all staff are now well and have returned to work.

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