I wish I could reveal the identity of the nurse I interviewed this week because she deserves public recognition for the incredible work she’s doing. Unfortunately her NHS trust wasn’t happy about her speaking to the press, so in order to share her story – because it deserves to be heard – I shall keep her anonymous. In any case, I have no doubt there are countless other nurses around the UK with similar experiences to her own (although she said the situation in London and the Midlands has been very different). Suffice it to say she is in her mid-30s, has been employed by the NHS since she was 19, and is currently working as a senior nurse in intensive care, doing shifts in a number of different hospitals up to one hour’s commute from her home.
Has your role and working pattern changed as a result of coronavirus?
We’ve had to bring in people from all over to support intensive care, so the training I was doing for another role is on hold for the foreseeable future. I’m still doing the uni part of it, but the clinical aspect depends on when we can get back to doing what we were doing. The working pattern is really good. They don’t want us doing a lot of extra shifts because of the risk of burnout so we’re doing three or four shifts a week. They’re 13-hour shifts. That hasn’t changed.
Have you had to make any personal sacrifices in order to fulfil your duties?
I’m working in a really high risk area. Even before lockdown, I had a lot of people turn around and say ‘you’re really high risk, I can’t take the risk of seeing you at the moment’. I haven’t seen people for a very long time, that’s been the main impact. I haven’t seen my family since the beginning of March. Pretty much every day I was off work, I’d see my friends, but I haven’t seen anyone. It’s horrible but I have essays to do so I can focus on that. Getting out for exercise, doing my runs every day, has been the saving grace.
Have you had any symptoms of coronavirus and have you been tested for it?
Not yet, touch wood.
What proportion of your working time is spent dealing with coronavirus patients?
Hospitals have split up into red zones, with coronavirus patients, and green zones, and we get allocated to the red zone or green zone. They try to mix it up so we’re not in the red zone every single shift because it is really hard work doing that. If you’re allocated to the red zone, you’re in PPE (personal protective equipment) for the whole shift.
Are you adequately equipped to deal with the pandemic?
I would say we are. In intensive care we are probably the area most fortunate in that PPE is first allocated to our area. On the wards, you might have a queried Covid-19 patient and you’re not necessarily doing the same procedures therefore according to Public Health England you don’t necessarily need to be wearing the same level of protection that we have in intensive care. That, I think, has put a lot of people at risk. It doesn’t help that Public Health England have changed the requirement for what we need to wear on a number of occasions. There have been times we’ve been very close to running out of, for example, gowns, masks and visors in particular. A lot of local companies have stepped in and made visors for us now, which is great. We haven’t got to the point we haven’t had the right PPE in intensive care. I can’t say for the wards but from what I hear from nurses who work in the wards in different hospitals as well, there have been issues in getting the right PPE.
What’s it like having to wear the PPE for long periods?
It’s absolutely horrible. You’re hot. You’re basically wearing layers and layers of plastic. Having a mask and visor is really claustrophobic and it’s painful. Your face gets really sore, particularly after a couple of shifts wearing that stuff. It is not an enjoyable experience. It makes communicating with everyone really difficult because they can’t hear what you’re saying properly. Your patient can’t see your face which is really hard first of all and they can’t hear and understand what you’re saying properly. It makes the whole situation so much worse. It’s a lot more frightening for them. It’s not a nice situation at all.
What other challenges do you face at work?
Because we’ve had to scale up our response so very quickly, and we’re moving into different areas – we’re not necessarily staying in intensive care, we’re moving into recovery areas, theatre areas – we’re having to really quickly redeploy a whole load of resources into different areas and it does take time finding everything and sometimes we’re working with equipment that we haven’t worked with before so we’re having to find people who are really confident in managing that stuff and talking through it with them. There’s a lot of learning as to all the different equipment. Patients are having to be moved into different areas and that’s quite time consuming as well.
Is it harder dealing with patients with coronavirus than with other conditions?
Definitely. We’re having to look after someone with PPE on which is really difficult and it’s an unknown condition – we’re learning so much about the disease, and really quickly. We may have been treating the patient in one way in March and we’re changing our approach as we’re learning more about the disease. That’s been interesting but challenging. These patients are sick – really sick when they get to ITU. They’re really struggling with their breathing.
Does the lack of visitors make it easier or harder for you?
Patients are not allowed visitors at all and that is really, really hard. The patients need the motivation and reassurance of having family members there and they’re not there. We’re doing video calling but it’s not the same as having your relative there. For us as well it’s really hard because you’re giving information over the phone and you don’t know if they completely understand because they’re not familiar with the environment of intensive care. Unless you’re there, you don’t really appreciate what that person is going through. You can see stuff on TV but unless you’re actually in that environment, you don’t actually get it. When people are dying, that’s the worst bit, because they’re not there. You’re doing video calls and they’re saying to the patient ‘we love you’ and ‘keep fighting’ as the patient is passing away. That’s really, really harsh.
Would you say this has been the hardest time in your career so far?
It’s definitely the hardest. Working in PPE is a massive challenge and you’re working with a disease that’s so new and you don’t know the risks of it. You’re going into each shift thinking you could potentially get the infection so you’re having that in the back of your mind all the time. You’re worried about your colleagues as well. There’s a lot of tension but there’s a lot of teamwork as well. Everyone is worried about it so they’re looking out for each other all the time, so that’s one big positive from it.
Any particularly rewarding moments?
