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Intensive care
Metropolitan Melbourne

I joke that I could never be interviewed by a TV show about the pandemic. You know the shot, healthcare workers speaking about the hardships of the pandemic to breakfast TV, standing in front of the COVID pod doors or a war chest of ventilators and medical equipment. I don’t think I’d be invited because I’d absolutely go off on a tangent about all the positives of the pandemic.

You see, I’m a silver linings person, I like to find any positive in a situation and see light in the darkness, and I was able to see it during this COVID pandemic too.

For me, an intensive care nurse at a major Melbourne hospital, in a morbid way, I kind of loved it!

I loved that it was the best teamwork I’d ever experienced. That for once, donning PPE wasn’t a barrier to getting timely assistance with my patient. Once you’re in a locked-down COVID pod, dressed up, your colleagues have no hesitations about helping! We’ve all experienced times in the past when you needed help and your colleagues were just that little bit reluctant because the patient you were assigned to had an antibiotic-resistant infection or gastro or—heaven forbid—nits! During the pandemic, once you were in the COVID pod, where every patient had COVID, everyone was all too willing to help, whether it was an urgent intubation, an unexpected late-night call to turn a patient onto their belly to improve their oxygen levels, or just a very inconvenient Code Brown (read: poo event). My colleagues were there for me in every instance.

I loved the safety of the COVID pod. I trusted the PPE. I trusted my colleagues’ actions. If I was all geared up, knowingly looking after COVID- affected patients, then all the surprise exposures were negated—unlike the unknown of COVID in the community. I knew if I was at work, then I wouldn’t be getting COVID.

I loved that there were twenty-five or more nurses on shift, plus support staff, allied health and doctors. In fact, I felt a little guilty. Here I was, getting in-person, face-to-face social interaction with all these people and only truly living the isolated life for two days a week.

I loved that the disease process became predictable. It didn’t matter if the patient had two or twenty comorbidities, once they had deteriorated, the care and interventions were the same. Everyone got ‘dex and clex, a breathing tube, PEEPed and proned’. Dexamethasone is a steroid and clexane is a blood thinner to prevent blood clots, both commonly used for COVID patients. PEEP, from positive end expiratory pressure, is a ventilator setting that helps improve oxygenation. Prone is turning someone onto their stomach, face down, to improve their oxygenation. In addition to this medical attention, every patient enjoyed the soothing tones of a retro playlist!

I loved that I finally had more time to get to know my colleagues. Was it the predictability of illness, the reduction in surgery and non-COVID presentations, or the exclusion of visitors that made me have more time? Or was it that we all just craved conversation and connection because we couldn’t see our families and friends? Those locked-in chats on life, cats and the latest COVID stats kept us going.

I loved what came from the influx of surge staff who came to help when we were short staffed. Sure the ‘conscripted’ surge staff had never set foot in an ICU, but I will forever appreciate their immediate willingness to learn and help. The experience and knowledge of non-ICU matters that they brought to the unit were refreshing and complemented the care we could provide. I learnt from them—they learnt from me.

I can attest that for the better part of the pandemic, I probably kept myself going with all the silver linings I saw and didn’t let the rest get to me. But the further we move away from 2020 and 2021, the more I reflect on, and struggle with, the things we saw.

I hated how visitors were restricted. I hated how our policies denied families their last chance to see their loved ones alive.

I hated how the many families who respected the policies had to watch their loved ones take their last breath via an iPad, while some families who were verbally and physically intimidating or abusive to healthcare workers ended up being able to come in.

I hated how patients were denied visitors for their entire stay in intensive care, sometimes up to sixty days. How do you get better when your number one cheerleaders cannot be at your bedside motivating you? I feel like this meant we chewed them up and spat them out as absolute shells of what they had been before admission.

I look back now, where the unknowns are now known and the PPE and isolation requirements are pulled back, and I hate the fact that many patients did not get access to critical interventions because there were too many COVID unknowns. I know we could have helped more.

The healthcare hero billing made, and still makes me, uncomfortable: I went to work, I did the job I love and I got paid. I would do this whether there was a pandemic or not. I felt awkward when family and friends remarked, ‘It must be tough’ or ‘I couldn’t do what you do’ or ‘We’re so thankful for you.’ We were lucky in intensive care because we could mostly control our risks. And we had non-COVID patients as well, which was a reprieve from having to suit up in PPE all day every day.

If people are to give praise and applause, give them to the emergency department staff. Their door was always open. The risks were hard to see and the demands were relentless. Or our colleagues on the COVID-positive wards who faced the risk of exposure head on and had no respite from PPE. Or those who went into the COVID-ravaged aged care facilities who may never unsee what they saw.

They were the real heroes of this pandemic.