The most challenging times to hit our Melbourne hospital arose when the second wave of COVID hit Victoria. The impact was not just on staff and COVID patients, but on the general surgical patients for whom we were caring.
Slowly wards were being converted to COVID isolation wards, leaving limited beds for the uninfected general population. Before COVID, there were four surgical wards in the hospital. At the peak of COVID, we had one surgical ward operating. This meant bed numbers were cut by seventy-five per cent, from one hundred and twenty-eight beds to just thirty-two. The demand for these beds came from elective surgery, emergency admissions, and patients transferred from regional and metropolitan hospitals.
The reality check fully kicked in when visitors were barred from the hospital. Eliminating a patient’s support network meant nurses became the key emotional support for patients. Imagine, for example, the emotional strain a cancer diagnosis brings to a patient and those around them.
This was encapsulated in the admission of a rural patient during the peak of COVID who waited for days to be transferred into our ward. He sat in a country hospital waiting for a bed to become available, having been told he had a brain lesion that needed further investigation and management in a metropolitan hospital. As the nurse receiving the transport handover, I saw the anxiety and uncertainty on the middle-aged man’s face when he finally arrived. It made me realise we were not only diagnosing, treating, assisting in the recovery and delivering the prognosis to the patient, we were also his only face-to-face support. To me, the admission procedure, the scans, the surgery, the recovery, the test results and the treatment plan were all routine, as were the follow-up imaging and appointments and the patient’s discharge plan for when he left hospital. But for the patient, arriving alone from the country, this was a completely foreign, scary and unknown world.
The reality was that we were now the ones who sat with the patient as he faced all the uncertainty to follow, the anxiety in the waiting, the fear in receiving the results. Ultimately, we were the ones holding his hand, rubbing his back, pulling the ‘magical privacy curtain’ around his bed so he could process and come to terms with what he was facing. I remember sitting with him the first day after his brain surgery to remove a lesion. The doctors had just seen him and told him the surgery had gone well and what would follow once he’d had a CT scan and the results from the tissue samples came back. The doctor then left. I sat on the chair next to the patient’s bed as he called his daughter, having a three-way conversation with her about how her dad was recovering, the plan for today and the expected wait on results. His daughter lived only twenty minutes from the hospital but she still couldn’t visit. She couldn’t support him physically or be there to hold his hand.
Part of our greater nursing responsibility as sole carers was to make sure everyone had the right information—the patient and their families and carers alike. Throughout our shifts, we were fielding the never-ending phone calls from the endless doctor teams, allied health staff, radiology, pathology and theatre departments, and concerned families wanting updates.
It was hard for patients not to go into an emotional downhill spiral when they had to ask doctors all the questions their families wanted to ask but couldn’t, process everything they were told, and then relay that information to their families and carers. For me, it was important I was there for the doctors’ rounds and could sit with patients afterwards to make sure they understood what was said. Although brief, it was five minutes of face-to-face conversation that let them release their fear, their emotions and their anxiety and helped them face the next challenge.
Mobile phones were a godsend. Patients who owned one were able to communicate with the outside world. Often, we’d have three-way conversations with family members. The mobile phone would be on loudspeaker and we’d talk about a patient’s questions, concerns and their discharge reservations—often in a full four-bed ward.
Many of our elderly patients were without mobile phones. We facilitated calls as often as we could for them, but we were so overloaded with all the tasks that took priority that it wasn’t always possible. It sounds horrible, but when your patients are so sick and unstable, and you’re being pulled to theatre or scans or a medical emergency, we would sometimes have to hand over making those calls to the nurses on the following shift. When we did make calls, we made them through the nurses’ station, so getting an available phone line was another challenge. Sometimes numerous attempts were needed to get a call through and we would often have to explain that, no, we weren’t ignoring the phone, but we’d had endless calls for the past two hours.
I tell graduates that if you could survive COVID, then you could survive anything in your nursing career because—in my nine years of nursing—COVID was the hardest thing I have ever done.
But there is this: the bond between nurses on the ward has been cemented through our shared history. Nurses are the only ones who will ever truly understand what we went through. Being isolated from our support systems at home, as we were constantly in lockdown, led to leaning on those at work.
For me, that meant working on my thirtieth birthday. I couldn’t celebrate with my family, so the next best thing was to celebrate with my work family. Although only half the shift could be in the tearoom at once, it was the happy birthdays as I walked down the corridor that made the whole experience a little more humanised.