by Tristan Pahuyo, Digital Pioneer Fellow – 26th February, 2021

Tristan Pahuyo, one of this year’s Digital Pioneer Fellows, is the Link Informatics Nurse at St Bartholomew’s Hospital and his role involves digital transformation, clinical engagement and strategy. He also leads on the digitisation of paper nursing documentation at the hospital. Prior to holding the Informatics role, he worked as a charge nurse in the critical care unit at Barts Heart Centre. In this blog, Tristan writes about his reasons for applying for the Digital Pioneer Fellowship programme, how COVID-19 has impacted his role and his perspective on the impact it has had on the NHS more widely.

I joined DigitalHealth.London’s Digital Pioneer Fellowship because I want to be at the forefront in the transformation of care. The programme will help improve my ability to self-regulate, build and cultivate agility. Working in a big and complex organisation, I believe that the Digital Pioneer Fellowship will help me acquire the flexibility and dynamism needed to respond as the landscape shifts, developing the on-going capacity to initiate and adapt processes and capabilities quickly. The ultimate goal is to lead and support a digitally enabled health and social care system that improves patient outcomes, enhances working lives, and makes services more efficient.

The impact of COVID-19 on my work

My role has changed significantly due to the second wave of the pandemic. With my nursing background in critical care, I have been temporarily redeployed to clinical work. I have been working in two ICUs (intensive care units) across the Trust, and the situation as I write this is challenging.

Although the number of cases has dropped, this has not been felt fully in ICU yet. During the first wave, I was not redeployed as I was helping facilitate virtual visiting on our site, although I did do a couple of shifts to help out. At that time, staff were supporting each other and there was a sense of solidarity and a can-do attitude. The public initiatives to boost health workers morale really helped, such as the Thursday evening clapping, letters of thanks and donations. It made nurses feel valued and appreciated.

This second wave feels different. My colleagues are extremely exhausted. It has been almost a year that ICU nurses have had to work in full PPE which can be incredibly uncomfortable. During my first shift, I felt the tension in the air. Everyone was stressed, on the edge and frustrated. News of people violating lockdown rules has also been a big blow to the hard work of our colleagues.

Despite all of this, things are getting better. As days go by, more and more people have volunteered to help. We’ve had doctors, allied health practitioners and the army come in to give us a hand. The Trust has also made sure that everyone’s wellbeing is looked after. The renewed sense of reassurance that everyone is fighting together, hand-in-hand has given us a massive boost to our morale. It has given us hope that soon, we will all get through this and things will be better.

Maintaining digital momentum

My biggest concern is figuring out how to maintain momentum of the new digital workflow without an informatics nurse in place.  My informatics role involves daily check-ins with clinical staff and senior nursing leads and I act as a link between clinicians and the wider informatics directorate, translating clinical requirements into digital solutions. The necessary staff re-allocation has meant that digital superusers and champions have been moved to intensive care. 

My shift work has also made it challenging to answer all the informatics related queries sent to me via email. As a result, I worry that nurses will lose confidence in the digital workflow. I try as much as possible to go to ward areas to catch up and check in with the rest of the nursing staff whenever I have spare time during breaks. I want to do everything in my power to ensure we don’t lose this momentum.

The role of digital within the NHS has changed massively since COVID-19. New ways of working have been introduced, people have been forced to adapt quickly and navigate in a digital space. Pre-pandemic, much of the digital solutions that had been rolled out were more reactive than proactive. The pandemic provided an opportunity to fast-track digital solutions.

The pandemic has afforded us the opportunity to embed digital competency in service delivery. It has allowed us to think about models differently, especially in change leadership. We are now able to champion re-invention, even if the status quo is working. With the accelerating digital transformation brought about by this unprecedented event, it is imperative that we provide better outcomes in care and service delivery.

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