Through the eyes of an ICU Sister

I suppose it was the cancelling of all elective surgery that brought home the realisation of what was about to happen. It all became very real, not just to me, but to all my staff. Were we prepared enough? How would we cope? How long would it last? So many questions without answers. The ultimate learning curve for us all.

Four weeks on (difficult to tell as days seem to merge into another), there are still many questions and even fewer answers, but yes we are coping in these difficult circumstances. The patients that we are looking after are very different to our usual post-surgical patients. The COVID-19 patients that we have were usually fit and healthy before contracting the virus.

I look at the staff at the handovers and I see fear and concern. Sometimes the terror in their faces is exactly how I feel, but I can’t show them this. I have to ensure them that they are safe and as well supported as they can be. They look to me for support and I give it to them with a smile; however I am often just as scared.

We all start a shift with unmarked faces, aware of the importance of having to drink as much water as possible before going onto the unit. The whole of our unit is a COVID-19 ‘hot-zone’, sweaty, dehydrating and unsuitable for refreshment. As they come out for their first break, the faces are getting marked from the straps on the mask - these only get worse as the shift progresses, so we proudly call them our battle scars.

I spend the shifts checking the patients to ensure that the medical plans are completed, coordinating the staff and relieving breaks, whilst keeping an eye on the juniors. It is very difficult wearing all the PPE to see who I am speaking to. I have ‘The Boss’ written on the front of my gown so staff know who I am!

It’s also personally emotional. The other week we lost two patients in the space of 10 minutes, both younger than me! One of them was being FaceTimed by their family at the time. I had to say sorry that they had passed away, while the nurse looking after them was desperately trying not to cry. Our staff are not used to people dying on the unit with such frequency. Of course there is also paperwork to go through with bereaved families, and the important process of supporting them as they grieve. Simultaneously, I must let staff know that it is okay to cry and that they’d done nothing wrong.

That was the night that I went home and cried - my kids came running up to me and all I could do was scream “Get away, I need to change before I can do anything.” I felt so useless.

One thing that this has shown is that I work with an incredibly strong team, and that real team work exists. I have worked alongside people that I have in the past only fleetingly met, and that now have become friends and not just colleagues. When this is over they will all remain so. It is important to remember that we will all come out of this a little broken, both physically and emotionally. I am confident that we will survive, but it’ll be an uphill struggle.

Vicky Hammond
Senior Sister in Intensive Care
Guy’s and St Thomas’ NHS Foundation Trust, London