There is no one COVID experience. As nurses and healthcare services, our responses to it constantly evolved. They had to. Let me tell you five short stories about our regional hospital.
Our general medical ward became the COVID-testing ward. Overnight we were no longer a regular inpatient ward. We admitted patients and started their treatment while their swabs were pending. If their swabs returned negative results, we sent them to another ward. This meant we could have up to ten admissions and discharges in a day—a very fast turnover rate for a general medical ward of twenty-four beds. We also introduced a runner role to help with the higher levels of sickness we encountered—a nurse who fetched things for the COVID nurses.
Later, the ward was transformed into the primary ward for COVID-positive patients and it began to feel normal again—almost. Patients were restricted to their rooms, rather than walking along the corridor during the day. So many patients required high-flow oxygen and some needed McMonty hoods—transparent, plastic covers fitted over their hospital beds and their upper bodies to reduce the spread of the infection. We administered lots of intravenous anti-viral treatments and antibiotics for regular chest infections. Most of our patients stayed for a week or more—much longer than our pre-COVID patients.
Before the pandemic, our nursing care was holistic. We would be in and out of a patient’s room all day. We had tasks to do every hour and we would often spend time chatting to our patients. During COVID, we shifted to more task-orientated cluster care. We grouped tasks like patient observations, blood sugar levels and medications together, usually to coincide with mealtimes. This meant we entered patients’ rooms less frequently—reducing our exposure to the virus and reducing the amount of PPE we were using. (Of course, if a patient needed something outside these times, we would gown up and go in to assist.)
A MET or medical emergency team call on a COVID-positive patient was probably the worst part of COVID nursing. These patients were clinically unstable with either very high or very low blood pressure, pulse rates, respiratory rates, temperatures or oxygen levels. It was hot and sweaty wearing a plastic gown, an N95 face mask, goggles and gloves for more than an hour while caring for an unstable patient. Occasionally we had to rotate the nurses who were with the patient because the heat became intolerable.
We took up the idea from an ICU nurse of using a hands-free baby monitor. This allowed staff in the COVID room to communicate with staff outside without opening the door and exposing anyone to COVID. It was a big improvement on shouting through the door and it made MET calls feel much calmer.
We didn’t have enough scrub hats during the first lockdown, so we reached out to a local quilting group. The women in the group were wonderful. They were keen to make a tangible contribution to the COVID effort, so the hat project began. Soon other community members became involved, donating spare material, transporting material to the quilters, and bringing the finished hats to our ward.
The hats were in two distinctive styles: the bouffant surgical scrub cap was like a traditional chef’s hat—and great for tucking up long hair. The other was a reversible tie-back design. There were heaps of different fabric patterns: Spiderman, Harry Potter, alpacas, and purple fish in the sea. Who was wearing Star Wars or kittens, dogs or flowers became a talking point at the start of each shift. My favourite was a green hat capturing the flight of purple and pink butterflies.
Restricted to their rooms with no visitors and with less contact with nursing staff, our patients became isolated. We made time at the end of every morning shift to contact each patient’s family with a daily update. We also helped patients with phone and video calls—but we knew a video hug would never be as good as the real thing.
The best part of COVID was seeing patients receive real hugs from their families on discharge. It was also good for us. The load and stress of the work made us more prone to burnout. We loved seeing a patient discharged safely home, and we also looked forward to some well-earned, sweat-free days off.