Breaking down the barriers of nursing behind closed doors

While single-bed rooms for patients offer privacy and dignity, Hayley Valentine, a former critical care nurse and a clinical consultant for Ascom, explores the challenges ahead for nursing ever larger numbers of patients in their own rooms.

The pandemic has highlighted a great number of things that many of us previously took for granted, both personally and professionally. For nurses, the ability to communicate with ease is one such thing. With colleagues, with patients, with relatives. All of which, it seems, was aided significantly by traditional multi-bay wards.

Because when we moved away from Nightingale-style wards and added isolation measures for infection control, we also turned all those previously easy to have, face-to-face conversations into phone calls, pager bleeps and messages left on whiteboards. Communication suddenly became harder during a time when it had never been so critical.

Patient visibility became an issue too, with single rooms creating physical barriers for nursing where previously a nurse could observe the whole ward in a glance.

That’s not to say I’m against a move towards single-bed wards. I’m absolutely not. The pandemic has emphasised the need for better infection control measures. There have always been issues on multi-bay wards around patient dignity and privacy and for some care, such as end-of-life support, a patient being treated in their own room is far more appropriate than in the middle of a busy bay.

However, we can’t ignore the very real worries nurses have, such as whether the lack of visibility means there is a greater risk of patient falls. And whether it is even possible for a night shift nurse to effectively care for patients when they’re all behind doors. Nurses need to be able to observe their patients at all times. It’s that simple.

Thinking beyond the four walls

So, what is the solution? Most can agree that neither ward setting is perfect. But, perhaps combined they could be.

Single-patient rooms with the visibility of an open ward is clearly the ideal scenario for both patients and staff.

Without visibility, we can’t expect nurses to be able to provide gold standard, holistic care to patients. But to achieve this we need to think beyond the four walls of a patient room, with technology enabling what once seemed impossible.

Clinically led, interoperative technology can enable nurses to be more connected to colleagues and patients, even when there are physical barriers.

Smart technology that integrates seamlessly with medical devices to alert nurses about when an infusion is nearing its end, for example. Or technology that provides nurses with near-real-time alerts about those under their care will make patients more visible and in turn, their care more manageable and effective.

What’s more, the technology is also being designed to streamline and improve some arduous processes, reducing administration time so nurses can focus on what they do best – caring for patients.

Making the ‘invisible’ visible

Where previously a nurse could look out over a ward and see all their patients in a glance, now technology can allow the status of a patient to be recorded in near real time and viewed from a dashboard. This means, still, at a glance nurses can check up on the whole ward, despite each patient now being housed behind walled partitions.

Rather than preventing effective communication, technology could power it. Nurse call systems will allow clear communication to and from nurses and patients and chat applications on smart devices can connect colleagues instantly.

What happens to a patient when they’re not in their full view is a real concern for nurses. Will patients feel isolated from care and how can an already stretched nursing workforce cope with the demands of ever-growing number of patients when walls are being put up between them?

Although safe staffing ratios is something technology will never replace, nor will it ever try to take away from the clinical skills of healthcare professionals, it is providing solutions to some of the biggest challenges hospital wards face.

Making the invisible patient visible can only add to the functionality of the ward and benefit patient safety and clinical outcomes.

Nursing post pandemic

The issue of managing a ward of single-bed rooms isn’t one which will be confined to the Covid-19 pandemic. The Government has pledged to build 40 new hospitals by 2030 and many, if not all, will consist of single-bed wards.

As a former critical care nurse, I know all too well the challenges and the chaos you have to overcome when providing frontline care. I feel passionately that the role technology can play in healthcare will allow nurses to deliver the care patients deserve. So to be part of making that happen is extremely rewarding.