AN advanced nurse practitioner in St Finbarr’s Hospital, Mary J. Foley has an insightful perspective of the impact of Covid-19 on older people and the staff who care for them.

She is based in the Assessment and Treatment Centre, where patients have rapid access to specialist assessment and treatment by doctors, nurses and therapists.

“The risk of Covid-19 required some changes to the way we work,” says Mary.

“Drive-through warfarin clinics were introduced where the nurse prescriber does INR checks with the patient sitting in the car. The wearing of masks can limit therapeutic social engagement and makes communication difficult for older people.

“Many of our patients are vulnerable with multiple co-morbidities, therefore, in the early lockdown period, we conducted many of our consultations over the phone and ipad discussing symptoms, offering advice and initiating treatment where indicated.

“People were fearful of the risk of infection and grateful of the opportunity to talk with a health professional. The symptom presentation of others required clinic attendance for physical examination and diagnostic investigations. Other were supported by our community-based team.”

Mary is on high alert at work and has been on high alert at home too recently, as her daughter Lorraine was expecting and gave birth to a baby boy Danny in the last few days.

“I already have a two-year-old granddaughter Cara and I am looking forward to having them all around the table on Christmas Day.”

Mary lives in Whitechurch with her husband Padraig and two sons Niall and Iain. She adds; “We will miss our son Kevin, who is in Perth, Australia. We were there on the beach with him last Christmas, so much has changed since then.”

Mary acknowledges the commitment of staff in St Finbarr’s to quality patient care, which has kept patients and residents safe during challenging times.

“Staff shortages due to Covid were alleviated by those who worked extra hours and healthcare staff recruited from closed health and education settings. 

"We were also grateful to student nurses who took on roles of healthcare assistants during the summer period.”

Mary has been involved in providing Covid specific staff education and Covid testing. Everybody played their part and great leadership was shown by managers who ensured that best practice guidelines were followed.

“We are fortunate to have infection control advisors on site.”

Mary says the restrictions on loved ones visiting the hospital has been difficult.

“The restriction of visitors has been particularly challenging, especially for those requiring lengthy in-patient rehabilitation and our long term residents.”

But they rallied.

“We are amazed at the resilience of older people to cope with changes,” says Mary.

“Much credit is due to staff, whose cheerful caring engagement put a smile on the faces of patients and residents.

“In St Finbarr’s, we are fortunate that our rehabilitation unit and some of our residential units are on the ground floor, allowing family members to communicate through window panes,” says Mary.

Was that a sad sight to behold?

“Yes, a strange but moving sight, yet this limited contact offered some comfort to our patients and residents. It also helped allay concerns of relatives.

“We aim to provide a homely environment, particularly in the residential units where caring relationships between healthcare workers and residents are well established,” says Mary.

“The activity facilitators were unable to take residents on outings but brought music and fun-based activities to everyone which cheered people up.”

As an advanced nurse practitioner, Mary is also called to rehabilitation and continuing care units to advise on treatment.

“I work Monday to Friday but it is not a 9 to 5 job,” says Mary. “Caring for older people is a labour of love for me”.

Her main clinic caseload consists of patients with Parkinsons disease. With the support of colleagues, she was instrumental in setting up the Cork Support Group and the Alzheimer Cafe at the hospital.

“We hope we can resume group sessions in 2021 if a vaccine is effective in reducing the risk of infection.”

Mary has many strings to her bow.

“I recently completed a doctorate degree in UCC, so that is a weight off my shoulders this Christmas.”

She acknowledges that it has been a year of highs and lows, and is looking forward to having family around her at Christmas.

“My husband Padraig is very supportive” says Mary. “Fortunately, I have time off over Christmas, unlike others.

“I am pleased to be part of the healthcare team in St Finbarr’s Hospital, who go the extra mile to meet the needs of patients and residents.

COVID, CANCER AND CRAIC

Even though Deirdre Mehigan is chief cook and bottle-washer at home in Gurranabraher, she is also a dedicated Health Care Assistant in St Oliver’s ward at St Finbarr’s Community Hospital in Cork.

“There is a lovely atmosphere among everyone in the ward,” says Deirdre.

“Typically, our patients undergoing rehabilitation and receiving physiotherapy after a stroke, after an accident or who are recovering from a hip operation, are elderly people. We all get to know each other.”

There’s always a bit of banter going on in the busy, bustling ward.

“The gentlemen like to chat and some of them can be full of devilment, enjoying a laugh and a joke!”

Hospital workers were often required to work long hours under challenging conditions during the pandemic when resources were stretched.

“Since March, things have been very challenging for us in the ward,” says Deirdre.

“It was very hard on us, and it was the most challenging period in the hospital during all my years there since 1980. It was a terrible year for us.

“It was very hard on the patients too who couldn’t see their families or friends. 

The elderly patients really look forward to having visitors and getting all the news.  They had to talk to people through a window and they couldn’t touch each other,” says Deirdre. 

“They found it hard to hear. Nothing was private and it was a shocking situation. Some patients used their ipads to communicate with others. But many elderly people don’t like looking into a box.

“They much prefer human contact. It was very sad for them.”

Deirdre and her colleagues made a super-human effort to cheer people up in St Oliver’s ward.

“Usually, we’d have loads of decorations and a tree with lights in the day room,” says Deirdre.

“The patients couldn’t congregate there this year, so we cheered up the ward with a few Christmas baubles and we had a sing-song now and again with the season that’s in it.

:It was amazing how everyone loved joining in remembering the words. We have great cráic.”

Yarns and stories are swsapped.

“No matter how old someone is, they still talk about long ago and about their mothers!” says Deirdre.

Memories and sentiments are embraced.

“We all feel like we are one big family.”

The hospital staff are kitted out to protect themselves and others from the virus.

“The PPE protective equipment we had to wear was a hindrance sometimes,” says Deirdre.

“There’s a lot of paperwork involved in the job I do. I found my glasses kept fogging up and I’d walk into things!”

Fatigue was a regular occurrence in the highly-stressful, highly professional environment.

“Working flat out on the ward days and nights could be exhausting,” says Deirdre.

“So far, we’ve got on with it and we’ve all survived.”

The mother of two is a cancer survivor and also a Covid survivor.

“Yes, I am a breast cancer survivor,” says Deirdre, who is married to Billy.

“I was diagnosed with breast cancer 10 years ago. Since being cancer- free, I’ve never looked back,” adds Deirdre, who looks on the bright side of life and who brightens up the lives of the patients in her care.

“I was on my feet for 12 solid hours at work during Covid,” says Deirdre.

“Everyone put in a mighty effort to look after our patients and to deal with the extra workload.”

Was she floored when she contracted Covid-19?

“You know, I half expected it,” says Deirdre.

“There were a few confirmed cases at St Finbarr’s. Some elderly patients were sick with it. I felt tired after night duty and I developed a cough.”

Deirdre knew what to do.

“I had a swab done on Saturday and the following Thursday I tested positive for Covid. The worst thing was I had no sense of smell or no taste.”

She isolated at home, took it easy, and rested up.

“Luckily my husband Billy and my son Jordan are house- trained!” says Deirdre who, like her patients in St Oliver’s, enjoys a laugh and a joke.

Deirdre returned to work when she was able.

“Working with like-minded people in a caring atmosphere is very rewarding,” she said.

Deirdre is also looking forward to some brighter days.

“If the promised vaccine does it’s job, there might be a holiday,” she adds.