10th April 2020

What.

A.

Week.

Nursing is a bit like childbirth I reckon – although you remember the physical effort and pain, the realism of it fades. After two 13 hour and an eight shift hour in immediate succession, I was quickly reacquainted with the overwhelming exhaustion.

Every inch of me ached, my feet were blistered and my brain felt like it had been in a blender. Despite all of this, I enjoyed my first week back.

Ward life is so different to A&E – I feel like a big useless fish out of water.

There’s so much to learn and I need to pick things up quickly if I’m going to be useful when the peak hits. It’s the organisational aspects of the role that are the issue, especially being a Sister I feel there is an expectation for me to be able to be the problem solver.

My new colleagues are amazing though, super approachable and knowledgable, I’m sure they will help me muddle through. To be honest we are all in the same boat in a way, the ward has completely changed function from originally providing care for Elective Orthopaedic patients.

It is now a Covid Ward.

I spent quite a lot of time off the ward this week due to training, it was great in some ways because I’m set up now to crack on, but it was a lot of info to take in. I felt a bit frazzled by the end of the week – although I’m not sure if that was due to unintentional Sertraline withdrawal.

Let this be a lesson for all of us, ‘cause I can assure you going cold turkey is not fun. Now I really only have myself to blame because I was busy Monday when I was meant to pick my tablets up and I’d already missed a days dose. I was then working so couldn’t get to my chemist – thankfully Dan picked them up before they closed yesterday because by then it felt like I was having a seizure. I asked Dr Google the symptoms of withdrawal before popping to A&E on the way home from my shift, cause I felt so weird.

Along with the more common side effects like drowsiness, dizziness, vivid dreams and headaches, I was also experiencing something that one site perfectly described as “brain zaps”. It literally feels as they say – “like an electrical shock or shiver in your brain” which isn’t ideal when you’re staring at a PowerPoint.

On my first day I was fit tested for ffp3 masks and trained on Continuous Positive Airway Pressure (CPAP) ventilation. CPAP is basically a way of ventilating people which is much less invasive and means they don’t require sedation. The mask fits snugly to the patients face and is strapped on tight, this attaches to a machine which uses pressure to increase the amount of oxygen transferred in the lungs.

It’s a really clever bit of kit and I think it’s great so many of us will be trained to use them, what I found so amazing is to experience the response to this crisis hands on. It seems very efficient and coordinated, almost army like.

All of us are small cogs in a huge machine that is being recalibrated to fight this battle.

It’s an honour to have my place back in the Transformer.

I passed the fit test for ffp3 masks, but the guidelines from Public Health England (PHE) and the World Health Organisation (WHO) state that unless the procedure is aerosol generating – you only require a surgical mask. My argument with that is those masks are gaping at the sides – we are entering bays of positive patients who are coughing etc. I need to read up further on where their evidence has come from to make that decision, but to me it doesn’t feel adequate.

I then have a bit of a moral dilemma with whether to buy my own and use them – what message does that show to the rest of the staff? I have been gifted a few – I currently have 4 in total which is amazing but will probably last me personally one shift if that.

How can I source enough to keep everyone safe?

The other issue is protection from fluid contamination – PHE have gone against the WHO advice which states that’s when at risk of droplet exposure staff should be wearing a long sleeved gown. What is worrying is that we are performing personal care, changing bedding etc for patients with the virus but only wearing a plastic apron and gloves to cover our skin/uniform – why are Public Health England and the government willing to take this risk with staff and patients? Their updated advice this week recommends washing your hands to your elbows but still no mention of gowns - shocking.

With another of our local NHS family losing her life this week - it’s something I’m going to see if I can change in our Trust. I’m not sure what the rules are on procurement during this time but surely there will be a way of sourcing what we need.