We’ve all seen the videos, heard stories and read articles in the media about the working conditions for NHS staff during the pandemic. The PPE shortages, lack of staff and hospital beds… for experienced nurses this might seem standard. But with the sheer volume and hysteria surrounding Covid 19, 2021 has seen a new level of shortages and hardship that even the most competent nurses have never witnessed.
So what has it been like for the nurses that were re-deployed out of their regular positions to support the adult Intensive Care Units (ICU)? We spoke to paediatric nurse Grace Francis who currently works at St Georges Hospital in London, one of the largest hospitals in Europe. Grace, who is 26, usually works in the children’s ICU but was called to duty in the adults ICU during the second wave in the winter of 2020. Having never worked with adult patients in her career, Grace described the experience as nothing short of ‘terrifying.’
How did you feel when you got relocated to the covid ICU ward?
Even for someone that comes from an intensive care background, it’s scary going into a new environment, with new people, new patients and a new ward. You don’t know where anything is. The ICU’s were ‘pop up’ on a normal ward so they weren’t built for ventilated patients at all.
Was it just nurses from an IC background that were called up to help?
No, it wasn’t only ICU paediatric nurses. Army medics, community nurses and retired nurses were also called in. As a collective we were called ‘support nurses’ and we would be allocated a group of patients to look after along-side an adult ICU nurse. I worked with nurses who had never worked with a ventilated patient before too which made communication often difficult amongst the team, but the adult ICU nurses were grateful for the support nevertheless. There was only one actual adult IC nurse per 4-6 patients. Before covid, in ICU it was one nurse per patient!
Also, Army medics aren’t technically registered nurses but they mainly helped with ‘cares’ (washing & bathing etc) and turning patients to make sure they didn’t get bed sores. We have to turn our patients every 4 to 6 hours and an adult on a ventilator requires at least three people to turn. It was often hard to find enough people to help you with that simple task, let alone anything else. There was also a team of doctors and aestheticians that worked specifically to prone and un-prone covid patients. This happened every 12 hours but required at least 6 people.
Proning means to carefully ‘flip’ patients from their backs, onto their fronts so they lay face down. This is to encourage oxygenation. The procedure requires a team of 6 to manouver the patient safely. Although it is not painful for the patient, it does hold multiple potential risks such as ulcers, line displacement and loss of airways. It can also cause patients to become unstable in their condition and deteriorate.
Did you get breaks?
I was lucky in St Georges. We managed to get our full hour breaks but you are very conscious of the fact that the longer you have on break, the longer someone else is having to cover you. And we all want to look after each other because we know how hard it is out there.
What was PPE like in your hospital, did you have enough to go round?
I wore scrubs, a big plasticy gown (like a thin table cloth) over the top, then a full FFP3 mask, a visor, and gloves. It was so hot and claustrophobic and you got really sweaty and you’re not supposed to touch your mask either! I didn’t feel the effects of the PPE shortages compared to how the first wave did, but shortages of general equipment like syringes did affect us massively and could be really stressful.
Did you feel well supported in this new environment?
When you’re at a new job, you’d expect to get a lot of support, but in this circumstance, it’s everyman for himself. That’s not to say we couldn’t ask for help when we needed it, but no one (including myself) really had time to stop. With the small experience I did have in intensive care I managed to crack on, I can’t even imagine what it would have been like for a community nurse for example who had next to zero experience in an intensive care environment.
Do you think the stress of re-deployment has affected your mental health?
I think, personally, it affected my mental health at the time. I think because I was exhausted, and experienced constant high levels of stress. Also, the sheer sadness of seeing numerous patients dying alone with no families there to say goodbye. For weeks patients would be scared and very sick and couldn’t see their loved ones, and in some cases passed on without ever seeing their family again. I see sad things happen on the children’s ICU too, but the vast amount of death was an entirely different experience.
‘A report from the Royal College of Nursing Research Society in May this year showed 24% of 4,063 nurses and midwives across the UK, surveyed between 28 April and 12 May, said they were suffering severe or extremely severe depression.’ (nursingpractice.com)
Lots of people have left nursing entirely or left intensive care. Some are taking career breaks because they are simply burnt out. I heard in some hospitals in the UK, lots of doctors and nurses actually died from covid. They were hit so badly, not just by the public getting sick but the staff getting sick too. This must have been so traumatic for the staff at those hospitals.
Did you ever feel like quitting entirely?
Sometimes. But, I wanted to help and I knew I was doing it for a short amount of time. I felt for the adult nurses who had to come in every day and all year. For me I still had some shifts on the children’s ward and knew that after everything had calmed down a bit I would be moved back to my normal post. I coped by talking about it with other nurses who were going through it with me and sharing experiences.
Has this experience changed the way you see nursing?
Being re-deployed was an experience I will never forget. I faced challenges and stresses I hope I never have to face again. However, I found a whole new level of respect for the NHS and my colleagues. Even through the last year of Covid and through the hardest times, I still enjoy my job and find it extremely rewarding and hope that prospective students do not shy away from this career path. I am very proud of the NHS and the teams I have worked with. I hope the public can appreciate their immense kindness, bravery and strength.
Phoebe Johnson is a Content Writer and Digital Marketing Executive passionate about telling stories and elevating the voices of others.