Secret Diary of a Student Nurse: Covid
So far the post that has gained the most attention is Secret Diary of a Student Nurse. It’s a very brief overview of some of my experiences as a student nurse. My student nurse journey consisted of two parts, with a hazy area of grey in between. It’s a distinction that affected almost every person on the planet – Covid. I started my metamorphosis in March 2018, some 20 months before the world shut down. In April 2021 I qualified, by which time Covid was rife in both healthcare and the community; with almost 4 million cases being recorded, and just shy of 91,000 people having died of the infection in the UK.
The Front Door - A&E
In early 2020, I was part-way through a 7-week placement in A&E. We had all heard of Covid-19, we would take our breaks in the mess room and in the background the TV would be invariably informing us how far the virus had spread, and that further cases had been found in an ever-growing list of countries. The first UK cases of Coronavirus had been diagnosed in Hull, and those patients had been transported to the Royal Victoria Infirmary in Newcastle – as journalists were broadcast updating the people with the RVI in the background, my claim to fame is that the RVI is the very hospital I was born in. Newcastle was heavily involved in the fight to suppress Covid, Geordie pride is a thing.
The virus was spreading. On the Monday, anyone triaged with respiratory viral symptoms who had recent foreign travel to Wuhan were immediately isolated; by the Wednesday, it was anywhere in China; Thursday, the area of suspicion spread to Asia; then it was Asia or Northern Italy; soon it was just anywhere. The advice remained if you are otherwise well stay away from the hospital. The hospital is full of vulnerable people, and as we already know infectious diseases spread like wildfire once they have penetrated our castle walls.
People were scared, there was an influx of worried people appearing at the doors of A&E with “flu-like symptoms”, invariably the advice was to go home. At this time, anyone who thought they may have Covid must stay at home, ring a dedicated helpline, and an ambulance would come to them to take a viral swab. Our labs didn’t yet have the technology to process these swabs, and any taken within the area had to be transported elsewhere (I think it was London).
I was on shift the day the first presumed-Covid positive patient came into the hospital. They arrived with all the pomp and planning of a royal visit, transported by paramedics wearing hazmat-suits. I vividly remember standing within earshot of a virology consultant as he loudly complained: “why are they wearing body-suits? This isn’t e-bola!” We drew curtains around the other patients as our ‘patient-Zero’ was wheeled through the corridors into the isolation room. He stayed with us for several hours, before being transferred to the infectious diseases ward – I vaguely remember plans being made to shut down the parts of the hospital that this patient would have to take on their route. Ultimately, I don’t know how their journey ended.
The Re-Deployment
Fast-forward some months, I think we’re now in June 2020. Placements had been suspended, lectures were taking place on Zoom, and in March we had all crowded around the TV as BoJo made the first announcement of “You must stay at home.” Lockdown had become law, shops had closed their non-essential isles, and – this is how you know the shit has really hit the fan – McDonalds branches everywhere were forced to close. It was scary.
Healthcare was changing. Covid had invaded the hospital, both patients and staff were dropping like flies. Final-year student nurses were being re-deployed as Band 4 Healthcare Support Workers to fill the staffing gap, which is what triggered my re-deployment into specialist services.
Renal patients, as I soon was to discover, are incredibly vulnerable. I saw more death in those three months than what I have in my past three years of being qualified. It was hard. I never experienced the PPE shortages that were being spoken of, but I like everyone else had heard the stories. At any one time, we would have at least two patients who were NEWSing a 9+, the score at which a peri-arrest call had to be made. Masks had to be worn everywhere around the hospital, and full PPE had to be worn around any patient – apron, gloves, mask, visor. Despite full PPE, my colleagues were still testing positive. We heard of colleagues in other areas of the hospital who had died, we watched and clapped as funeral processions of our fallen comrades were driven through the hospital grounds, their immediate colleagues forming guards of honour and their funerals being live-streamed directly to the hospital chapel. Everyone knew someone who had died.
Covid was cruel, and indiscriminate. Visiting was suspended, and families were forced to say goodbye to their loved ones over FaceTime. On several occasions, I held the tablet up to the comatose patients as their husbands, wives, sons and daughters would cry their final goodbyes, unable to hug, kiss or see their loved ones in life again. My tears would steam up my visor and turn my mask damp. I held the hand of dying patients, in lieu of the people who should have been there holding their hands. When sitting at the nurse’s station writing notes, I could hear the sound of patients drowning in their own secretions – maxed out on all the drugs we could give them to keep them comfortable. We tried, and I mean we really tried to do our best by these patients – many of them would die anyway.
We would nurse patients whose entire families had been wiped out by Covid. One patient caught Covid at dialysis, brought it home to his father and two brothers, and was the only one to survive. Cruelly he was forced to live with that guilt despite our recurrent platitudes of “it wasn’t your fault.” Patients would be clapped out of ITU, having survived the initial Covid infection, only to die with us weeks later from the damage that had been caused to their bodies. Extended use of vasopressors caused necrosis in fingers and toes, which had to be amputated. Our job was to teach patients how to live their lives forever changed by the physical effects of Covid, whilst we struggled to deal with living our lives with the psychological effects of what we had seen.
I remember driving home that summer past Roath Rec, and seeing dozens of people picnicking on the green. I had to fight the urge to tell them that just half a mile up the road, people were dying. Mostly, I was too exhausted to care. I would cry at work, cry on the drive home, and then cry at home. There wasn’t an option to take a personal-care day. We had jobs to do. The only reprieve you would get as a healthcare worker at that time was if you caught Covid yourself, at which time you had 14 days off work, and then went back to continue the fight. Mass testing centres were erected almost overnight. On one shift, my throat became more and more painful as the day went on. When I got into bed that night, I felt like someone had put a pick-axe through my skull. I dug out my pulse-ox and was unsurprised when my oxygen levels were low, and my heart rate was high. The next day, I dutifully drove across Cardiff to the City Stadium. I tested Covid positive on 21st December 2020, my mum cried when I told her.
All the while, the people who were supposed to be supporting us, who stood on the steps of Downing Street clapping every Thursday, were having clandestine cheese and wine celebrations. I suppose I am at least relieved that some people were finding reason to celebrate, while those of us in the real world were comforting damaged and dying people whilst damaged and broken ourselves.