At the coalface of the COVID-19 crisis

(Southern Health News, Autumn 2020)

The COVID-19 crisis has taken SALHN – and indeed the world – into previously unchartered territory.

As a health service, we have had to adapt and evolve quickly to address each new challenge the virus has brought. Our staff have worked around the clock to ensure the health and safety of our patients, staff, visitors and wider southern community.

So who are the faces behind SALHN’s inspirational COVID-19 effort? They are the nurses you see driving at night to start their shift at our SALHN hospitals and health services; the Patient Service Assistants you see wheeling beds throughout our hospitals; the FMC and Noarlunga Hospital volunteers who have continued to work throughout the crisis to provide a helping hand; the doctors who work tirelessly to care for patients; the cleaners who mop and sterilise even more thoroughly than usual; the administration staff who come to work each day even though they have families of their own.

There are too many to count, but in this special article we salute just a handful of our SALHN employees at the coalface of the COVID-19 crisis. From all of us, we say ‘thank you.’

Elisa Matheson

Nurse Consultant, COVID-19 Testing Clinic at FMC

When FMC opened its COVID-19 testing clinic on March 9, nurse consultant Elisha Matheson hit the ground running. She’s hardly had a chance to catch her breath since.

The COVID-19 Testing Clinic is open seven days a week from 10.00am until 8.00pm. Anyone experiencing cold, flu or respiratory symptoms is able to get tested without referral. The test looks for the virus from a swab. It is collected from the back of the throat, then nose.

Thirty-five staff, including doctors, nurses and support staff, work in the clinic. Elisha’s role is to coordinate the day-to-day activities of the clinic, along with Annette Cieslak, Co-Director of Medicine Cardiac and Critical Care Services (MCCCS) and Damian Loades, Nursing Director of MCCCS.

What does a 'typical' day look like for you at the moment?

“When the clinic first opened there was no ‘typical’ day. For most of us it was a new and foreign environment, and patients were extremely concerned and anxious when presenting to the clinic for testing. It has been an absolute privilege to assist in the navigation of this situation.

“The clinic has been open for more than two months now and we have a core team working there. My typical day now is providing leadership and support to a very professional team that have adapted quickly to working in a very different environment and continuously adjusting to a large volume of patient presentations for testing.”

What have you learnt during this time?

“As a health professional it is a privilege to be part of such a responsive team that can come together to focus on a common goal. Our collaborative team has been able to achieve a positive patient experience under challenging circumstances.

“I am very proud to have been involved along with all of my colleagues - including Annette and Damian who have been so supportive - in the COVID clinic, MCCCS and SALHN.” 

Patrick Ryan

Manager, SALHN Disaster Resilience Unit

Patrick Ryan heads the ‘engine room’ of SALHN’s COVID-19 response.

As Manager of the SALHN Disaster Resilience Unit, Patrick is responsible for SALHN’s overall strategic disaster management, including emergency response, major incident management, business continuity planning and security. He also ensures effective and efficient fire safety services across southern Adelaide, including emergency response requirements.

The formation of the SALHN Incident Management Team (IMT) is a critical part of SALHN’s response to the pandemic - and has been active since the State Emergency Declaration.

“My role since then has been to manage the Incident Command Centre and the IMT structure to ensure we have an effective, sustainable and safe response to this emergency,” Patrick explained.

What does a ‘typical’ day look like for you?

“A ‘typical’ day starts with an 8.15am briefing where the past 24 hours is reviewed. I give a situation update to the team, and identify issues and risks that need to be resolved or escalated to the State Control Centre. I spend most of my day implementing operational directives; and liaising with the technical, operational and workforce teams to resolve problems and manage response teams.

“The early days of the global pandemic were very dynamic and our response evolved on an hourly basis. The establishment of the first COVID-19 testing clinic at FMC on 9 March was a significant challenge logistically. To do this, we repurposed the FMC Rehabilitation Pool and Gym; and developed patient pathways for COVID-19 positive and suspect patients for admission and discharge.

“The SALHN Pandemic Plan was also implemented and subsequently improved (and continues to be improved).”

What have you learnt during the pandemic?
“I have been so impressed with all the people I have worked with, from cleaners to infectious disease consultants, our CEO and admin support staff. Everyone has stepped up. My faith in humanity has been boosted by the dedication of all the people I am working with. People who do not normally get involved in the emergency response arena have been engaging, and have shown great respect and gratitude. I am truly humbled by our efforts and achievements.”

