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Nursing

A&E Covid 19 Story: London

Confidentiality disclaimer: To ensure the NMC’s guidelines on confidentiality are adhered to, no personal or identifying information will be in this blog. All names used will be pseudonyms and no place, staff or patient details will be used. 

Week 1: Cancelled training sessions, e-learning and apprehension

Week 2: Starting in the Emergency Department

Week 3: Emotional Strain and Covid-19 Resus

Week 4: The logistical issues of discharging patients with Covid

Week 5: #ClapforHeroes

Week 6: Myth-busting and FAQ’s

Week 7: Changes to the NHS

Week 8: Scrubs and the Inequality Beneath

Week 9: Post Covid Complications & an Innovative NHS

Week 10: Covid 19 and BAME Inequality

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Nursing

5 Reasons to Study Nursing in 2020

If you’re currently doing A Levels and are thinking about applying to University, I’m here to give you 5 Reasons to Study Nursing in 2020. 

It is undoubtably a very uncertain time in the healthcare field, and the NHS has never featured more in the news than it has in 2020. There have been Nurses heralded as heroes, Nurses protesting and Nurses dying. This definitely makes considering a career in Nursing a daunting prospect. 

Additionally, when talking though your University options at college or sixth form, many people struggle to understand why anybody would want to study to be a Nurse! Especially to work in the NHS at the moment. If you’ve found this page because you’re unsure wether nursing is right for you, you’ve come to the right place.

Hopefully reading this list will help inspire you, restore your confidence in pursuing a career you know in your heart you want to do! Here is why studying Nursing in 2020 is still a good idea.

5 Reasons to Study Nursing in 2020

Its Reliable

To say 2020 has been a difficult year would be an understatement. Covid-19 has not only caused tragedies, it has also left us with many uncertainties about the future. Many people working across a broad spectrum of industries are facing job insecurity in addition to economic uncertainty.

However, Nurses never struggle to find work! You can confidently stay assured that whatever place you are at in your life and whatever situation you are in, you will always be able to find a job. This goes for the state of the world and economy too. It is one of the few roles that are absolutely essential to life and society. Your job security is always guaranteed as Nurses.

It’s Broad

I am an A&E nurse who is also a blogger. I also volunteer with Yorkshire’s Brain Tumour Charity as part of the digital marketing team. The options of where Nursing can take you, are quite literally endless. If you finish University and never want to go into a hospital ever again? You don’t have to! You could work in a private clinic! Ever thought of starting your own business? Many Nurses train in Aesthetics! Additionally, you could work in an edgy IV bar in Shoreditch! You could be a District Nurse! You can be the Heart Failure Specialist Nurse! 

Whatever interests you hold in your personal life, there is no doubt you could find a job within Nursing that inspires you every day. (Think Sepsis Nurses, Palliative Care Nurses, Cruise Ship Nurses, GP Clinic Nurses etc etc etc I could go on forever!).

It’s Rewarding

No one would try to claim that being a nurse is easy. However, in terms of making a difference you can’t really top it. The job is challenging, especially when you have to juggle many priorities at the same time. However, as you gain experience, you will feel your confidence growing. There will be some days when you just KNOW you’ve smashed it?! and that’s a great feeling.

Travel

You have freedom to travel anywhere in the world. This point ties in with the first point. However I thought it deserved a special mention. If you train in the UK, the Registration is internationally recognised as one of the best Nursing qualifications in the world! This means if you want to move to Australia and earn £60,000 a year? The job. Is in. The bag.

Progression

Many people go into nursing with the immediate intention of progression. The starting salary of a band 5 RN in the UK is now £24,907. If you are willing to dedicate a few years to your career there are many progression opportunities within nursing, allowing you to increase your salary if thats one of your aims! Due to staff shortages many jobs offer guaranteed progression pathways within 1-2 years as an incentive to retain staff. I myself know people who are motivated and exceptionally good at their job who become Managers and specialist Nurses within a few years of qualifying.  

Student Nurse? Check out the Nursing Hub for more Nursing resources!

Here is what I learned in 6 months of being a Newly Qualified Nurse!

