Kim Hunt tells her story to Joshua Neicho.
I worked for six years as an intensive care nurse in the late 1990s/early 2000s before becoming a transplant co-ordinator. I’m currently an hourly-paid lecturer at Kingston University, teaching core clinical skills to undergraduate nurses.
At the start of the crisis, a friend at one London hospital was involved in training up staff for Intensive Care Units (ICUs). There was such a shortage, with up to six patients for each ICU nurse. Although my ICU skills were very rusty, I felt I had something to offer. I made contact with senior nursing staff at a big south London hospital and they got me signed up to the staff bank for ICU.
I went on a two-day Introduction to ICU course with nurses from all different backgrounds, which was a good refresher for me. I also found extra reading in my own time was very helpful. The training staff explained that we would be well supported, and that we would only be expected to work within our limitations.
I did day shifts over the course of a few weeks. Each day when I arrived, I changed into scrubs, went into general ICU and was allocated to one of four ICU areas. Then I put on PPE – a gown, an FFP3 facemask, a hairnet, double gloving at the start (it changed to single gloving while I was working at the hospital) and a visor.
Between 7.30 and 8.00 a.m. you do handover with the bedside nurses. There’s checks on the condition of the patients, when their drugs need changing, working out what needs to be done in terms of ventilation and other aspects of their care. Every patient I looked after was ventilated. Many of the very sick ventilated patients were proned (turned over on their tummies, which helps ventilate the back of the lungs). You have to move their head and arm position every couple of hours. Generally patients were proned for 16 hours a day. There were proning teams whose role was to turn the patients when needed.
The fundamentals of looking after a ventilated patient haven’t changed since I last worked clinically, but the whole experience was very different to a “normal” day in ICU. It’s very hot working in PPE and the masks and visors can be uncomfortable. As a new team member it was difficult to know who everyone was, as only their eyes are visible when wearing masks (thankfully people had labels with their names on). There were many others in the same boat, with some redeployed staff working in critical care for the first time. There was an incredible sense of commitment and team work. We were very appreciative of what volunteers and fundraisers have done to help, such as all the food that’s been donated.
As well as the number of proned patients, I was shocked and saddened by the complete lack of family members visiting. Normally in ICU, you get to know the families. They would talk about the patient and you would talk to the patient (even when sedated) about their family when they weren’t there.
Shifts were 12-and-a-half hours with two or three breaks, and you’d generally be in your PPE for three hours at a time. We were doing observations every two hours unless somebody was very unstable. There wasn’t really a set routine to each day. The patients were generally very unwell and needed a lot of care and intervention. There were two shifts when we lost two patients.While doing the training, I worried about what would happen if I caught Covid-19, and passed it on to my family. As soon as you’re in there, however, it feels like you’ve got a job to do. I was very careful about washing all my clothes, leaving my shoes in the car, not touching family members and disinfecting before I had a shower.
I worry how we’re going to get out of this period and re-establish contact with loved ones and friends until we develop a vaccine. I also worry about another peak if we go back to normal life too quickly.
I think the NHS is a fantastic organisation, but there’s definitely issues along the way. It would be amazing if the experience of coronavirus does inspire more people to go into nursing – the right people. Workforce shortages have made nursing a much harder job than it could be.
I saw a couple of patients extubated while I was working in the unit. It was a joy to see when there were any improvements – you desperately want these patients to get better and get back to their families.
Many thanks to Kim for finding time to speak to On London.
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