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MAY 22/2020

Reflecting on a Global Pandemic - A Month in the Life of a COVID-19 Agency Nurse

At the start of this year, few of us could have predicted how 2020 would play out. Virus outbreaks and quarantine were merely scenarios used by Hollywood directors to make cinematic thrillers, in which a hero rises to the occasion to save the day.

Of course, this is far from fiction. The reality is that we find ourselves in the vice-like grip of a global pandemic. Fortunately, help is at hand. With no capes or Lycra in sight (just plenty of PPE), the protagonists we’re relying on are healthcare professionals who are stepping forward and working tirelessly to save the world.

Agency Nurse Sam’s Story

One of the many brave and determined nurses operating on the front-line is Sam, a qualified adult and children’s nurse who is a valued member of the Medacs Healthcare family.

Before the COVID-19 outbreak, Sam was primarily stationed in A&E and resus, due to her vast experience in PICU and ICU. However, once the pandemic reached the UK, she returned to critical care to help care for patients who had contracted the virus.

Speaking one month into the pandemic, Sam assures us that she’s “very well”, before adding: “It’s incredibly busy and emotionally draining, but as nurses, we are able to maintain our resilience in supporting each other. As an experienced agency nurse, it is more important to support the substantive staff we work with.”

This is Sam’s story.

Week 1 – The first wave

As the first patient with suspected COVID-19 symptoms was admitted to hospital, no one would have guessed what the next few weeks would have in store.

To begin with, many of the staff were cautious when it came to approaching the patient. The pandemic was still in its infancy and many nurses didn’t yet fully understand the impact or implications of this new health threat.

As the week progressed, further patients entered the hospital in need of treatment. These first few COVID-19 cases were initially referred to as ‘Wuhan patients’ as they had travelled abroad close to the original epicentre of this pandemic.

Week 2 – A revamp in A&E

Just one week after the first wave of COVID-19 cases, we began seeing many more patients who were beginning to display symptoms. Some individuals were being brought in via ambulance for testing.

The A&E department had become a ghost town and was hurriedly being remodelled to ensure COVID-19 patients were kept separated from the general population.

One lady was admitted to hospital; she had just returned from Wuhan. With fear and speculation around the virus having grown, many of the staff were so worried about their own safety that they daren’t approach her for fear of contracting the virus. 

However, as an agency nurse with plenty of experience, I knew it was my duty to step forward and treat the woman. I was supplied with the appropriate PPE to maintain the safety of both myself and the patient. I just had to believe it would protect me.

I went to see the patient, who was extremely anxious and unsure of the situation. Providing reassurance, I gave a full explanation of why precautions needed to put in place. This gave the patient a greater understanding of what was happening and allowed her to feel comfortable with the management of her care.

Week 3 – My patients are getting sicker

By week three, the patients being admitted to hospital were far sicker than those who had arrived in the past fortnight. It’s safe to say, in all my time working as an agency and substantive nurse, I’d never seen patients as poorly as this.

Sadly, some of those arriving by ambulance had already passed away in transit. This was quickly turning into an emotional rollercoaster and the enormity of the situation had started to take its toll.

The Majors department followed A&E in being transformed into a COVID-19 ward, while two resus wards also followed suit. With so many departments being devoted to COVID-19 patients, the minors became majors to help those patients attending A&E, especially those with poor emotional and mental health.

These changes were also affecting how we performed our duties. We were made to zip in and zip out of the department, dressing ourselves in PPE.

Week 4 – A new hospital and emotions running high

As week four dawned, PPE still remained available, but shortages were starting to become a concern for all. The appearance of each department was further changing too. Tape was laid out on the floor, allowing staff to practise social distancing measures where possible.

I began working at a different hospital in intensive care. I arrived sharp and smiley ready to take on any challenges that came my way. However, I wasn’t quite prepared for the handover I received.

I walked onto the department where my colleagues and I dressed one another in full PPE, before heading through the unit. As I passed each side room, instead of there being just one patient per space, there were two ventilated patients and one nurse. These patients were classed as ‘level three’ due to the amount of care they required. Patients like this usually have one nurse responsible for their care; however, here an ICU nurse was caring for two. Due to COVID-19, there wasn’t enough ventilatory support, so adaptation of other equipment was required to meet the demand of the pandemic.