Bridget Dowding

ICCU Equipment Service Officer

From gloves and masks, to gowns and ventilators, Bridget Dowding is the Intensive and Critical Care Unit’s (ICCU) ‘go to’ person for equipment.

It’s no surprise to learn, then, that during the COVID-19 crisis Bridget has been run off her feet.

“My main goal is to keep my colleagues safe and protected and have every single item they need at their fingertips while they are at the front of this pandemic,” said the ICCU Equipment Officer.

“I am working a lot harder than I have ever worked before. I am putting 110 per cent into everything and putting my colleagues ahead of myself at the moment.”

Bridget orders a wide range of equipment, including ventilators, consumables and Personal Protective Equipment (PPE).

“Pretty much anything that is needed in the unit, I am hunted down and asked to order!”

What does a typical day look like for you at the moment?

“The first thing I do each day is check and approve all the invoices from stock I have purchased. I then chase up equipment faults, unpack deliveries and order more stock.

“I’m on the phone a lot, calling suppliers to get an estimated time of arrival on stock that we need in a hurry. It’s no easy task as the rest of the world is looking for similar stock. Some items we need are distributed from places like Spain and Italy, so that just adds another element of complexity.

“The rest of the day is spent taking any malfunctioning equipment or instruments down to our trusty Biomedical Engineers for repairs, and distributing PPE around the unit.”

What have you learnt during this pandemic?

“I have learnt that working under pressure is where I excel at my job. I’ve also learnt more about the equipment we use, infection control and how much my colleagues really do put others ahead of themselves. This pandemic has been a very big learning curve for us all. However, our educators have been on the ball to teach us everything we need to know to keep ourselves and our families safe when looking after infected patients. It is a great honour to be a part of this team and I could not thank them enough for welcoming me with open arms. I am very proud to be working alongside these heroes.” 

Dr Santhosh Daniel 

SALHN Infectious Diseases Specialist

When a pandemic such as COVID-19 strikes, it is critical that clinical decisions are made not only swiftly and seamlessly – but are based on current evidence and are consistent with available guidelines.

Dr Santhosh Daniel’s role at SALHN during the pandemic has been to act as a ‘technical advisor’ to the Incident Management Team (IMT), ensuring the right clinical decisions are made — first time, every time.

“My role is a bridge between the IMT and the Infectious Diseases and Infection Control teams - enabling the transfer of information and ensuring that decision making has been seamless and consistent across the region,” Dr Daniel said.

“For example, the idea of contracting Marion Holiday Park to house COVID-19 positive patients initially came from the Infectious Diseases team; and was then embraced and acted upon by the IMT. The result was a first such endeavour in the State and probably in the country. This role also facilitated a real time update of clinical information to IMT from the COVID-19 clinic, Hospital @ Home, SA Pathology and various clinical units in the hospital.”

What does a 'typical' day look like for you in the midst of the pandemic?

“The first thing I do when I wake up is to check my work emails to find out how many patients have come through the FMC COVID-19 testing clinic in the last 24 hours, and how many have returned positive results.”

“Positive results are forwarded to the clinic to facilitate a face-to face review (SA is the only State in Australia to do this; other clinics just do a phone review) with positive patients.”

IMT starts like clockwork at 8.15am and it is business from word go.

“In the initial days of the pandemic deliberations went well past the hour, but when we left the room we all knew what was expected of us for the next 24 hours.”

After a full day of sub-committee meetings, live streaming education events for SALHN staff, answering phone calls and emails, and writing and reading briefings, Dr Daniel heads home in the dark, “always with mixed feelings - the scary thought of what if the cases worsen, balanced by the sense of warmth that I’m not alone in this fight; I’m part of a team.”

What have you learnt during this time?

“My work in this capacity would not have been possible without the support of the Head of the Unit and all of my colleagues in Infectious Diseases, Microbiology and Infection Control. Many of the ideas and information that I provide to IMT and others have come from this core group.

“I’ve also learnt the amazing power of teamwork – doctors and nurses would be helpless without the concierge staff, cleaners, food handlers and IT experts who diligently go about their jobs. We are strong when we are united and play our part in the big scheme of things.

“Finally the brevity of life has impressed upon me the preciousness of life. I would do it all again in a heartbeat.”