13 Portugal, Rita Leal

Hello, my name is Rita Leal and I am from Portugal. I am a family nurse and a midwife and I am a head nurse/charge nurse for my department. It is a community care centre. We work from 8am to 8pm but I get messages outside of business hours for scheduling, etc. I have a good team which makes my job easier. I am a midwife at the same community care centre. I deliver babies and work with pregnant women and families. There are four (4) midwives in our labour and delivery department. As the charge nurse I control schedules and deal with quality management, patient satisfaction and nurse motivation and satisfaction. During Covid, job satisfaction was diminished among the staff. Changes we made during Covid include focusing only on Covid and keeping our families safe. When I look back, we could have done things slightly different, but we didn’t know what was going to happen. My centre stopped our family consultations, our prenatal classes, and everything that we could stop. Our community care takes care of people who are dependant in their homes and those did not stop. We kept essential services. The home care team kept going. But the essential is not enough for families so we also focused on testing for Covid. Our team started testing for the whole region. We had a drive thru and also did phone calls to check up on our families. We checked in on patients with Covid and triaged them and gave instructions as to when to go to the hospital, keep quarantine, noting symptoms, testing other family members etc. but we did leave a lot of our family care behind.  I think one of the worst things was leaving behind our families with small children and newborns. It was difficult for families with children at home doing internet schooling and we wish we could have done more for them. We had to work with what evidence we had at the time, however. In our region, we were looked upon as the Covid nurses. Family nurses became pandemic nurses. We also started vaccinations in December 2020. We were in charge of the vaccination centre and gave more than 1 million vaccines and worked hard to inform families. We went back to family nursing structure in January 2022. We don’t do Covid vaccinations anymore. In Portugal we have a high vaccination rate and that is because of nurses. When we started getting back to normal practice we saw that we left important family issues behind. For example, post partum depression patients were not getting proper care and support. Today I look back and see how we could have helped them more efficiently and if it ever happens again, we will be prepared. Today I would prefer to vaccinate more slowly and keep our other services. We have to be there for families. One thing I am very proud that we did do, we never stopped respite consultations for families or help with breastfeeding. We never kept the other parent out of our consultations. Both parents could come to the appointment. If we want results, we have to work with the whole family. This was a priority. Other facilities separated families and we now see the negative effects of that separation for example on mental health. We convinced our politicians to stop the separation.