As the unit manager of a respiratory ward I knew straight away that we would be caring for people with COVID. It made sense. We had six negative-flow rooms that enabled us to care for people with tuberculosis and any other condition that needed respiratory isolation. Little did I realise that the whole ward would become entirely for people who had COVID.

The early days were very challenging. For me, images of the impact of COVID on Europe’s hospital system before the introduction of vaccines were frightening. However, having years of isolation experience, I resolved to do the utmost for our patients, staff and families.

I saw, and was part of, many changes, good and not so good:

Not so good

• COVID and non-COVID patients in one ward
• Patient isolation during a very challenging time in their lives
• Nil visiting hours unless death was imminent
• Staff resignations over mandatory vaccination
• Casual staff refusal to work in COVID areas
• Palliative care, allied health and other services no longer face to face with patients
• Graduates or students unable to be placed in COVID areas (although RUSONS—registered undergraduate students of nursing—were)
• Model of care becoming task-orientated instead of person-centred
• Nil staff celebrations, inhouse or outside—this meant some nurse unit managers and staff left without a farewell
• Cancellation of leave
• The inability to attend funerals of relations who died overseas
• PPE very uncomfortable to wear

Good

• Use of IT for patients, relatives and managers
• Mandatory training on comprehensive infection control
• Fitted masks
• Scrubs: they became the universal uniform and were laundered by the organisation
• RUSONs: they became vital members of our team and this enhanced their registered nurse training too
• Increased staff ratios in COVID areas, especially during night duty
• Vaccination
• Increased closeness between staff: they could debrief and socialise together unlike the community
• COVID-testing stations in wards and twice-weekly PCR tests
• Optimised handover and debriefing
• Dedicated resuscitation trolley, dangerous drug cupboards and medication supply for our ward

And very good?

The reduced traffic was awesome!