5 reasons to study nursing
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Nursing

NHS London Nursing Protest

London Protesting as a Nurse in the NHS

On the 8th August myself and hundreds of other health care workers engaged in an NHS London Nursing Protest. the March took place from St James’s Park and walked to Number 10 Downing Street. The purpose of the march was mainly securing a 15% pay rise for Nurses within the NHS.

A pay rise been an issue in the front of Nurses and healthcare workers mind’s since it was announced that hundreds of pubic sector workers were getting a payrise. However, nurses were left out of this post Covid ‘Thank you’, leaving many nurses feeling like we had been ‘stabbed in the back’.

In the spirit of protesting, many issues affecting the NHS were addressed. This included many recent tragedies such as the death of NHS workers and PPE shortages. Other things mentioned were NHS cuts, staff shortages and difficult working conditions. I myself was carrying a banner with my friend and colleague saying “Overworked Underpaid”. Half of the banner appears in headline news stories.

Messages

“Torys Lied, Nurses Died”

A chant heard on the day

One of the popular chants heard in the march included “Torys Lied, Nurses Died, Now its Time to Turn the Tide”.

The protest was very powerful, many nurses and healthcare professionals turned up in scrubs. I unfortuately did not plan ahead enough to collect scrubs for the occasion. Thankfully, many of the nurses there today had clearly been planning ahead for the day. When I arrived at my hospital to join the other nurses, the lead gave everyone a sheet with the words to the chants to learn and use

My favourite to chant was “1,2,3,4,5 Keep our NHS alive”. The main chant of the day was “What do we want? 15%! When do we want it? Now!”. Chanting was an important factor in the NHS London Nursing Protest.

Strikes?

A not so surprising factor of the day was the mention of nursing strikes in the future. Strikes were mentioned in some of the chants. In Particular, “What do we want? Pay rise. How do we get it? Strike!”. As I don’t hold any further information on this I can’t comment on any further plans of action and I don’t wish to perpetrate rumours.

If Nurses were to strike?

It wouldn’t be the first time members of the NHS have gone on strike. In 2016 Junior Doctors held a strike to oppose the imposition of new contracts, which reclassified the ‘working week’ to include weekend and late evening working. This was preceded by a protest 3 months prior.

Union Representation

There was strong representation present from Unite and from Unison. However I did not see or feel as though there was much RCN representation present. This could have been from where I was standing though as I was near the front.

Im ironically having to rush writing this as I have a 12 hour shift tomorrow (third in 4 days). It really drives home how important it is to fight for these issues facing our workforce.

Read A&E Covid-19 Story Here

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Lifestyle

Volunteering for Yorkshire’s Brain Tumour Charity

Hi everyone! Today I am here to talk to you about the volunteering I now do for Yorkshire’s Brain Tumour Charity. Click Here to see my face on their website!

Previously, I have been running the Instagram page @survivingnurse. This is with the intention of connecting with other Nurses and Healthcare Professionals in an online community. Additionally, I understand running a connected Instagram also increases the reach of the blog.

Transferring Skills

After running the Instagram page for 4 months I began to think about how I could transfer the blogging skills I had learned. Especially since the pandemic began to wane from the News headlines. This is when I had the idea to apply my skills to support a charity that is very close to my heart. This lead me to contact Yorkshire’s Brain Tumour Charity. I applied for a voluntary role of running and content creating for the @YorkshireBTC Instagram page. 

Yorkshire’s Brain Tumour Charity is very meaningful to me. This is because in 2017 my stepdad, Dean was diagnosed with a brain tumour. During this time, the support groups and community offered by Yorkshire’s Brain Tumour Charity was invaluable. My Mum, Hilary especially found great support from the group meetings. She has since volunteered regularly and become an Ambassador for the charity. Dean passed away in 2018 and since then, Yorkshire’s Brain Tumour Charity has continued to be a charity I feel very strongly about promoting. I hope to help raise money for this charity. This is because I understand, first hand, the vital work they do. 

What I Aim to Achieve

What I aim to achieve in volunteering for Yorkshire’s Brain Tumour Charity is assisting in promoting the charity. I hope to do this by increasing the reach of the Instagram account and supporting Yorkshire’s Brain Tumour Charity Community. This is so they can continue to offer their wonderful support to people and their families, in Yorkshire, who have been diagnosed with a brain tumour.

