Friday 22 May 2020

I've gone a few weeks without posting. Not intentionally, but mostly because work has been busy and when I'm not at work, I'm trying not to think about work. Since my last post, I found myself getting increasingly angry and irritable. I have been trying to work out where the anger and irritability is coming from, and so far have only come up with various complex reasons. Of course, one of the main ones is probably that our locked down state has lost its novelty. That might sound superficial, but I don't mean it in that way. I feel very strongly that lockdown was the right way to go, albeit, in my view, far too late. I'm more than happy to comply, as it is the right thing to do - protecting lives. I also feel that lockdown should have been extended. The current message, 'stay alert', is too vague - people need clear rules, clear guidance. I am sure there are many, many people still obeying the rules, still staying home as much as they can, only going out when it's needed. Sadly, we are now allowed to go out for exercise for as long as we want and where we want. The weather has been glorious (I keep thinking that is at least one good thing about this situation - how awful it would have been if we'd had constant rain!) so what do people do? They flock to the coast. It doesn't seem to matter that various tourist boards are saying, don't come here, please stay away, we'll still be here in a few months' time, next year. There are news reports of gridlocked areas around the coasts. This is not what 'stay alert' means - but what does 'stay alert' really say? It is vague and unclear. It is not as if you can see the virus and run away from it if you spot it.

So, as a family we're still practising lockdown. The golf course has reopened, under strict rules, and Simon is out from time to time, but the children are still home, and I still only go to work and home, nowhere else apart from a bike ride on days I'm not working. And I know this is for the best, and I have lots of hobbies to get on with, but there is so much I miss. Going out for breakfast on a Saturday morning, reading the paper and drinking coffee for a few hours; spontaneously driving to Ikea for a bit of retail therapy, pottering over the market and coming home with some cheese and ideas for that evening's supper. I have found myself unable to focus on anything for very long. I want to make the most of the days off work, and frustratingly I spend them with very little to show for it at the end. I don't seem to be the only one. which helps a little. It's a feeling that I keep trying to fight, but I seem to be fighting a losing battle.

Another factor is being at home with the same people all the time. The other day I bumped into a friend from knitting after my study day. Her daughter has recently been diagnosed with diabetes and they'd obviously just been for an appointment. As she was on her phone, I didn't want to loiter, but it made me realise with a shock how long I'd not seen her. We have done a few zoom meetings where we try and catch up, where we even sit and knit, but it's not the same as meeting in a cafe in town or at each other's houses where we eat together, knit and set the world to rights. I stay in touch with my old Dutch colleagues through Skype, and normally we'd meet up every few months for a coffee and a chat. And again, last week I realised how much I'm missing that contact. I sing with a choir in Stowmarket and we have set up a WhatsApp group which has been great. I've got to know people who I only knew by face. We've laughed, we've cried, we've shared news, ups and downs. I've gained a lot of support from it. But I also miss going to rehearsals, the uplift you get from singing together, from getting to grips with a piece, from meeting in the interval and buying a jar of homemade jam or chutney, from chatting with the two friends I share a car with. At the moment, I see people from work or the people at home. Normally we each have our own activities - sometimes these get so busy that we're like ships passing in the night. It makes you appreciate your time together even more. But right now, we have all our free time together - and I crave a bit of alone time. It's been hard to find a space that doesn't get invaded. I think this might be partially to do with work. At work, I spend 12.5 hours looking after people, ensuring they are comfortable, safe, minds put at rest. You give, give, give. Now, because there are constantly people at home, I spend more time than usual at home too, giving, giving, giving. And there are days when I just don't want to have to look after anyone. It's like I've got nothing left to give - and in a normal situation, I'd get that alone time and the chance to recharge my batteries, but that is not possible at the moment. It's that old cliche of 'you can't pour from an empty cup', and right now I really don't know how to fill that cup.

