I’m An Intensive Care Nurse – This Is What Working During The Covid Pandemic Has Been Like

"I don’t think there has been any area of my hospital which has not been affected by the pandemic"

Emma gives her perspective of working as an ICU Nurse in the NHS during the Covid 19 pandemic.

Topics Covered In This Article

My Most Challenging Year As A Nurse

How Covid Has Changed Practice In My Hospital

Working On Covid Wards

What It Feels Like As A Nurse Working With Covid Patients

How The Pandemic Has Impacted Staff And Colleagues

What Has Been Learned in ICU During Covid

My Most Challenging Year As A Nurse

Taking off my PPE after a 12-hour nightshift, I felt defeated.

The inability to save these patients despite doing everything you can is the hardest pill to swallow.

That night two patients sadly lost their battle with Covid and a third family had just turned up to say their goodbyes to their Dad.

I recognised this family. This was the second time in a matter of days this family had made the harrowing journey to the Covid ICU to say goodbye to their loved one; a husband and wife in their 60s spending their last days, both intubated and ventilated, just a bedspace apart.

My name is Emma, and I am an Intensive Care Nurse (or ITU Nurse - Intensive Treatment Unit Nurse) working in a Covid ICU in the North East of England.

The above is just one of the many tragic and poignant memories I have of this pandemic.

As we approach the anniversary of the Global Pandemic, I wanted to share my personal, raw and unfiltered experience of what working in a busy Covid ICU is really like.

This time last year, we were told by our peers in Italy to “prepare, prepare, prepare” and we tried.

We prepared for the influx of patients with oxygen saturations lower than 50%. We sourced more ventilators. We gathered PPE. We suspended elective surgeries.

We did our best, but the truth is we couldn’t prepare for something that we did not understand.

We are only now, a year on, beginning to gather the evidence-based research to enable decision making.

We are only now beginning to piece together the disease transmission, the clinical manifestation, the risk factors and subsequent morbidity/mortality rates of this virus.

Since graduating from University College Dublin in 2015 with a BSc in General Nursing, I have worked in Ireland, Australia and the UK.

I have developed a broad experience across many healthcare settings including rural Australian Outback and Acute Trauma Centres.

However, no amount of experience or education could have prepared me for the most challenging year in my Nursing career.

How Covid Has Changed Practice In My Hospital

I don’t think there has been any area of my hospital which has not been affected by the pandemic.

From the moment you reach the front entrance there are “AMBER ZONE - DO NOT ENTER” signs everywhere.

It feels strange knowing that, by simply entering my workplace, I might be infected by this deadly airborne virus or worse still, take this virus home to loved ones.

I now separate my Nursing experience into Pre-Covid and Post-Covid because the day-to-day running of the hospital looks radically different now.

Since Covid, my unit has been forced to expand ICU beds. We have taken over the previously specialist gastroenterological ward next door, in order to make a Covid ICU and non-Covid ICU.

This has made working conditions more difficult because we are now staffing two units, often with less staff due to sickness.

My shift starts with reading the allocation board to find out which side I will work on and which patients I will look after.

I then change into my uniform and greet colleagues, which has been the best part of working throughout this pandemic.

Being able to support each other and still keep up some part of the old “normal” in an otherwise alien “new normal” way of life.

Working On Covid Wards

If I am on the Covid side I will have a quick drink (without taking too much) and I make sure to go to the bathroom before getting into PPE as I never know the next time I will be able to go.

Of course, next comes my least favourite part of how our practice has changed. I don PPE before entering the red zone- Long Sleeve Gown, FFP3 Mask, Surgical Cap, Plastic Face Shield.

In my trust we have followed the Public Health England guidelines and adopted the “bare below the elbows” method which has been a welcomed change to combat the heat.

In addition to this, before patient contact, I put a plastic pinny and gloves over my gown.

After a while of being in PPE, the heat and thirst becomes distracting.

I try to ignore it and do my job as best I can.

We often have other members of the Multi-Disciplinary Team e.g., Consultants, Physios, OTs, and SLTS as well as Nurses from other departments, come to relieve us Nurses for quick breaks out of PPE.

This has been a god-send on busy days.

Oftentimes, there are kind donations in the breakroom - food, care packages and so many thoughts and messages of kindness from local business, charities and the general public.

This is often the pick-me-up needed mid-way through a shift to carry on.

What It Feels Like As A Nurse Working With Covid Patients

Walking into the unit, I am confronted with scenes that have become household images over the past year.

Intensive Care beds, each one taken up with a critically ill patient being documented on national news.

Most patients are sedated and ventilated, their organs being supported and kept alive by these therapies.

Others fighting for breath on non-invasive methods of ventilation.

The breathlessness, anxiety, isolation, pain, fear and loneliness.

The true realisation you may not get better and are now facing your own mortality.

I have cried with patients.

I have held the iPad of the patient, who is seeing their loved ones for the first time in weeks over FaceTime.

The “I love you”s, which are the last spoken words before they are put to sleep and onto a ventilator.

I feel a huge sense of guilt knowing that I am involved in such an intimate moment and I get to hold their loved one’s hand while the family cannot.

How The Pandemic Has Impacted Staff And Colleagues

Being surrounded by so much death and dying takes a toll; for those of us working on the frontline it is so important to look after our mental health.

I have been practicing daily mindfulness and meditation techniques as a means to switch off the mental chatter.

Apps such as Calm and Headspace are a great place to start.

The stress amongst colleagues has been immense.The pressure on Nurses has been unrelenting since last March. We are seeing this in my unit especially.

More and more Nurses are going off on extended sickness due to stress.

Every day, there are new faces in report.

Nurses who don’t usually work in ICU are being redeployed to this intense environment. And we are so thankful.

They are experiencing all the anxieties of the rest of us, while being completely outside of their comfort zone of knowledge and experience.

What Has Been Learned in ICU During Covid

‘The greatness of a community is most accurately measured by the compassionate actions of its members’ – Coretta Scott King

When exploring what has been learnt during Covid, the most obvious response, would be the growing body of evidence-based research, gained through lived experiences and still ongoing clinical trials.

We will be better equipped to ‘command and control’ subsequent waves and potentially other virus’ which could threaten our NHS in the future.

However, for me, the enduring lesson has been the strength, courage and comradeship shown by my peers.

Hierarchies and inter-professional boundaries have been blurred and broken down.

The resilience, adaptability and innovation demonstrated by those who have been unwavering in their care and compassion, has been the beacon of hope.