Follow their Instagram Here

Would you like to donate to support the invaluable work they do? Text INSTAGRAM followed by the amount you wish to donate (for example INSTAGRAM 3 to donate £3) to 70085

Texts cost your donation, plus one standard rate message. You will be opting in to hear more about our work and fundraising via telephone and SMS. If you’d like to give but do not wish to receive marketing communications, text INSTAGRAMNOINFO with the amount your wish to donate to 70085. For example Text INSTAGRAMNOINFO 3 to 70085 to donate £3

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Lifestyle Nursing Self Care

July Must-haves

Today marks the start of July! From July 4th there will be new liberties such as pubs and hairdressers being open in the UK! As July has so much change and excitement to offer I would like to share some of the purchases, including masks, fashion and art, that I have enjoyed recently and (in my opinion) are worth investing in for the coming month! These are my July Must-haves!

Must-haves: Fashion

  1. To begin, my first July Must-have is the face covering I have bought from Etsy. After researching online for a cotton face mask I found the delivery times for most masks are delayed. Most of them stating they will be take over 10 days to be delivered. As we all know it is now mandatory to wear a face covering on public transport so I didn’t have long to wait. This option from Aliciasgiftstore on Etsy came through perfectly.
  • Next, is a t-shirt generously sent to me by Fezshirts. The soft white tees are comfy and perfect for chilling summer vibes. I like this tee because it also recognises and thanks key workers who can often by overlooked whilst NHS staff see more of the appreciation. Here is a photo of myself in the tee
picks of the week

Must-haves: Art

Moving onto Art, this month I have particularly enjoyed a print I purchased from Drawfor.

Drawfor is a non profit platform which raises money for a selection of causes by producing limited editions of prints that artists have drawn for various causes. I bought this print to support their #ThankyouNHS campaign, where 100% of the profits go to NHS charities together.

Picks of the week #thankyounhs print
#ThankyouNHS print by Daisy Bernard

Their latest campaign focuses on Equality and has a gorgeous selection of prints where the profits will support Stand up to Racism.

This is one of my favourite prints in support of Stand up to Racism (Artist Marco Oggian) and I think will be my next purchase.

Must-haves: Plants

The final item in my July Must-haves is a plant mister. As we get into summer, a mister is a great way to moisten the leaves and the soil of a plant which does not require very frequent watering, such as succulents, cacti, rubber plants etc.

I bought this one from LisaAngel

Plant Mister July Must-haves
Plant Mister

Importantly, it also works well for a top up, to nourish the leaves between regular watering, for Ivy’s and Cheese plants.

plant mister 2 July must-haves
Plant care is Self Care!

I hope this is a helpful guide for what to buy this July!

Click here for how to do a homeshoot!

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Lifestyle Photoshoots

How to do a Homeshoot

A few weeks back myself and my housemates were finding ourselves bored, unispired and creatively stifled. As there hadn’t been any reason to look pretty in a while, we were finding we had unworn clothes in the wardrobe and our daily routines had become mundane and lacking creativity. I had seen some posts on Instagram showing content produced over facetime such as this amazing shot from @flashbachphotos and I was #shook. I decided to write this post to help anyone who wanted to know how to do a homeshoot!

This prompted me to message my friend Polina who is a photographer temporarily living in france. I asked if she would be up to collaborating on a home shoot together and she was on board immediately. We soon set up and started laying the plans for the shoot. I didnt know how to do a homeshoot, however Polina took a directors role with Kandys help and we ended up producing wholesome quarantine content we were very happy with. Here is the process in case anyone wanted to know how to do a home shoot!

Here is a step by step guide to ensure you produce the best home shoot content.

  1. Set up your team. contact the people who you want to involve in the content producing process. This includes deciding on the models, photographer and who is going to edit the content. If you live with other people you can also swap into the role of photographer/model.