At the weekend I was with a patient who had been ventilated for 25 or 26 days and she had a tracheostomy – a tube in her throat. We were able to take her off the ventilator and put her on a bit of oxygen. The patient didn’t quite get how exciting that was for us but her family did and were really, really happy because then we could also do a video call for them. Seeing the excitement and happiness on people’s faces when you’re giving them positive news because they’re not hearing positive news from the media – all they’re hearing from the media is ‘everyone is dying’. A large number of people are dying but some are recovering. It takes a long time to recover from this. When you see them being discharged out of intensive care after 30-odd days, when you didn’t think that they would survive, two weeks previously they were at death’s door, that’s really good. My patient at the weekend was so demotivated, she hadn’t seen her family for ages, she was thinking they had forgotten her and it was just that they couldn’t come in at all. People come in absolutely frightened and when they leave you can see the relief on their faces. When they leave intensive care they’ve still got a long road ahead of them, but seeing them recover is really good.
There have been some reported instances of hostility towards NHS workers from yobs – have you experienced this and what’s your reaction to it?
I haven’t experienced it. You’re always going to get a small percentage of people who react to things like that. I feel more frustrated towards the government – because of their handling of things – than I do towards those people. I think it’s a case of not going out and flashing about your NHS card, don’t go to the supermarket with your uniform on, if possible. Obviously it’s difficult if you’re a community nurse. It’s laying yourself open to it. I wouldn’t go out and say I work in intensive care because you don’t know what kind of response you would get but generally people’s response has been very positive.
NHS workers are widely being called heroes – do you think they have stepped up, or were they simply underappreciated before?
They were underappreciated – taken for granted. People have worked so damn hard, there’s no doubt about it, and a lot of people have stepped up but I don’t think nurses were generally appreciated. The recent support from the public has been great. The amount of food and things we’ve been getting from the public is crazy, it’s fantastic. All the donations have been amazing. It keeps you going when you’re having a hard shift and you get some really good food come in. We get a lot of pizzas, curries, pies, chocolate, cupcakes. They go down well. We get fruit as well. We have to stay healthy during this crisis.
How do you feel about the ‘Clap For Our Carers’ on Thursdays at 8pm?
When it first started everyone was really quite emotional about it. Now it has kind of been overwhelmed with all the other things regarding PPE, the number of healthcare workers who have died… At the end of the day, none of us would describe each other as heroes, we’re doing our job, we want to be able to do our job safely. That’s been the main thing. It’s lovely hearing the claps but what we want is for people to stand up and make the government take account for their actions during this. When this is over, we need to have a proper review into the handling of this crisis. Also we need the public to support us in making sure the NHS is properly funded. We’ve had years of underfunding and that has really shown during this crisis. We’ve come into this crisis with a massive nursing vacancy rate as a result of cutting bursaries, pay freezes… You can give us ventilators, you can build new hospitals but without the staff to run it and look after patients, it’s pointless. Look at the Nightingale Hospital which has had barely any patients. They couldn’t admit patients there because there wasn’t enough staff to look after them. We need to push for proper funding of the NHS and support for getting more people into nursing.
There has been controversy around NHS workers dancing in videos on social media – what are your thoughts on this?
They’re doing it to keep morale up. They’re not doing it in times they’re looking after patients. They may be doing it at the end of a shift, the beginning, in breaks, and they’re allowed to have a break. I personally wouldn’t do one, which is strange because I’m quite a social media person, but I can understand why people do it. It’s to keep morale up and it’s like a team-building exercise as well, getting together as a group to make a dance up or whatever they’re doing. It’s a bit of stress relief.
What’s your message to the general public?
Stay home until we’re allowed to go out again. We don’t want another surge in it. We’re worried about potentially having two surges. One will be more corona patients because they’ve gone out too quickly or whatever. But we’ve had a massive drop in the number of people coming to hospital with other conditions like heart attack, stroke, mental health problems. All of these patients we’d normally be looking after, but they’re not coming into hospital and that worries us, they’re all waiting at home, holding on for too long and then they’re going to come into hospital too sick. If they’re feeling awful they need to come into hospital. Hospitals have been split up into green zones and red zones. They won’t even go near a Covid-19 patient. They have to remember that. And we’re really grateful for the public being behind us, supporting us, and we need them to stay at home to keep themselves and everyone else safe, until things get more under control.
What’s your message to the government?
I’d have to think about that.
Do you think the measures taken i.e. lockdown have been timely and effective?
It’s difficult to say. Personally I think it should have been earlier and should have been potentially stricter. We’ve already passed 20,000 deaths and that’s far too many people to have died from this. It’s difficult to compare countries because they have different epidemiologies and healthcare systems but potentially they could have implemented lockdown earlier. They could have been tighter on restrictions because a lot of people have flouted them. I don’t know about tougher punishment. The police are under-resourced as well and are doing the best they can and to go out giving out fines to everyone is unrealistic. They can’t physically do that. But PPE has been the main thing. They were slow in the uptake of that, they did not communicate properly with us. They were saying one thing but something else was happening. They said a shipment was coming from Turkey and they hadn’t actually agreed it with the Turkish authorities. Things like that. Healthcare workers have been affected by it. At one point, 45 percent of our patients were healthcare workers. You can’t say it’s definitely down to PPE but it’s interesting and something you have to think about. Now we’re seeing numbers go down which is really good but we have to see the government’s response to getting us out of lockdown. They’re having to weigh up the economic effects versus people’s lives. If they do it the way they got us into this, it’s going to be quite worrying and we will probably see a resurgence. If we come out too soon, it will cost lives.
Any last thoughts?
At the end of the day, yes it’s hard work in the NHS right now but I have a job and a lot of people can’t say that. I have income and there’s no chance of being made redundant and I’m really fortunate, I have to say. There’s a lot of people worse off than myself.