Catríona Brennan, Staff Nurse in her PPE at the Midland Regional Hospital in Portlaoise
It is just amazing to me looking back how quickly all our lives changed.
I remember having coffee in early March with my group of friends. I was talking about COVID-19 and what I felt we were facing into. My friends thought that I was being a bit dramatic. I suppose given that I work in the health service and I was following the progression globally quite closely, I had a sense of dread about what could be coming our way.
But soon after that coffee it was announced that the schools, colleges and childcare facilities were all closing.
I am lucky that my husband works in IT, he was in a position to work from home so I didn’t have the same child-minding issues that a lot of my friends struggled with. And then on the 24th March the Government announced new measures aimed at controlling the spread of COVID-19 and the rest as they say, is history!
The hospital had to transform rapidly and adapted very quickly to the new measures. My manager Melissa ensured we were well stocked with PPE so thankfully we were well prepared with a robust supply. The Day Ward where I work suspended day services and was transformed into a special COVID-19 ward. This was a huge change for us, the Day Ward usually operates 7:30am to 8pm on a 5 day service looking after patients who were well, presenting for a day case surgery, a medical investigation or maybe endoscopic procedure. We then adapted to a 24-hour duty infectious disease ward for acute admissions of COVID-19 positive patients.
Adaptability and flexibility have been key, not only in the physical restructuring of the department but for us as a team to get used to the new way of working. We amalgamated with endoscopy and clinical skills staff to help cover a 24 hour roster.
My shifts could be nights, days and weekends in order to have a sufficient amount of staff in the department at all times. We needed to look after each other and did what was required to provide a 24 hour service with adequate staffing.
We are in a pandemic and as a team we are prepared to do what is needed. Every day I would shower before leaving work, bag up my scrubs and wash them at a high temperature to reduce the risk of bringing home the virus. It was very difficult at the start as we didn’t know the health consequences for not only ourselves but our families. My family were very worried at the start, as were the families of most healthcare workers.
I was terrified to go near my family for the first few weeks until I knew the system worked. We have definitely become more confident in the measures as time has gone on but I am still very careful around vulnerable individuals. Just today I was working with patients who present to the Emergency Department with ‘suspect COVID-19 related’ illness. We have to remain flexible in our roles as we could be required to cover different departments and we remain exposed on the frontline.
Resourcefulness and keeping up to date with an ever-changing medical landscape has also played a big role for me. This virus came so quickly and information changes on a daily basis so keeping informed has been paramount. But it has also been imperative to trust your own skills and your colleagues, knowing that you all have each other’s backs has been such a comfort in all of this. We did so well as a team on the Day Ward because we all worked so well together.
We adapted to working in a “buddy nurse system” where two of us would work the shift together. The “buddy nurse system” is paramount in line with infection control. One of us would gown up in the PPE gear, gowns, gloves, goggles and visors and the other would remain outside the room. The nurse outside the room would get any supplies needed, take any samples that need to be processed for testing and complete the patients’ paperwork.
We would take it in turns so as not to spend the whole shift on the ward in PPE. I know it has been said so many times, but it really is quite hot and uncomfortable to do such a strenuous job in PPE so it is nice to get a break from it. Your buddy then will also ensure that you put on and take off PPE correctly which reduces the risk of cross-contamination. The “buddy nurse system” has been an absolute lifeline for us here.
Working in PPE has not only been a physical change for us but it has fundamentally changed the way we communicate with our patients. As a nurse, communication is extremely important! Patients can often be quite nervous and a kind smile and a soft touch of the hand can go a long way to put them at ease.
We need to communicate clearly, explain what is happening, make sure that they understand, get the information we need to do our jobs correctly and give bad news on occasion. When Covid came this all changed, we are wrapped up in PPE and needed to find a new way to put our patients at ease. We now smile with our eyes, soften our voices and try to make jokes about being ‘togged up in the PPE’ to lighten the mood. Not being able to comfort someone with a touch has been difficult.
And it’s not just our faces that the patients cannot see. We had to implement visiting restrictions in the hospitals to help protect our patients. People may visit patients in critical care but this has to be prearranged with nursing administration. It has been very hard on the patients not only to not have visitors but to not have family advocate for them.
The public have been amazing at sticking to the restrictions and the national guidance so far. We have all been in this together and that is clearly visible in the numbers of new cases every day. Seeing the figures come way down and stay down has been the boost we all needed!
But we can’t relax just yet, the threat is going to be with us for some time and we need to stay careful. As of this week, businesses are starting to reopen and you can now travel outside of your county. You can take a holiday from your county but you can’t take a holiday from the pandemic. If you do go outside your county you must stick to the public health guidance and take responsibility for your own health, and that of your family who you could be bringing the virus back to. The Laois/Offaly R Rate has remained low and we want to keep it that way.
You are still advised to wash your hands well and often, practice cough and sneeze etiquette, keep your 2 meter distance, limit your contact with others and wear a face-covering in situations where physical distancing is not possible.
Our ward has changed back to a Day Ward in preparation for the resumption of services but COVID-19 is not gone. To coin a phrase, winter is coming and we are in planning mode. With general winter illness, the seasonal flu and now with a possible second wave of COVID-19 we are more anxious about what is coming than what we have just been through. We are currently working on a reconfiguration of the hospital to be as prepared as we possibly can be.
Also as normal hospital services resume, I would encourage people to attend for their appointments, particularly screening services as these are crucial health services that people need to re-engage with once these are fully operational and that is expected in July.
To reduce the risk of spread of coronavirus, we have developed new ways of working and developed plans for how appointments and procedures will be organised. For example, we have made changes in the Day Ward to enable social distancing. We have done and will continue to do everything we can to protect our patients and we look forward to welcoming you back for your regular diagnostic tests or investigations.
I’d like to finish on one piece of advice for the public. By staying fit and healthy you will be giving yourself the best possible chance if you do get sick. Regular physical activity is key to getting and staying healthy and a healthy diet is of huge importance to your overall health.
Look after yourselves by eating well, keeping active and get outside in the sun for your vitamin D. There is no place like Ireland when the sun is shining.