Starting in the Emergency Department: A&E Covid 19 Story
Welcome to A&E Covid 19 Story Week 2. When I first started writing, I had high hopes of following the ins and outs of every shift…this probably wont happen. Even though, like everyone else, I (sadly) have no social life to currently speak of. My state mandated hour of exercise, 2m apart queuing for Tesco and performing excessive amounts of laundry really doesn’t leave me with lots of spare time on my days off. In light I will aim for posts to be once a week.
I start off as a supernumerary nurse. I am shown the staff room and where to change into scrubs. At the start of the safety huddle, one of the matrons asks how we all are. There’s a few seconds of awkward silence. She then thanks everyone for their hard work and says she wishes she could hug every one of us. This makes me nervous. I get a “everyone say hi to our new starter” shoutout and a lot of people laugh at the improbability and impracticality of starting in one of the busiest A&Es, in the capital city, mid pandemic. A lot of people comment things like “picked a good time to start didn’t you” but everyone is welcoming.
I meet the nurse educator for an induction walk around. The department is intimidatingly big and I’m unsure how I’ll ever remember my way around it. She tells me A&E is split into the usual sections. This includes: Majors cubicles, Rapid assessment and treatment (RAT), Urgent treatment centre/treatments (UTC) and Resus. However this has changed due to Covid. Instead, there is a confusing switch around throughout the whole department. Meaning Majors is now entirely for Covid patients. UTC is in use for majors patients who aren’t suspected Covid. A select number of majors cubicles are now set up for a ‘covid resus’. Normal resus is now ‘clean resus’ for non covid patients. The Paediatric department is relocating and with it, all paediatric nurses. This including the nurse educator who is co ordinating my induction period.
Despite these changes, everything is going smoothly so far. The educator who is showing me around keeps remarking how quiet the emergency department (ED) is. It’s not unusual for ED to be quiet in the morning. However, the nurse tells me, on a regular evening it’s not uncommon to have 100 patients in the department. The lack of patients makes everyone uneasy. Therefore, people are throwing phrases like ‘the calm before the storm’ and ‘before shit hits the fan’ around. Apparently tourists, workers and students make up a large amount of the patients who come in and as central London is emptier than usual (understatement I know), this A&E department has the luxury of around a week with minimal patients to prepare for what we all know is coming.
The week follows in a rush of training sessions and chaotic rearranging of the department. I learn how to use 3 different types of CPAP machines. the trust has just adopted new ones to prepare for the forecasted surge in demand for these, for the treatment of hypoxic Covid patients. There is a change in the PPE guidance daily, one day we are told we need to wear masks, aprons and gloves even whilst not seeing patients, the next day we are only told to wear masks at all times, unless we are seeing patients, in which case we must wear an apron and gloves.
A lot of nurses are moving beds and trolleys around to make more room for an increase in patients and stocking new PPE stations. There’s also a large induction of new doctors to the department. This is because they have been pulled from other areas of the hospital to support the Emergency Department for the upcoming weeks. The rules are switching and changing at an unsettling rate and I know this is only the beginning.
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If you enjoyed A&E Covid 19 Story Week 2, check out week 1 and week 2 by clicking on the links below!