And the last but not least factor playing a part, is that the current situation and how the government has responded, is creating deep political divisions. These divisions seem to become clearer as never before on social media. Everyone has an opinion, that is only natural. Personally, I feel deeply upset about the number of deaths, and deaths of keyworkers in particular, and think this could have been avoided to some degree if action had been taken sooner. But that is my opinion, and someone else may well disagree - which they're entitled to. But any of these opinions seem to create heated arguments on social media, and I hate that it causes arguments with people who I'm friends with in 'real life'. At a time when a lot of people are dealing with a fragile state of mental health, we don't need arguments, we need each other for support. The only way I can deal with it is by staying away from the news (I can't get cross about the current situation if I don't know too much about it) and social media (too much being posted about what's happening and whether or not the government is doing a good job or not). I feel sad about it because I miss out on all the lovely news, and I admire people who feel strong enough to post their opinions without worrying about the possible responses, but it's not for me - peace of mind is more important for me.

Many people ask how work is going. And I usually respond with, an emotional rollercoaster. Physically, nothing much has changed since my last post. We still have the plastic sheeting in place, sealing off the five different bays, we still wear as much PPE as possible, including a surgical mask all day long. We have had funny moments: pretty much everyone has put on a mask inside out by now. I've attempted to clean my visor only to discover I wasn't actually wearing it and was wiping my glasses and face instead. We all agree that the best bit of the shift is taking your mask off. There have been uplifting moments: the patient who had spent 3 weeks in ITU with Covid19 and who I didn't think they expected to survive, but came to us for recovery, and was discharged from us. When IT set up a FaceTime call for an elderly patient with her son, and she didn't understand at first she could see him 'live' and talk to him, and the way her face lit up when she figured it out and then spoke to him for 45 minutes. Feeling part of a team and that they'll be there for you if you need them. And of course there are low points. Being short-staffed can be so hard, when you wish you had ten pairs of hands.  When you're in the middle of looking after someone's needs and another patient calls out that they need to spend a penny - now! and you can't just leave the first patient. When one of your colleagues returns to work after recovering from Covid19 and hurts her back on her first shift because the patient we are looking after, misjudges a distance and has a fall, and said colleague tries to break his fall and ends up in tears with pain and guilt. And discovering a patient who has become unresponsive, which means calling an emergency, everyone coming running, crash trolley, CPR, the lot. Patient rallies, we carry on our job. Doctor comes to talk to me and asks if I've had a break - no, no time, and you know, these things happen, glad patient is okay. He tells me to make sure to have a break, and suddenly I feel tearful. It is my first proper emergency and yes, it is quite something. This doctor with far more experience than me might actually be right about having to take a break after such an episode.

A part of me sort of feels like I'm waiting for things to go back to normal. But another part of me is beginning to wonder if we'll ever go back to normal. And I haven't got used to that idea yet.

(Photos all from recent bike rides)

Saturday 2 May 202

Vaguely back to normal, that's what I was expecting when I went back to work on Wednesday. Whatever normal is, these days! It may have been wishful thinking.

When I got to my ward on Wednesday, a few things had returned to 'normal'. We were all in uniform rather than scrubs, which makes it far easier to see who is who. The plastic sheeting that had been covering the entrance to the bays was still in place, but rolled up, which much improves visibility. And as far as we knew, our patients were now all non-Covid19 patients. We're a so-called Green zone. In a way, it's a positive sign: the hospital is probably able to cope with the number of positive patients and doesn't need as many Covid19 wards as were open. Great news.
However, in the course of the day it became obvious that things aren't back to normal by a long shot. We're still wearing surgical masks all day. They are a necessary evil. They're warm, they hurt your ears, they dehydrate. We still have relatively few patients. To observe social distancing, we only have 4 patients to each bay, rather than 6, but not all the bays were full. I had two bays to look after with 6 patients in total, alongside another nursing assistant and a brand new nursing assistant who was doing her very first shift. When you first start, you don't get assigned a bay of patients on your own yet, but you shadow someone with more experience for a number of shifts. More often than not, these 'shadowees' soon start to build confidence and it's great to have them work alongside you, as it's an extra pair of hands.
On Wednesday, we looked after a patient whose Covid19 test result was still pending. At the end of the day his result came back and it turned out to be positive. He was very swiftly transferred to a Covid19 isolation ward, and the patient who was in the same bay with him, was moved to a Covid19 specific ward. It caused a lot of confusion and many questions among the staff, and morale took a bit of a battering. Slowly but surely you are beginning to tell that all the uncertainty, all the changes are taking their toll. Some staff members are worried about their health, others become snappy and irritable. I thought I was doing alright until I came to realise that maybe I was getting a bit short-tempered. It is sometimes easy to forget that everyone is dealing with it in different ways and to make allowances for that.
I had another shift yesterday. New rules yet again. Now it feels as though we're a halfway Covid19 ward. The plastic sheeting is down again, which means the corridor gets very full and very warm. We've been advised to wear visors again when in direct patient contact - pretty much back to full PPE (for us). And we do have patients whose test results have not yet been returned, although they are not symptomatic. But we all know there are patients who test positive but show no symptoms. Allegedly, these people are less infectious, but whether that is true? There is so much still to learn about this virus.
Yesterday was a very busy shift and felt almost like the ward in the 'old days'. Patients being discharged, meaning there is a bed space to clean and prepare for the next patient - who in one case turned up while I was still cleaning. A fairly new colleague who needed some extra time and support. A patient who during the course of the day started to deteriorate, meaning the frequency of all clinical observations increases. Patients with very different emotional needs - one who was rather unpleasant to most of the staff, but mellowed a little when I took a bit of time to sit down and just listen to him. A patient with communication problems and at the end of life. Another patient who was obviously lonely and just enjoyed having someone to chat to. A very varied shift, a very tiring shift but one that in some ways is immensely rewarding.