The Team

View this post on Instagram

❤️ #selfie

A post shared by Polina (@polilare) on

Polina: Photographer
Photo of Myself and Kate how to do a homeshoot
Myself & Kate: Models
Photo of stylist Kandy how to do a homeshoot
Kandy: Stylist
  1. Get creative! Have a think and discussion about the type of content you want to produce. what props do you want to use/what outfits and acccessories do you want to feature to style the shoot and what ultimate content do you want to end up creating. In this shoot my housemate Kandy took on the role of stylist and worked with Polina to coordinate the outfits with the shots. Have a look at other home shoot examples by using the #homeshoot tag on instagram and pintrest. Due to Covid 19 and the necessary social distancing measures, many brands (such as ASOS, seen below) who usually produce professional editorials in a studio, are now resorting to homeshot content. Thus setting the trend for some time to come on how most editorials will likely be styled.
  1. In the absence of professional equipment, use the phone with the highest quality camera availabe in your house and set this up to facetime or skype the designated photograher. As the photographer involved for my shoot had use of professional equipment Polina was able to take photos of her laptop screen.
Photo of myself and Kate, how to do a homeshoot
Photo captured by facetime screenshot function.
  1. Vary the way you capture photos. Try using self timer on a phone with assistance and direction of your housemates and photographer on a FaceTime call. As a result of using FaceTime, you can also use the photo taking function in facetime to capture live photos on an Iphone.
photo of myself, how to do a homeshoot
Photo taken of her laptop by Polina with a camera

5. Go for some outfit changes to switch up the content

photo of kate

Props!

6. Use household props to capture that staying at home vibe!

photo of kate with a plant
black and white photo of myself and kate how to do a homeshoot

7. Have fun and create something you will remember! As soon as pubs, bars and restaurants are open again and you have more excuses to get out of the house you probably wont be rushing to create home content, so use this opportunity to create something to remind you of the good times had during this strange time.

black and white photo how ot do a homeshoot
phot of myself and kate at a table

Hopefully this helps anyone who wants to know how to do a homeshoot!

More Resources

For resources on how to look after you mental health in lockdown

For more Selfcare in Healthcare

A&E Covid 19 Story

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Lifestyle Nursing

Top 10 Motivational Songs for your Journey to work

Dragging your body to a shift on less than 6 hours sleep that you really wish you didn’t have to go to? Been there. Here are the top 10 motivational songs your journey to work that I would recommend listening to if you need a real moral-boosting-you-got-this feeling to tackle the next 12 hours. To summarise, the songs are arranged to start with gentle motivation and slowly progress until you’ll be so pumped off adrenalin you’ll be ready to face the next Karen who tries to have a go at you. Spotify link to this playlist here: 

The Playlist

The Songs

I Won’t Back Down – Tom Petty 

To gently ease you into a motivated mindset I recommend I Won’t Back Down as the first song on your commute.

It’s My Life – Dr. Alban 

Slightly more upbeat – a strong second track on the commute. This song perks me up, it’s very useful for when someone asks you why you didn’t train to be a doctor instead.

One Way or Another – Blondie 

This song really puts me in the ‘I can achieve anything and i’m fabulous ??? mood’

Paper Planes – M.I.A.

Moving onto the next track- This song by M.I.A. is just an all round banger tbh, its not too adrenalin stimulating but still upbeat enough to perk you up for work.

Galvanize – The Chemical Brothers

Next, we have one of the more relaxing Chemical Brothers songs. However, it works to slowly increase the energy levels as the playlist develops

Savage – Megan Thee Stallion

Perfect for the pre-work confidence boost!

Survivor – Destiny’s Child

This song should remind you that you can survive anything the shift has to throw at you!

212 Azealia Banks ft Lazy Jay

Upbeat, fast-paced – Just like your 12 hour nursing shift!

9. Pump It – Black Eyed Peas

Clue is in the name, really just a great song to pump you up!

Lastly, we move onto the Kanye song. Above all, this song has a certain focused energy, perfect for the start of a shift.

10. POWER – Kanye West

If this song doesn’t make you feel like you can do anything – what will?

Hope you enjoy these top 10 Motivational Songs for your journey to work and feel like you can face whatever work throws at you after listening to this power playlist!

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Nursing

A&E Covid 19 Story Week 10

Covid-19 and BAME Inequality.

