Peggy McHale, senior clinical engineering technician, Mayo University Hospital, Castlebar, Co Mayo, discusses her life in engineering.

What brought you into the profession?

I had really enjoyed physics and biology in secondary school and stumbled on the instrumentation apprenticeship in Sligo, without really knowing what I was getting into. In my first week, I had asked my instructor for a few hours off to attend an interview for nursing which didn’t go down too well.

Nevertheless I stuck at it, and when it came to being handed out some of the course books, I was told not to write my name on them. Red rag and bull!

Peggy McHale

This was a turning point for me and drove me to prove my ability, I started my apprenticeship with what was then the North West Health Board as an electronics technician in Sligo General Hospital and from there I got hands-on experience with medical equipment including in the Renal Dialysis Unit and never looked back. 

Where did you study and what were your favourite subjects and was your plan to work or stay in healthcare engineering?

I served my apprenticeship in Sligo General Hospital while attending the Regional Technical College in Carlow for a 12-week period, each year, over four years.

This was a mix of studying the theoretical principles in college while getting the opportunity to see practical applications in a hospital setting. I loved the hospital environment and the interaction with other staff and patients.

I didn’t really have a plan following completion of my apprenticeship and had considered travelling to Australia where I have relatives but a post was advertised in Letterkenny and I went on to spend almost four years there, working mainly with dialysis equipment.

This led me back to my home county when a satellite dialysis unit opened in Mayo with initially eight bed spaces. I started what is now the Clinical Engineering Service for the hospital with the help and support of colleagues and hospital management over many years.

When you were in college did you think you would spend your career in the healthcare engineering?

Clinical engineering was just beginning to develop as a profession from a mix of electronic technicians, or biomedical engineering grades but no two hospitals had the same structure.

The BEAI (Biomedical & Clinical Engineering Association of Ireland) was just being formed when I was training... I remember the inaugural meeting in Dublin and some ‘think tank ‘meetings in the Harcourt hotel. 

It was an exciting time for clinical engineering in Ireland and formed the beginning of the structure that is still in place today, so I was always hopeful that I would continue to work in healthcare in some form.

What are the biggest changes you have noticed over the years in clinical engineering?

Attempts to replace obsolete or aged equipment in the earlier years was a complete solo act and was entirely dependent on the hospital's revenue budget, which consultant shouted the loudest and the relationship you had with the hospital management.

Introducing Aims (Asset Information Management System) was a game changer in provision of evidence of inventory, history and economic impact and a no-brainer for hospital management to see the bigger picture in planning and managing equipment resources.

The introduction of the NERP has been the biggest change, in my view, in upgrading the fleet of equipment for HSE and while we have been playing catch-up for many years, prioritising equipment needs for the hospital is now shared within the MDEMC (Medical Devices/Equipment Management Committees).

In a small department this collective responsibility makes decision-making so much simpler and effective. It’s not who shouts the loudest any more.

Equipment repairs are certainly less common with increased reliability built into more advanced medical devices. The more common changes to our service are increased reliance on IT systems/patient information archiving.

Software compatibility and connectivity issues between medical systems and HSE systems take time to resolve. There is a greater reliance on IT but when connected to a medical device, there seems to be a disconnect between IT supports and medical device suppliers, with conflicting security and capacity.

There have certainly been improvements in value for money relating to equipment procurement due to the framework of national tenders by the national procurement office but, in my experience, there is less availability or certainly opportunities for certified technical training.

One of the positive impacts of COVID-19 was increased availability of online webinars, training videos etc, which is certainly beneficial. But, of course, there is nothing like protected time to attend training and gain valuable hands-on expertise with a network of colleagues from other sites. Roll on these days again!

How has the clinical engineering profession changed over the years?

There has always been a professionalism to clinical engineering and a competitive drive to make improvements in the structure and provision of resources for departments.

Senior hospital management are reliant on good advice and guidance to ensure safety and reliability of medical devices, and the clinical engineering profession is well placed to give a pragmatic, well-informed decision.

There is a now a huge network of the clinical engineering family both in hospitals and within support companies to draw from a wealth of knowledge and experience, and I have always found a willingness to share information, best practice and new developments.

In your role as a healthcare professional what inspires you most about your job?

It’s a most rewarding profession and interaction with patients and staff is hugely important in keeping in touch with the needs of the service, whether that’s in a general ward or more critical care.

Engaging with other professionals to resolve technical issues, finding an alternative solution to a common problem for clinicians or completion of a new project is most rewarding.

It can make a big difference to clinicians but the knock-on effect to patient services can be massive. We are in a unique position to see issues from all sides, clinical and technical, while being aware of the constraints of finance and infrastructure.

Would you encourage young women and young men to follow a career in medical physics and clinical engineering?

Yes, absolutely. It’s a challenging and interesting job and no day is the same. We can face anything from routine transport of adults and babies with complex care by air and road, provision of reassurance and support to clinicians and management regarding any equipment, throw in a few cyber-attacks, floods, a couple of storms and a global pandemic.

It is a team effort always, a reliance on one another to keep moving forward with quality improvements, plans and sometimes compromises but there is always a sense of achievement when it all comes together.

Can you share some of the main highlights of your career?

In my first few years in Mayo, a new hospital building was under way which involved transfer of patients from the old to the new wing of the building in stages.

One of the most challenging moves was the transfer of babies from the old SCBU (special care baby unit) to a new unit. This was a most memorable day with a co-ordinated transfer of an active SCBU.

We had a number of stable babies transferred in incubators and two runs of ventilated twins using a transport incubator. It was a steady convoy of equipment and patients by clinical, technical and support staff, from the old building to the new areas.

Being involved with the design team for a central decontamination unit, after years of non-compliance with HSE RIMD, was a particularly rewarding project, as I had developed an interest in the whole area of decontamination.

It was great to be involved in a building project with a mix of expertise from within and outside of the hospital, to shape a unit that will benefit patients in Mayo for many years ahead.

Most recently, COVID-19 planning and management of equipment has proven to be challenging and my colleagues and I have been completely immersed in this huge burden of work, but it is also rewarding to see what has been achieved in a short time with many projects and long-term plans fast tracked within a few months. 

A concerted and focused effort by our small department has overseen the introduction of dual ICU and ED departments for Covid and non-Covid and the introduction of many additional services, eg a CCU, Telemetry, and a 40 bed off-site acute beds.

The level of co-ordination required has, like many other hospitals, been difficult with limited resources but I am heartened by the support and commitment of my colleagues in equipment planning, co-ordination and installation.

While projects and individual repairs are too many to mention, one constant has been the people that have worked in the clinical engineering department and those that we have close connections with throughout the hospital, colleagues in our hospital group and fellow service engineers in medical equipment companies.

There is always an avenue to seek advice and support within the clinical engineering field, no matter how difficult the circumstances.

This interview was first published in the BEAI's Spectrum journal