Critical Care with Covid-19 — Pass the Tape
So it’s been a while. I last wrote in April last year, nearly a whole year ago now. I haven’t written partly because I wrote my master’s dissertation instead, and partly because I didn’t quite know how to put work into words. The temptation just to rant and vent was strong which didn’t seem like an enjoyable read. Also I had no desire to depress the pants off of everyone; tired and low (with regards to work) was where I was at. So now I have a little more perspective, I’ll try to catch you up.
In the year since I last wrote we didn’t really get a let up. The numbers of covid patients backed off a bit in the summer and we closed the covid ITU (ITU2) for a couple of months. Unfortunately, the rest of the hospital was hit with a rush of patients I suspect were delayed presentations in addition to the normal attendees. ITU nurses were lent out to our sister ITU and our wards to keep staffing levels safe. I’ll be honest, sometimes we begrudged the need, largely due to exhaustion, I think. We would never want to leave another nurse struggling or patients at risk because of staffing though, so, begrudgingly or not, we went to support.
And then Delta happened.
We reopened ITU2 in July I think, and it remained open until February this year. For me that was the hardest period of the pandemic so far. The patients we had in were some of the sickest we ever had, mostly unvaccinated and a lot of them young. In my thirties, it’s the first time in my career I have had multiple patients my age or younger dying on me. I started to find it hard to see hope for my patients. We made it out the other side however, and back into main ITU. We still have the odd covid patient around, but most of the positive patients in the hospital now are incidental findings as opposed to covid being their primary problem.
I’m finding it hard to explain why it has been so hard. Why I have found it so hard. I think, part of it is that I loved my job. Being an ITU nurse is awesome as far as I’m concerned. It’s mentally stimulating, challenging, rewarding. Sometimes adrenaline-fuelled (both patients and staff!), which isn’t a plus for everyone, but it works for me! And then it completely changed. Almost overnight, my dream job was just gone. In its place was a task that felt impossible, a slog that there was no way out of. Every nurse that walked away (and absolutely no judgement if you had to) made it harder for the ones that remained so that was never an option for me. And then they applauded! Thank you they said! And all I wanted to do was scream at people “I DIDN’T GET A CHOICE!”.
I am aware this sounds ungrateful. And I don’t mean to be. It would have felt a thousand times worse to be in it with no acknowledgement of what we were doing. But not all of my feelings on this are entirely rational, so bear with me.
I want to stress to all the people who came to help us, who’ve only ever seen critical care during covid — that wasn’t ITU! This isn’t what it’s normally like! They saw all of the worst parts (death, stress, more death and more stress) and none of the best bits! The attention to detail, the training and education you get, the holistic view of patients, how well you can get to know a patient. All gone up in smoke in favour of what was essentially crisis management. And I watched my team struggling. They are a remarkable group of people. It was (is) so hard to see them struggle. We all did what we could to prop each other up, but it genuinely feels like coming out of a warzone now. We all have our baggage to carry, some more, some less. But I don’t feel like any of us have made it out unscathed.
See what I mean?! I don’t want to depress anyone! I just don’t have a lot of good memories from this period of work. I have a playlist of obnoxiously cheery music that I used to put on in the covid ITU and dance around like a plank (picture me in full gown, mask, visor, swirling antibiotics in one hand and dancing, whilst my consultant looks over from his ward round with raised eyebrows, quite clearly wondering if I’ve finally cracked) and we smiled and laughed. There were happy moments. But there was no respite.
I’m hoping we’re on our way out the other side now. The number of people coming into the hospital with covid but not requiring ITU is encouraging. Far fewer people are getting seriously unwell with it now. And we have a full range of normal ITU patients again, which is nice even if we are still struggling for staff. The impact of self-isolation and staff testing positive is still hitting us hard.
I’ve always joked that the NHS runs on nicotine (less so these days), caffeine, sugar, or a combination of the above. Now I’m pretty certain that the things holding the NHS together are goodwill and micropore tape. And with the level of exhaustion being what it is…we are going to need a lot of tape.
But we’re still here. Still standing. And not going anywhere just yet.
Which is one hell of an achievement, I feel.