Previously, I have talked about the gender inequalities that wearing scrubs has exposed within the healthcare system. This weeks post there will be a wider focus on Covid-19 and BAME inequality. 

Recently, the murder of George Floyd, a 47 year old Black man, has been brought to the attention of the public eye. Footage has been shared of the (now charged) police officer kneeling on George’s neck. This happened for 9 minutes, whilst he begged for his life and can be heard saying “I can’t breathe”. This event lead to the murder of the 47 year old. This tragic death is an unforgivable casualty of police brutality and systematic racism.

A Subject People Find Difficult to Address

Firstly, it is undoubtably a difficult subject to address. It is extremely important to talk about, regardless of how uncomfortable it may be. Secondly, its important to address the leading voices on the matter Alicia Garza, Patrisse Cullors and Opal Tometi (Founders of the Black Lives Matter movement). Finally, I can only speak from my own expertise and experiences. Therefore, I wanted to make this next post about something I am very familiar with. Concluding this, this post will be (as you might have guessed) about Covid 19!

Covid-19 and BAME Britons

This week I would like to talk about how BAME Britons have a disproportionate mortality rate from this virus. This is twice the risk of death according to the ONS. This is a health inequality that needs addressing.

Whilst we are in the middle of the pandemic with a virus that has many victims (including young and usually health people) many people seem to think its unimportant to focus on specifics such as who is more affected. However, as the affects of the virus have unrolled across the UK, it has become ever more pressingly apparent that people from ethnic minority backgrounds are disproportionately dying from the Corona Virus. Out of the 200 health workers who have died in the UK from Covid 19, 60% of the people were BAME.

It has never been more important to collect, study and distribute the findings from a health crisis. To look into who is disproportionately affected by it and what we can do to minimise this public health inequality. In summary It is not ok to place unequal value on the lives that have been lost during this pandemic and its time we addressed it. 

On the 10th May there were calls for a public enquiry into this issue. 70 public figures (including London Mayor Sadiq Khan) signed a letter to the Prime Minister demanding transparency into this matter. Public Inquiry’s are important for safety, education and can lay foundations for future policy makers and research. An inquiry could help employers make appropriate allocation decisions based upon risk assessments increased safety for staff.

Risk assessment for BAME NHS staff

Gal-dem.com outlines excellently why there is a need for an independent public inquiry into this.

Moving on from the public inquiry, here are other recent and relevant pieces of news.

Firstly the first news story I will mention is, The tragic death of Belly Mujinga. A woman who lost her life 2 weeks after being spat on by a man claiming he had the Corona Virus whilst working her essential role at London Victoria station. 

Additionally, The tragic death of Trevor Belle a 61 year old taxi driver who died 3 weeks after being spat at by one of his passengers.

What you can do

Firstly, for people living in London who want to support communities in the capital.

Similarly, for people who want to volunteer:

Moreover, if you can donate money to support memorial services for BAME families, bereaved because of Covid-19

Additionally, if you can sign a petition supporting a public inquiry into BAME loss of life to Covid:

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Nursing

Post Covid Complications: A&E Covid 19 story Week 9

This week I will be addressing post Covid complications. I think I looked after the first (known) patient at my hospital with post viral delirium due to Covid. It was a rather scary experience as the patient, who will remain anonymous, was usually healthy/non-elderly. Delirium is a dangerous condition in which a persons mental state is altered. This means people can be confused, disorientated, aggressive, restless, incoherent and/or unengaged. Delirium can be due to infection, sepsis and pain. It can also be from other reasons like hypoxia, recent extubation etc. Despite the cause, it is most likely always a sign someone is unwell.

In this particular situation, the patient was experiencing delirium as a viral complication due to a previous infection of the Corona Virus. Delirium is very serious and it can lead to an increase in the chance of mortality. It can also mean patients hurt themselves and do not tolerate treatment interventions they desperately need, such as cannulas, IV fluids, IV antibiotics and oxygen that they may need to reverse the delirium! My patient was being violent, throwing things around the room, trying to turn on the defibrillator in the room and spitting at staff. They needed to be sedated in best interest i.e. for cooperation in care so they were not a danger to themselves and would tolerate the treatment.