Earlier this week I was talking to a friend about nursing and having changed career. She asked if I ever regretted it. And the answer was, without a moment's hesitation, 'not a single second'. Yes there are days when I come home and I'm so tired I can barely move. There are days when I want to cry. There are days where I feel frustrated at the workload. But always, there will be highlights, something that makes me smile, feel grateful, be humbled, and always there will be something that makes me think 'I love this job'. Every single shift.

Tuesday 28 April

And then I ended up off sick. On the Saturday or Sunday after my last shift, I can't remember when exactly, I started to feel achy, headache, sore throat, tired. Nothing major really, just under the weather. A few days in I developed a low grade temperature. Which was still there by the time I was supposed to be back at work (last Thursday), and I didn't dare take the risk. It didn't sound like Covid19, but then not everyone presents with classic symptoms.
By this point, all self-isolating keyworkers were eligible for a swab, so my manager referred me and I had one done on Friday. Not particularly pleasant to have a cotton bud shoved up your nostrils until your eyes water, but heyho.
Of course, this meant we all had to self-isolate. Minor panic ensued. Lots of offers of help from neighbours, colleagues etcetera, but it still feels awkward to ask! Fortunately, the milkman came to the rescue (ouch that was expensive), and then teenage son with his lightning fast internet fingers got us a Tesco delivery slot. He now knows exactly which ones are released when - and promptly got us a click and collect too. I think we have enough food coming to last us a month!

My swab results came back on Sunday morning as 'invalid'. By this point Simon and teenage son both had vague symptoms similar to mine, and I still had a slight temperature. As a keyworker, you can have members of your household tested if you are self-isolating - of course, the NHS would rather have you back at work if you can. So I'd managed to get us an appointment for a swab in Ipswich, but the only way to do that was to have me tested too. I had planned not to use it, but now that my test was invalid, I needed to be tested again so this worked out quite well.
This was completely different from the first swab, which was fairly relaxed apart from the mild discomfort. It was a warm day, full sun, and of course we couldn't open any windows. We had to pass several 'booths' where staff would hold up signs telling us what to do - show my NHS badge, ring this number, don't do this, go there. We had been told you could either do the test yourself or have someone do it for you, but nobody actually offered so we ended up doing it ourselves. The instructions we were given on the phone were rather concise and very different from the instructions in the pack, and even those weren't 100% correct. It was rather obvious that this was all set up very hastily. After a stressful 10 minutes where teenage son kept saying he couldn't do it and Simon was making retching sounds for swabbing his throat and I thought I would faint with the heat, we threw our biobags in the collection bin and were off again, not feeling particularly confident that these had been done properly.
We spent the next day or so trying to come up with all the different permutations of test results and the consequences. To our surprise, last night during supper teenage son suddenly said he'd had a text saying his results had come back negative. Much to our relief, all our tests were negative. I have no idea what I've had, but I've definitely been under the weather with something that is still lingering. However, the test proves I have no active disease at the moment, and so I'm safe to go back to work. Tomorrow is my first shift in 10 days or so - and in the meantime our ward has gone from Covid19 ward back to a normal ward again! There is still a possibility that we will return to Covid19 ward, should we suddenly have more Covid19 patients again, but for now, it is good news. Still the stricter rules, as in getting changed at work, wearing surgical masks at all times, no visitors and restricted numbers in the staff room, but we're not receiving Covid19 patients, the bays aren't sealed off anymore and things should feel a little bit more normal.
Ten days in isolation, and I'm looking forward to a little bit of normality!