My first three 12.5-hour shifts were unbelievably challenging and draining, both physically and emotionally. Ten ventilated patients, five on haemofiltration, cared for by four ICU nurses, one ODP and one A&E nurse. An eleventh patient needed to be cared for by an ICU doctor. No one had a break throughout those shifts.

By this time, my admiration for the hospital staff was overwhelming. The three ICU nurses never lost their temper or their professionalism. In return, I brought my sense of humour and attitude that nothing was impossible, as long as we had each other. I later contacted Helen, my lovely recruitment consultant, and stated that I wanted to support this team throughout the pandemic.

Due to the enormity of the situation, staff were banded: a) ICU nurse; b) nurses/ODPs comfortable in ICU with experience of caring for ventilated patients; c) other health professionals willing to care for a ventilated patient under the supervision of an ICE nurse (each ICU nurse could have up to six ventilated critically ill patients); and d) auxiliary support to staff and the department.

I must say, these individuals were the real heroes as I couldn’t have adapted or applied myself as an experienced practitioner and agency nurse. Without them, we could not have cared for these patients in such demanding circumstances. The patients and their loved ones were cared for with dignity, commitment and love.

During one of my shifts, my colleague, a very experienced A&E nurse, came to work with me in ICU. I had told her how wonderful the department was and she was more than willing to step out of her comfort zone to boldly embrace and adapted her skills to care for a critically ill patient.

She had looked after this patient the previous night under the supervision of another ICU nurse. The following night, she chose to return to him as observations indicated that he was slowly passing away. My colleague looked for understanding and confirmation of this grave situation before returning bedside to hold his hand. She spoke to him gently, “You’ve been so brave. You’re loved, but it’s okay to go now.” As he peacefully passed away, we both shed a tear. We were only 40 minutes into a 12.5-hour shift.

The situation was surreal. We all felt completely overwhelmed. Breaks were difficult to take, emotions were high as the true magnitude of COVID 19 suddenly became very real. But despite the challenges we faced, we never lost our patient focus or our sense of humour.

I made use of a spare moment, using it to call Helen. I broke down over the phone; I couldn’t stop crying. A large part of my frustration was with how this awful illness was inaccurately being portrayed by the media, and the lack of social respect this virus was being shown.

Throughout this week, we were making use of headbands and uniform bags. We’d all wear our COVID clothes to work before changing into our scrubs. And once our shifts were completed, we’d change out of our COVID clothes to protect our loved ones from the virus.

We even received gifts of lip balm, hand cream, food, and refreshments. This generosity gave us all a sense of warmth and hope.

Protect the NHS

After one particularly busy night shift, I was travelling home and what I witnessed left me in a state of shock. I was gobsmacked to see the sheer number of individuals not complying with social distancing. “No one is staying at home. Why won’t they just stay home?” I asked myself, coming close to tears. When we’re all under such stress, the public should be doing the right thing.

I stumbled into my local supermarket to pick up some essentials. I’m a regular and the staff, as always, were so welcoming and friendly. Upon paying, I was even offered a 10% discount on my shopping. A heart-warming gesture, but I politely declined the offer.

As I was about to leave, I spotted a friend who works in the store. “Are you OK?” She asked. Maintaining a safe two-metre distance, we chatted before eventually crying in unison as I talked through the struggles I had faced over the past days and weeks.

This isn’t the first time I have faced a virus as a nurse, as I was on the front-line of the AIDs crisis. I remain adamant that COVID-19 doesn’t scare me. However, I am anxious about a second wave. That’s why it’s vital that people avoid spreading the virus. Please, stay home where possible, wash your hands thoroughly and stay safe. These actions will help protect your NHS!

Find out more

The NHS needs your support. Medacs Healthcare is standing on the front-line in the nation’s fight against COVID-19 and we’d be honoured if you’d join us.

If you are interested in becoming an agency nurse, contact us today using the details below.

For England and Wales, call 01785 236 202 or email nursejobs@medas.com.

Or for Scotland, call 0800 442 215 or email scotlandnursing@medacs.com.

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