More Post Covid Complications

Other post covid complications I have noticed is many patients attending the emergency department with chest pain. When this happens the patient has blood tests, ECGs and chest Xrays (the appropriate investigations). If diagnostic test results show the persons life isn’t in danger from things like an MI (heart attack) or a PE (blood clot in the lungs) or severe sepsis/pneumonia/covid etc affecting the body; and the persons observations are stable i.e. oxygen saturation levels adequate without supplementary oxygen, then the person will be discharged. The doctors inform these people, who experienced Covid a few weeks/months ago that they are experiencing pain from the effects Covid has had on their lungs and it could take weeks to months to resolve. 

I have also encountered many patients who are experiencing Covid 19 symptoms saying ‘do you get many people with Covid in this hospital?’, and are worried about catching it in hospital when it is most likely they already have it. Many patients are also wearing gloves, touching their phone, using public transport and touching their face with the same gloves. Thus causing much cross contamination. The importance of following guidelines such as hand-hygiene is important to note here for infection prevention and control.

Innovation within the NHS

Covid has necessitated a lot of innovation within the NHS. Rapid Covid test swabs are one of the newest pieces of innovation I was excited to see rolled out. A limited number of these are now available in some A&Es for testing for patients who fit a tight criteria. For example, for patients who are at risk of becoming particularly unwell from the Corona Virus and need to be ‘shielded’ from Covid in hospital. This includes people who are immunocompromised, have diabetes or may be on chemotherapy.

Ideally, these patients need to be in a ‘non covid area’. The difficulty lies when these people need to be admitted to wards. However, they have presented with symptoms in which Covid cannot be ruled out as the cause of their illness. They also could have post covid complications. Therefore these people cannot go to wards where they could potentially pass Covid 19 onto other people. There is also a limited number of side rooms available in the hospitals as most of them are already occupied by similar patients.

Testing

The Rapid Covid swab machine technology is helpful here. As it results in 1 hour, it can dictate if patients are suitable to go to a covid/non covid area. This saves from breaches in A&E. (Find out what a breach is here)

There has also been the opportunity to have asymptomatic testing for all patient facing staff in the trust. Thus, allowing data collection on Covid 19 prevalence among healthcare staff without symptoms. This means preventing staff working with high risk patients such as on chemotherapy/cancer wards unknowingly spreading Covid to vulnerable patients. If any of the asymptomatic staff test positive for Covid they are to follow self isolation protocols as usual. There is also the opportunity for me to take part in a vaccine trial if I wanted to! I am not taking part in this trial however I am excited to hear more about it. Especially since it is beginning to look like social distancing will continue until a vaccine is found. So I am very much hoping there will be scientific advancements regarding vaccines quickly!

Antibody Testing

Antibody tests are another thing I am eager to try. I had Covid symptoms in early February. However this was before it was prevalent in the UK and I really want to know if I have had the Corona Virus or not as knowing this would make me feel less worried about catching Covid at work.

In conclusion, as we approach the 10th weekly #ClapforCarers this Thursday I think it is important to reflect on what the NHS has achieved during these times. I have seen an incredible amount of innovation and change in the past few months and I am incredibly in awe of everyone who made it happen and adapted to it so well.

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Nursing

Scrubs and Inequality: A&E Covid 19 Story Week 8

Week 8: Scrubs and the Inequality Beneath

Today I am going to address something that has come to light due to Covid 19 which I believe deserves addressing, scrubs and inequality.

If you ask people who work in healthcare if they enjoy wearing scrubs, the majority of nurses (myself included) would say they prefer scrubs to the usual uniform as they are far comfier. Historically people adopted scrubs as they began to realise the importance of a clean surgical environment. Since then, in England it is my understanding that most nurses wear a uniform. The exception to this would be surgical/recovery nurses and nurses in some emergency departments. However, due to the Covid 19 pandemic most staff members who work in hospitals are now wearing scrubs. This is for infection prevention and control reasons – to prevent staff members bringing the harmful virus particles home and on public transport on their clothes. 

Pre-Covid-19

In a time before Covid, nurses, physios, health care assistants, domestics and porters wore a uniform whilst doctors seemed to be the exception to this rule. It seems doctors had the choice between wearing their own (smart) clothes or scrubs. This means doctors wear suits/dresses or ‘professional’ clothes whilst working on a ward, despite having contact with bodily fluids.