Patchwork cushion finally finished, plus painted garden chair

Cat approves...

Friday 17 April 2020

I've had 5 days off. Originally we were supposed to go on holidays to celebrate a few big birthdays, but because of lockdown that obviously didn't happen. I'd offered to return my annual leave in exchange for shifts, but I was the sixth person to do so! And in the end I was actually quite glad I had some time off. After the uncertainty, tension and emotions of the last few weeks, I was more tired than I realised and a break was definitely needed. When I first started in this job, my then ward manager told me one day that you need a bit of time off every 2 months or so. You give so much in this job that you need time to recharge the batteries.
I thought I'd feel confident about going back, having done 2 shifts already. Oddly enough I felt nervous. Our WhatsApp group had been much quieter of late, suggesting we are settling into the new routine. There had been a few texts with do's and don'ts, a few supportive messages here and there, a happy birthday, but that was it.
So I really didn't know what it was like on the ward at the moment. Were we full? Lots of confused patients? Would we cope with increased patient numbers and the more demanding routine, where everything inevitably takes longer?
Annoyingly enough, I'd accidentally had a cup of caffeinated tea at 9pm. I turned the lights off at 11 and was wide awake. Normally I fall asleep within seconds, now I lay awake for hours. I must have dozed a few times because I had weird dreams, but it never felt like a proper sleep. Not a good start to the day.

One of the many gifts we have received. Lovely surprise and much appreciated

Another beautiful morning sky on my way in, which helped settled nerves somewhat. I found myself a set of large scrubs hoping for length - instead they were short and wide. Not the most flattering of looks! (see photo at end of post for a laugh)
We had about 15 patients in total (capacity of 23 beds with social distancing). A very manageable number. Originally I was supposed to 'float' which means not having a dedicated bay but helping out where and when needed, but because of a confused patient who needed regular supervision, I ended up assigned to two bays along with another nursing assistant and two nurses (one of whom was supernumerary).
This was the first shift since we had transformed to Covid19 ward where I had someone confused to look after, and it threw up a few new challenges. PPE isn't quick to put on, and no PPE means no care. You can't just quickly nip into the bay when someone is attempting to do something that puts them at risk (this usually means a patient is trying to get out of bed or chair when their mobility isn't good and they are at risk of falls). These patients often wear what's called a 'wanderguard', a device that sounds an alarm when they try to get out of their bed or chair. It gives you the chance to do some of your other tasks without having to stay with the same patient for your entire shift, which isn't really possible or practical. Our patient today was wearing a wanderguard and set it off several times, but by the time you have put on your apron, visor and gloves, the alarm is driving everyone spare - sometimes even including the patient! Fortunately she didn't put herself in any danger and the wanderguard was more of an extra precaution. We spent most of our time when not in the bay, by the window in order to keep an eye on her. It did make me wonder though how we'll cope when we have someone who is more at risk of falls.
We started off with five patients in two bays, but two of them were discharged in the course of the day. It meant we had plenty of time for our other patients, and I noticed we're gradually getting used to the new normal. New routines don't seem quite so strange anymore, and in some ways this makes me sad - of course it is good we're getting to grips with the new ways of working, but I don't want to forget this isn't normal. Because we had a confused patient, we spent more time inside the bays than during my first two shifts. You start to realise how uncomfortable, hot and sweaty it is to wear all your PPE for longer periods of time. We wear our surgical masks all of the time, and the elastic starts to hurt your ears after a few hours. Most of us now wear a strap of fabric with buttons on at the back of our head that the elastic attaches to.
My biggest realisation today though was how isolated and lonely patients must feel. We have had a no visitors rule for a few weeks now (apart from patients who are in their last few days or hours), and in some cases, patients have already been self-isolating at home. It's sometimes easy for us staff to forget that a hospital stay can be an anxious experience. Quite apart from the health worries, a lot of things happening in a hospital are familiar to us, but new, unknown and possibly frightening to patients. Add to that the lack of familiar faces, the reassuring presence of a loved one, having to stay in an isolated ward plus staff so dressed up that it's hard to make proper eye contact, and you can understand why now it is even harder to be in hospital.
One of my patients today needed a little help using the commode. As she got ready to sit down in her chair again, she remained standing, saying it was good to stretch her limbs after sitting down for a while. She then looked at me almost guiltily and said, I know I'm probably wasting your time. My heart just broke. I reassured her that I only had three patients to look after and that she could 'waste' as much of my time as she liked.
Every shift, it is obvious that we have to work in a more business like manner if we are to stop the virus from spreading. We have so many new things to remember, things that aren't second nature yet. With every shift it also becomes more obvious though that this pandemic doesn't just have an effect on our mental health, but on patients just as much. It's a balancing act - keeping patients and ourselves safe, while looking after their emotional wellbeing too. One I'm determined to master.

