Patient Safety Learning interviews a critical care outreach nurse who has been shielding during the pandemic and hears about the effect it has had on her and the support she has received.
About the Author
The nurse interviewed wished to remain anonymous.
Questions & Answers
Tell us a little about yourself
I have been working as a critical care outreach nurse which entails assessing deteriorating patients, supporting their care outside of critical care and, if required, facilitating a timely admission into critical care. I have been in this role for 6 years. I am also part of the medical emergency and cardiac arrests team. I’m involved in delivering education to nurses either at the bedside or on teaching days as well as reviewing all patients discharged from critical care once they recover from critical illness and return to the ward.
What is it about your job that you love?
In all honesty, I consider myself very lucky because there is not one thing that I love the most about my job because I love every single part of it.
What were your aspirations pre-covid?
Before covid I felt like I was about to fly with a big quality improvement project I had been working on. I always aspire to really make a difference, not only to my patients but to my colleagues too. You could say that I was at the peak of happiness in where I wanted to be in my career.
Can you tell us a little about your health and why you had to shield?
Three years ago I was diagnosed with an autoimmune disease which requires me to take immunosuppression medication. Luckily I am now well, so having a health condition has not been an issue for some time!
When the pandemic hit, were you still working?
When the pandemic hit I was still working. No one really knew the risks then and at the time there wasn’t any government advice about risk groups or shielding. I was concerned about exposure at work; however, we had plenty of personal protective equipment (PPE) and I was reassured that it was safe for me to continue working.
What conditions were you working in?
Initially it all felt a bit chaotic; however, green (covid-negative) and red (covid-positive) areas were soon established and plans were in place. We were ready and prepared to receive patients. PPE was the one thing though that was causing the biggest amount of stress to staff. We had plenty of it, but the guidelines for its use were forever changing, sometimes day by day. I did nurse covid-positive patients and this made me and my colleagues nervous. Nervous to step inside the room and nervous not knowing if the PPE was enough to protect us.
How did you feel about working in the covid wards?
As a critical care outreach nurse you deal with the most sickest of patients, so as numbers were increasing throughout the hospital I was beyond terrified. I was becoming anxious and having episodes of crying at work. I felt unsafe and feared for my life, to the point of planning in my head my resuscitation wishes, wondering how my children would cope without me, and visualising my family all arguing over who would be the one nominated person allowed to visit me in my final hours. Clearly I wasn’t coping, yet at the time I felt like I was overreacting, telling myself to get a grip. Luckily, after speaking to a few close colleagues, I realised that a lot of others were struggling too. Everyone was terrified. We were in it together and needed to do our best to help fight this. Our patients needed us and we all needed each other.
When did you get the shielding letter?
I can’t remember when exactly I got notification to shield because I threw it away when it came in the post. I was in denial that I couldn’t work, all because of a health condition that is under control yet totally out of my control. This was foolish of me I know.
Did it correspond to when your Trust took you off clinical practice?
Luckily my manager knew about my health condition and knew I was struggling. She was proactively cautious with me, so I was asked to work in a non-clinical role for the critical care control room focusing on nursing workforce. Within a few days of receiving my shielding letter I started to shield as soon as I came to realise how irresponsible I was being. I only spent a few days burying my head in the sand but I am thankful I was in a non-clinical role by then.
How did you feel when you had to shield?
Devastated, as I assumed I would be working all hours doing my bit. Initially shielding made me feel like a reject and that I wasn’t good enough. I felt guilty for leaving my team behind and guilty for being upset. After all, I still had a job while others were losing theirs. I was healthy while others were suffering. I am usually the protector, not the one who needs protecting.
What have you been doing while shielding?
I admire anyone who works from home, it’s very challenging! Technology has enabled me to do my bit more than I had anticipated. I’ve been managing my team’s roster, developing audits, policy writing, handling enquires from the community, making shared hearts (we don’t need any more luckily!), contributed to the CardMedics initiative, writing an essay, attending online meetings, revisiting quality improvement work and trying to motivate and home school my children! I’ve even ignited life into my greenhouse with a million seedlings! All the work I have done however still feels paltry compared to what my colleagues have to work through. They are all amazing.
Have you felt a valued member of the team?
At times I have felt very detached from my team; however, most of them are in touch with me on a daily basis which has made me feel very much valued and very much missed!
How have you been able to keep in touch with developments at work?
Thanks to technology I have been kept up to date with most developments at work. We even have a virtual staff briefing with live Q&As from our Chief Executive and deputy CEO which is brilliant. It’s offered inclusion and helped me to stay in touch.
Have you received any emotional support by the Trust or your manager?
We are very lucky in our Trust because we have access to some fantastic staff welfare services. I haven’t been actively contacted by any of them but I know I can call them when I need them. My manager and the Critical Care Matron have been extremely supportive, as have my colleagues. I can’t praise them enough. Supporting me, on top of trying to cope themselves. This pandemic has truly shown there are some incredible people out there.
Do you know when you are returning to work?
Not knowing when I can return to work has been the hardest thing. I’m trying to focus on my own professional development alongside the remote work I do, so I can feel like I have achieved something during my time shielding. When I do return, I will hopefully be there to enable others take a bit of relief.
Where can you see your future now compared to where you thought it would be?
Where do I see my future? Well at one point I did question if working in such a frontline role would be possible for me long term. An alternative, however, is not one I wish to consider at the moment. I love my job too much. I am just hoping people will continue to follow government advice, strict social distancing and hand hygiene so COVID-19 can be wiped out and we can all go back to normal, whatever our new normal may be.