Whilst there is the argument there to say that doctors are involved in less direct patient contact than the nurses; it does not explain why it is suitable for a doctor to do a rectal exam in a suit with a thin plastic apron on whilst the nurses who hold clinics or research studies are still required to wear a uniform.

Guidelines

The Department of Health published guidelines known as the ‘bare below the elbow’ guidance. It also outlines the three objectives when it comes to what health care professionals should wear. To summarise these are: Patient safety (ie infection prevention and control), Public confidence (clean/professional workwear) and Staff comfort (I.e., cultural practises). Reviewing this guidance, I cannot see any reason there should be differences between what doctors and nurses should wear whilst at work. 

Now I may be mistaken here, but I believe the contradictions present in these rules date back to a time, pre Florence Nightingale. A time when doctors were the Professional staff members who held a degree and nursing was an uneducated profession. Hippocrates who is widely regarded as the father of western medicine, claimed doctors should be “clean in person [and] well dressed”.

I believe that due to nursing being a ‘pink collar’ job i.e. a profession held mostly by females (89% in the UK) there is a long withstanding lack of respect and recognition for the level of education and professionalism required nowadays in the nursing profession. 

Hierarchy

Sadly, there is a very intense hierarchy present in healthcare. Anyone who doesn’t work in healthcare probably couldn’t grasp just how tangible that hierarchy feels sometimes. I have seen some people disregard people in job positions such as health care assistants, domestics and student nurses. I was actively terrified of doctors when I was a student nurse which I now realise was ridiculous. Obviously, most organised workforces involve a hierarchical structure. However, this is a problem when it means people feel that they are less important than others. I find uniforms to be an important reflection of hierarchy. 

What about now?

Nowadays, an RN requires a Bachelors degree. Additionally, nurses register to a professional body, the NMC. The discipline of nursing also encompasses many advanced roles such as Advanced Nurse Practitioner’s and specialities i.e. Heart Failure Nurse. Many of these professionals take an active roles in the Medical team. They often prescribe, advise and consult – skills attributed historically solely to doctors. Many nurses also take on a senior roles in the hospital and community settings as matrons, managers and coordinators etc. So, yes it did raise a bone of contention when I saw an Advanced Nurse Practitioner wearing a uniform whilst the doctor holding the same clinic in the room next door did not. This prompted me to write this post – scrubs and inequality.

Going back to the present day, everyone, despite their role is wearing scrubs. Whilst this is more confusing and this practice will not last, I think we can all learn a lesson from this. Nurses and Doctors deserve equality in their uniform or non uniform policies. 

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Nursing

A&E Covid 19 Story Week 7

Changes to the NHS

This week I have noticed firsthand some of the changes to the NHS that Covid has brought about. Firstly, for most of the week I have been working with the non covid patients who come into A&E. These are the patients who present to A&E with no Covid/respiratory symptoms or temperatures and signs of infection. These people are triaged straight to the non covid side of the department. 

These patients have been steadily increasing in number over the past few weeks. Whereas when lockdown started, perhaps due to the #stayhome (or now #stayalert) message being promoted to the public, there were very few patients coming in. However the illnesses and accidents requiring emergency care such as heart attacks, strokes and mechanical injuries are still happening. This lead to NHS England’s Medical Director making a public announcement. He encouraged people to attend the emergency department when needed.

During this period, as Covid patient attendances decrease and non covid patients increase in numbers, there is an uncertainty of how A&Es and wards across the country need to change and adapt again. This would be to ensure minimal cross contamination so inpatients aren’t put at risk of catching the Corona Virus.

To adapt to the pandemic hospitals are changing to have Covid and non covid areas. I.e. there may be a ‘Covid ITU’ where the normal Intensive Care Unit is situated and a ‘non covid ITU’ in i.e. a theatre recovery area.

Patient Flow

As the patient numbers are changing week by week it has thrown many things into question. For example, if the designated areas can now fit the size of the population they are treating. It is also a tricky problem to solve. This is because after having people with Covid in, these areas will need to be kept empty long enough to be extensively cleaned. This is so it would be safe for the non covid patients.