In full PPE kit, about to enter the sealed-off bay. I'm smiling - not that you can tell! 

Sunday 12 April 2020

It's been almost five years since my last post. 2015 was rather an eventful year, and for various reasons I didn't feel like writing, or if I did, I didn't feel like publishing. But in the last few weeks, for us, as for so many other people, life has changed considerably again. Whenever I feel stressed, I tend to find writing things down helps me, and suddenly the urge to not just put pen to paper, but to actually publish it, was there again.

A quick update: just over 5 years ago, my relationship with B. came to an end very abruptly. Although it wasn't my choice, with hindsight, it should have ended much earlier, but then hindsight is a wonderful thing. A few months later, in fact, three weeks after my last post, I met Simon, funnily enough at the concert at the church that I mentioned in my last post. I was helping out, he was part of the 'choir' that came to sing (it's an octet), we got chatting at the end, and four years later I walked down the aisle of that same church to marry him. In 2017 I sold the house that we'd lived in since 1996 and where the children were born. Not an easy decision, but the house needed so much doing to it which I couldn't afford on my own, and we were getting fed up with living in two houses. The children are now grown up and live with us full-time. 21yo is reading English Literature which suits her down to the ground. 18yo was doing his A-levels which obviously stopped very suddenly. He is hoping to go to university later this year, all being well.
The last of the big changes is my career. After 23 years as a translator, I resigned in September 2018 and joined the NHS as a nursing assistant in our local hospital. 18 months on and I've not regretted it a single second yet. I sometimes wonder if I should have gone into it sooner, but I think having a bit of life experience helps me.

Of course, being in the NHS means I'm in the thick of the corona pandemic. And that is why I've started writing again. Emotions and tensions run high and one way of dealing with it, for me, is to write. I've noticed that people on the outside seem to be interested in hearing what life is like 'on the frontline', so I thought I'd resurrect the blog. And even if nobody reads it, it will still help me by writing about it.

A bit of background: I work on a ward that specialises in diabetes and kidney disease, and acute general medicine. In the main, we see a lot of elderly patients, often with dementia. In the last week though, we have become the latest Covid19 ward in our hospital, the 8th ward to date. So far, we have patients who have tested negative, but where there is strong suspicion that it was a false negative. I have done 2 full shifts now, and started writing the day before my first day shift, just after we had had our training:

Thursday 9 April 2020

Tomorrow is my first shift on a Covid19 ward. There had been rumours for weeks that it was going to happen, but apart from getting fewer and fewer patients as the pandemic grew, nothing much changed on our ward. At first it seemed so far away. Of course we talked about it, at work, at home. Then the first case was confirmed in the UK and everything seemed to happen faster and faster. Still nothing much changed on our ward. It became quieter, most bays having an empty bed or two. Then we started talking about staff getting ill. The first case was confirmed in our hospital. The first Covid19 ward was opened in our hospital. There were lots of goodies for NHS staff, which made me feel weird: it was nice but I felt it was almost undeserved as I wasn't doing any of the scary work that you'd see pictures of in the news. Then the lockdown came into force, and there were lots of new rules. We had to get changed at work rather than come in in our uniform. Visitor numbers got limited and then had to stop altogether. And then the ward next to us, separated by fire doors with windows in them, was turned into a Covid19 ward. We knew it wasn't long before it was our turn.
We got the go-ahead on Saturday. At this point, most of the staff started to feel nervous and jumpy. Some staff were off with possibly Covid19 (no way of telling unless we're tested), some were isolating because of household members showing symptoms, some were shielding, some were off with anxiety. I felt (and feel) very lucky that the four of us at home aren't vulnerable. The next few days were very strange - so many questions, so much nervous energy.
During yesterday's shift, the five remaining patients were either discharged or moved to other wards. We were empty from around 11 o'clock, and we spent the afternoon tidying, studying, talking about our worries and making a silly little music video.
This morning we had a ward meeting with the whole team, our CEO, and various other people who you know by face but can't quite place unless you've worked with them. All very knowledgeable, experienced, approachable and reassuring. We had our masks fitted. Mine failed and I felt like a failure for not being able to get it airtight. I thought I'd come away from the meeting feeling reassured, instead I felt tired, scared and tearful. I came home and cried - at people flouting the lockdown rules, at my stepdaughter-in-law for working in ICU, for not having bought any Easter eggs for our mad Easter egg hunt.
I spent most of the afternoon knitting and chatting in our ward WhatsApp group. The anxiety is quite overwhelming and I just wanted the comfort of the others going through the same thing.
I'm now all packed, alarm is set. 18 months ago I took a huge step into a brand new world. So much I had to learn from scratch. But just as I felt more confident, this world is turned upside down and I'm having to start all over again, but this time with a scary, unknown and sometimes fatal virus in tow. And I'm frightened.

Friday 10 April 2020

I don't think anyone doing today's shift slept very well. By 6am our WhatsApp group was already chatting, mostly about sleeping problems.
I got to the ward early and sorted out a set of scrubs. The two patient bathrooms are now for the staff to use, and both have sets of scrubs in them in various sizes and states of wear and tear. The uniform dress I normally wear, has four deep pockets and I can carry so much stuff with me - scissors, tape, sachets of cream, handover, my FitBit, lip balm. Scrubs mostly only have one pocket and a shallow one at that. Anything you don't want to lose, can't go in there. The trousers were too short of course, and you have no idea what people's roles are anymore. After 18 months I have a pretty good idea of most uniform colours and who wears what, but scrubs come in a rainbow of colours and everyone wears whatever they can find. I didn't realise until now that I feel quite proud of my uniform - to me, scrubs just look scruffy.
I had 4 patients on my handover, with two other nursing assistants and two nurses. One female bay and one gentleman in a side room. After handover was finished, we were all a bit of apprehensive. It was obvious that our normal routine wouldn't work. Normally you nip in and out of your bay, but all bays are now sealed off with plastic (with zips in them to create an entrance), and you spend as little time as possible in there to minimise the risk of getting infected. You go in there and try and combine as many tasks as you can. We also quickly found out it was easier to have one person outside watching and waiting, who can pass things into the bay or take them out without the person inside the bay having to leave. We all wear surgical masks at all times, but getting into the bay means more PPE: plastic apron, gloves, visor. When you exit the bay, the apron and gloves come off and go in the bin inside the bay. You use hand-gel to clean your hands and leave through the entrance in the plastic. You then clean your visor and store it away for the next time, and you wash your hands thoroughly with soap and water. It's not something you can do quickly and you don't want to do it too often if you want to save on PPE.
I didn't actually go into our bay until 10am. I'd just happened to be the one staying behind and handing things in or taking them from the nursing assistant or nurse inside. I was nervous about going in, although I'm not sure what I was expecting. But as soon as I was in there, I realised the patients  were no different from our usual patients: human beings who needed care. And once I realised that, all my fears were gone.
We spent the rest of the day trying to get to grips with the PPE, the most comfortable way to wear a surgical mask (the elastic does hurt your ears), telling people when they weren't using PPE correctly (including doctors). And cutting and laminating shapes for our new board with post-pandemic wishes, trying to bring some positivity to it all. Lots of people taking part and lots of lovely wishes appearing.
We visited a colleague who had been admitted to hospital and had tested positive.
We chatted, we laughed and we all felt very tired - the release of weeks of tension.
I'm going to sleep well tonight. Tomorrow's shift will feel far less daunting.

