Working in a New Norm: Covid 19

Case Study Submitted by: Suraya Binti Said, Health Nurse Supervisor, Pejabat Kesihatan Daerah Sik, Malaysia
Country: Malaysia

The State of Kedah State in Malaysia has seen over 19,000 cases of COVID-19 ( Ministry of Health, Malaysia 2 June 2021). The Sik District Health Office (Pejabat Kesihatan Daerah Sik) provides Pregnancy Services, Child Services, Women’s Health Services, Outpatient Services and Maternal Care during Post Natal and employs 108 nurses. As a result of the pandemic, planning has been undertaken to provide knowledge and standard operating procedures (SOP) to all nurses. The New Norm Brief is given at the health clinic level so that nurses can obtain accurate and clear information.

According to the New Norm Guidelines, services are provided based on “staggered hours” appointments. Patients are limited to one day appointments with only two people per hour for standard cases and one person per hour for more difficult cases. Each appointment is planned according to the patient’s needs and the number of staff interacting with the patient is limited. The time with the patient is also limited to within 15 minutes. A maximum of seven people allowed in the waiting room and companions are advised to wait outside. The queue number system is given according to the patient’s turn so that there is no congestion in the waiting room, and chairs are spaced and lined up behind each other.

All clinics practice screening at the entrance using checklists for body temperature and signs of infection such as fever, cold, sore throat, etc. Patients are asked if they are from a region with a higher risk COVID-19 cluster, and an isolation room is available if needed. All clinics have opposite entry and exit routes for patients attending the clinic. Users of the prayer room must bring their own prayer wear and prayer mat to prevent infection.

All nurses have download the My Sejahtera application which monitors the movement of staff. All nurses record their temperature when entering duty and returning from work. Nurses adhere to the practice of using Complete PPE (personal protection equipment) and maintaining social distance from colleagues. Work schedules have been organised to reduce the number of staff working at the same time. All clinics display posters and streamers as notification of the implementation of the New Norm Movement Control Order. As a spread control measure, the sanitization process is performed twice a day in the morning and evening. Compliance to the New Norm Guidelines is monitored by the clinic supervisor and the the State Health Department

Challenges that have occurred include handling cases online as patients in rural areas have bad connection service making it difficult for nurses to implement counselling services. Ppatients with financial problems, where family has lost their source of income is another challenged faced. Some t resource assistance is provided to reduce the burden on the family, including the contribution of “maternity kits” to mothers who gave birth during the pandemic.

Suraya Binti Said, Health Nurse Supervisor, Pejabat Kesihatan Daerah Sik, says “COVID-19 has taught nurses to be more aware of the importance of nurse ethics, self-discipline and compliance to instructions and the SOP issued by the Ministry of Health.”

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