Nursing Webinar Series 2020 : Webinar 3

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Our final webinar of the U21 HSG Nursing Webinar Series ‘‘Working with COVID-19: Policy and service responses’’ took place on Thursday 26th November.

In Ireland, the first confirmed case of COVID-19 occurred in the community on 29 February 2020. Like many European countries, Ireland experienced the greatest impact of the first wave of the COVID-19 global pandemic on its acute hospital and intensive care services and on residential care settings for older people. The initial response of the health system was to increase surge capacity in the acute hospitals, ensure efficient testing and contact tracing capacity, and procure personal protective equipment. The response to managing the pandemic in older people’s residential care included early case recognition and isolation, supportive care, infection prevention and control, as well as, testing and contact tracing. The coronavirus presented enormous challenges for the healthcare system, but also demonstrated great effort, innovation, and collaboration in response to these challenges.

This webinar examines aspects of the health system response to the pandemic in Ireland within acute care and residential care services. It examines the initial level of preparedness for the impact of the first wave in residential care and considers whether the health system response, along with public discourses concerning older people’s vulnerability to the virus, may have betrayed latent manifestations of societal and institutional ageism. The webinar also presents the design and preliminary findings from a study that examined healthcare staff experiences of team working in response to COVID-19 pandemic in the hospital setting. The study considered how understanding and supporting changed ways of working may transform the health services and strengthen the international response to future pandemics. The webinar also offers some emerging evidence of changes that have occurred within teamwork during the initial period of the health system response, including evidence of new ways of working in the health and social care of older people. These ways of working include role expansion, innovations in communication, environmental restructuring, and training and enablement.

Speaker Presentations

>Professor Gerard Fealy

Constructing older people’s identities during COVID-19

Ageing continues to be the subject of stereotyping, and ageism is manifest in two distinct but related ways: in the ways that public policy regards older people as a distinct demographic group and in the ways that older people are talked about in public discourse. These manifestations of ageism, in turn, give rise to older people’s experiences in areas of public life, like the health and care systems. This paper examines latent manifestations of ageism during the first wave of the COVID-19 pandemic in Ireland, focusing firstly, on the health system response to older people in residential care homes, and secondly, on public discourses concerning older people. Drawing on published sources related to the COVID-19 pandemic in Ireland, including official reports and media reportage, the paper will demonstrate a lack of preparedness for the impact of the first wave of the pandemic on residential care homes during the early weeks of the pandemic. It will also instance recurring public narratives concerning older people and the coronavirus. In this way, it will demonstrate how the pandemic provided a new context within which older people were discursively constructed and how, from these discourses, some ageist tropes revealed themselves.

>Dr Deirdre O’Donnell

Capturing ‘New Ways of Working’ in the Care of Older People During Covid-19: Results from a Rapid Exploration of Emerging Evidence

Older people are disproportionately affected by the Covid-19 pandemic; they are more likely to require hospital admission and they are more likely to die from Covid-19 infection. Therefore, health and social care staff who provide care for older people from acute to community settings have had to rapidly adapt and change their ways of working in response to the pandemic. Strong inter-professional team working is essential to this response. We aimed to capture and reflect upon some of the emerging evidence of changes that have occurred within teamwork during the initial period of response. We undertook a scoping exploration of evidence emerging between 1st of March 2020 to 11th of May 2020. We retrieved evidence of new ways of working from three sources: For a broad perspective, we used the Twitter Advanced Search function to retrieve tweets which mentioned ‘new ways of working’ related to health and social care (N=317). For a more focused exploration of new ways of working as they related to the health and social care of older people, we conducted a systematic search of the Lexis UK Database to retrieve newspaper articles describing responses during the initial period of the pandemic (N=34). Finally, we conducted a validation workshop with members of the interprofessional working group of the Irish National Integrated Care Programme for Older People (N=11). Changes in team working were captured under four themes relating to role expansion, innovations in communication, environmental restructuring as well as training and enablement. The context for these changes is unprecedented and relied on the commitment and goodwill of staff who were working beyond their roles. Reflection upon these changes is important for developing an understanding of team dynamics in health and social care with older people. Furthermore, this work may help to identify ways of working which are beneficial for inter-professional collaboration and which have the potential to be sustained.

>Dr Aoife De Brún

The COVID-19 pandemic in Ireland produced an extraordinary response from healthcare professionals and healthcare teams.  There are many stories that have been shared in the media and through social media detailing the enormous effort, innovation and collaboration that has contributed to adapting and improving the health service in response to the challenges presented by the virus. Although there are differences in the types of changes made and how they are put into practice, there are also common aspects, including the quick identification of needs, undertaking new collaborations and ways of working, a primary focus on the patient, and individuals contributing over and above their usual role or area of expertise. The challenge we now face for the future is to continue these beneficial ways of working. This research aims to harness the learning from staff experiences during the pandemic to inform ongoing and future reform and improvement. We will adopt a multi-method, phased approach to data collection and analysis to: (i) understand staff experiences of healthcare delivery during this period, (ii) to explore the perceptions, motivations and attitudes of staff to adaptation of healthcare delivery to learn how we can improve the quality and sustainability of these approaches throughout and beyond this pandemic. COVID-19 provoked an unprecedented level of collaboration and effort in the delivery of healthcare. Understanding and supporting these changed ways of working has the potential to transform our health services by directly informing policy and practice, as well as strengthening the international response to future pandemics.

About our Speakers

Hosts

This webinar will be hosted by Professor Gerard Fealy (above), University College Dublin with the support of Dr Julia Slark, University of Auckland who is the Chair of the U21 HSG Nursing & Midwifery Discipline Group.