Saturday 11 April 2020

A far less anxious start to today's shift. Beautiful sunrise as I drove to work. The weather has been glorious the last few days, in fact, for most of the lockdown period so far. I deliberately arrived early so I would have enough choice from the scrubs. They are still a novelty; today we seemed to have only large sizes, making some people look like they were wearing pyjamas. They come in various colours, and the aim is to find a matching set. Oddly enough most of us were in blue today, with the nurse in charge in turquoise, which set her apart a bit. There is still the weirdness of seeing your colleagues in ordinary clothes as they arrive for their shift, although most of us are now in clothing as close to PJ's as possible.
I had the same set of patients as yesterday, albeit with a different team. The nursing assistant I was paired up with, hadn't done a Covid19 shift yet, so there was lots of telling her what we'd done the day before, what worked, what didn't. Having someone in the bay doing as many things as possible in any one visit, while the other stays behind to be on hand for passing things in and out, that works well. The problem arises when people don't understand the rules: the patient who comes out of his side room to let us know his water jug is empty, instead of using his call bell; the doctor who doesn't realise that there is a computer inside each bay to be used and comes out with gloves on to use the clean computer in the corridor. The principle is very simple: what is inside the bay, is potentially contaminated and has to stay there. Patients aren't allowed outside of their bay (or room), so we try and keep as much as possible of what they and we need in there: computer, obs machine, commode. Anything that comes out, has to be thoroughly cleaned, including us. Today I tried to keep track of how often I'm washing my hands, but I lost track very quickly. I think it might be close to a hundred times a day (a long shift is 12.5 hours) - our hands are definitely showing the signs. I'm going through endless tubes of handcream, but more often than not when you have only just applied the cream, you have to wash your hands again. I don't think my hands have ever been this clean, and my skin is very tight.
Although all our patients have tested as negative, these might be a false negative as the test is only 70% accurate, and we have to work around and with them as though they are positive. So far, we have had two patients become poorly; one of them was moved to an isolation ward and the other seemed to have something not Covid19 related.
The type of patient seems to have changed. I don't know if that is a coincidence: does Covid19 not occur in our usual type of patient or are they going to other wards? We usually have a lot of elderly patients, often with dementia in various stages. They pretty much always need our help, washing, dressing, moving, feeding. It is the part that is the most tiring, but I often find it the most rewarding too. If you have an independent patient, which doesn't happen all that often, you're usually relieved as it means that you have more time for the people that need help. There are plenty of shifts where you need more staff and you wish you had ten pairs of hands. Now, most of our patients are a bit younger and independent. Of course, it is only the second day and it is the Easter weekend, but right now it is working well, as it gives us the chance to get used to the new routine and we don't have to spend long periods inside the bay. It might all change still, I'm very aware.
The downside of the new routine is that I'm missing the patient contact. All the bays are sealed off which means there is far less visibility. Normally I pretty much know all our patients at least by face, and often most of them by name. Now I have no idea who the patients are in the other bay or even how many there are. When you go inside a bay, your mask and visor make you sound muffled, and patients can't really see much of your facial expressions either. None of this benefits patient contact. Not being able to wander in and out of a bay doesn't help either. It feels functional, which is how it has to be for now, but I miss the human side of nursing.
At the end of the day though, when I go in to a patient's room to take his observations, he tells me he has a relative waiting by the hospital entrance with some things for him, including his phone charger. I've come to realise how incredibly isolating a hospital stay is now and being without a phone must be very hard. He says someone was going to fetch his things, but that was 20 minutes ago and his family are still waiting. I tell him that after doing his blood pressure, I will go and find them. I meet a very grateful granddaughter, talk to them briefly about the lovely summery weather that we don't notice at all on the ward, walk back through an eerily deserted hospital and deliver the bag to the equally pleased patient. He asks my name. At the best of times most patients struggle with my name; add a visor and mask and it's worse. After a couple of attempts this patient gets it. Half an hour later I pop my head around the door to ask if he's been given something he'd asked for. Yes thanks Cybèle, he says. He's remembered my name and I leave the room with a smile. This is what nursing is all about for me. I think in the weeks to come, these moments are going to be even more important to hang on to.

Last summer, long before lockdown