The intensive cleaning involves many steps. Firstly, removing and replacing the curtains. Then, wiping down all surfaces and walls with disinfectant and disposing of any items left in the room. This is usually unused ECG stickers, unopened cannula packets and untouched dressings. Additionally, if these areas were switched back too quickly to ‘clean’ spaces, it might mean there wouldn’t be enough spaces to treat the Covid patients if the prevalence of Covid hospital admissions spike again.

Accident & Emergency

Where I work in A&E, the changes to the NHS are very visible as the entire department has been rearranged. The non Covid majors patients are treated in the small cubicles that under normal circumstances are used for minor injuries. For example, used for people who need stitches, casts, and wounds dressings. These cubicles are not as big as the standard majors cubicles. These are equipped with a cardiac monitor, a trolley and a patient table.

The nurses looking after the Non Covid Majors patients have to work in a small number of cramped clinic rooms that weren’t designed for majors patients. The environment feels overcrowded and chaotic. For example, it makes simple tasks like getting a hospital bed into the room, difficult due to space. Someone may require a hospital bed in A&E due to being in a wheelchair and not being able to transfer to the height of a hospital trolley or requiring a bariatric bed as the A&E trolleys would not fit these patients.

Redeployment

Additionally, another change the NHS has had to adopt is the mass redeployment of staff. Services like childrens ED’s and speciality clinics are getting relocated. I personally know a lot of stroke and paedeatric nurses who have been told at a few days notice that they will now work at a completely different hospital. This is miles away from where they currently work. This has meant lots of staff have had to sort out temporary accomodation. Staff in management roles have had to leave half way through their current projects/workloads for inductions at totally new trusts.

Redeployment is not always as easy as it sounds. For many, it means going through the stress and hassle of learning new IT systems, acquiring new access badges and getting to know a totally new site or even job role. It means teams who know each other well being pulled apart and has left nurses unsure of what they are allowed to do in their new role specification. (The RCN has a useful advice page if you are going through redeployment here). 

Redeployment has meant the relocation of many specialist nurses and doctors. A lot of whom were about to commence/were mid way through training for a speciality role. They have been since asked to move to places such as emergency departments and ITU’s to support the staff with the projected strain on the NHS that Covid was thought to bring. A close family member of mine, who usually runs a podiatry clinic, has been supporting the district nurses. She has been taking some of their visits to change dressings and give medication. Although this has been difficult and a lot to get used to, she also reports it has been a refreshing change from the usual workload!

Teamwork

The feeling of teamwork and the liberation of being able to ‘pull out all the stops’ to support frontline services has been quite incredible to behold. It has been very useful to have extra staff around to help out when needed and I have felt very supported by this.

Sadly though, the cost of this short term relief has been great. Elective theatre lists have been placed on hold which has left patients with cancer waiting for their operations. It has meant, patients with osteoarthritis that stop them walking have been in debilitating pain. These are just two examples of the people that will have their lives affected by the changes to the NHS and the measures necessary to ensure the NHS would be able to cope with the Corona Virus. Post Covid there will need to be changes brought about to control the after affects of this pandemic, such as an increase in theatre capacity to clear the now massive backlog of theatre waiting lists.

Concluding

This post was not intended to be overly negative and cynical, only realistic and reflective. Whilst this has been a time of great tragedy and suffering, which we must not forget, there are also many things to be thankful for this week. For example, passing the peak of the Corona Virus and the relieving of some lockdown measures. I am extremely proud of my colleagues, friends and family members who have all acted and continue to act so bravely. I know my parents, like many around the world, have been so worried about me, themselves and the people they love of course, and they continue acting bravely. 

There have been large amounts of support available at work. A wellness centre to came to visit with socially distanced activities such as yoga and group support sessions. I have also had a therapist visit the department and taken part in a mindfulness session. Myself and other staff found it to be very stress relieving. 

Its easy to feel overwhelmed at the prospect of facing more long term social distancing, increasingly difficult working conditions. Especially as more changes happen to the NHS and there is a rapid crumbling of summer plans. However the mantra of taking it ‘one day at a time’ helps me here! I hope it helps others too.