Diary of a Nurse

I am an experienced cardiac nurse working in a District General Hospital. These are some of my diary extracts about my experiences during the Covid-19 pandemic. Names and details have been changed to maintain confidentiality.

Friday 13th March

Sometimes I avoid watching the news because it frightens me. We are warned that more of us will, inevitably, lose loved ones as the Coronavirus pandemic spreads across the globe. I’m frightened for my family and I’m frightened for myself.

Friday 20th March

My inbox sags with the weight of Covid-19 updates and lists of online training we need to complete. The advice on PPE (personal protective equipment) changes frequently, sometimes more than twice a day, I can’t keep up with it. In the office, my friend gets upset; she is worried about her kids and who will look after them if she dies as her husband is abroad. I promise her that I will help them, we both have a little cry and we make sure her eldest still has my number. My hands are getting sore from extra handwashing and even hand cream stings.

I am a wimp.

Monday 16th March

Work is changing, and our regular patients are phoning to cancel appointments for important scans and consultations. I can’t blame them, but I worry about what will happen to them in the weeks to come. They speak in quiet voices and whisper ‘Am I at risk of dying if I catch this? Am I classed as vulnerable?’ And I respond that, yes, I’m afraid they are vulnerable and I give them the best advice I can. They tell me to take care of myself and ‘stay safe’ and I thank them and hope they stay safe too.

My voice cracks a bit.

Friday 20th March

My inbox sags with the weight of Covid-19 updates and lists of online training we need to complete. The advice on PPE (personal protective equipment) changes frequently, sometimes more than twice a day, I can’t keep up with it. In the office, my friend gets upset; she is worried about her kids and who will look after them if she dies as her husband is abroad. I promise her that I will help them, we both have a little cry and we make sure her eldest still has my number. My hands are getting sore from extra handwashing and even hand cream stings.

I am a wimp.

Tuesday 24th March

We’re spending more time helping out on medical wards. Today it’s one where patients wait for their Covid swab results. We can tell now, before we get the official result, who has it and who doesn’t. These patients have lots of other medical conditions and won’t be going to ITU for ventilation. The latest advice today is that we only need to wear FFP3 masks for certain procedures likely to generate lots of droplets into the air, so I wear a normal surgical mask and hope for the best.

I see one of my ‘regular’ patients. He is in a side room and is very poorly but looks calm and drowsy. His breathing is slow and he only coughs every now and then. There are no regular visitors allowed, so we will have to call loved ones if we think patients are near the end of their life. I speak to my patient, but he doesn’t recognise me with all this PPE. His hands feel cool, even through my gloves. I cover him with more blankets and wet his lips.

He is fading. The IV continues to drip silently and the oxygen hisses through his mask. I will wait with him until a member of his family arrives – and there can only be one. They will carry the weight of the huge responsibility of being the one who was there at the end, the one to report back to the rest of the waiting family. I speak quietly to the patient and ask him to wait a little longer, his son will be here soon. When I leave the ward later the fear that ‘this is only the beginning’ grips my heart and I take a long time in the shower room trying to scrub off the bitterness of the day.

Wednesday 25th March

I find out the patient I spent a lot of time with yesterday was Covid-positive. I remember that at one stage when he couldn’t hear me, I moved my mask aside so he could see my mouth. I feel a bit sick and decide not to tell anyone. It’s done now.

I am stupid.

Friday 3rd April

We finish a training session for staff who don’t usually work on ITU, to prepare us to support the critical care staff. I haven’t worked in this type of setting, let alone managed a 12½ hour shift on my feet, for years. My shoulder is painful – I have a tear in the muscle and I don’t know how I will manage to move and roll patients on ITU without making it a
lot worse.

I am useless.

Tuesday 14th April

I can’t settle to sleep. I get up again and check my bag for tomorrow (this is disturbing my husband, but he doesn’t complain). I have numerous bags for my clothes, work shoes and toiletries and try to work out the process of changing into scrubs when I get to work and changing out of them, showering and getting back into my own clothes again after my shift, so that I reduce the risk of contaminating myself and, worse, bringing home this invisible enemy and infecting my family. I’ve become obsessed. How on earth can I manage to care for the sickest of patients in ITU if I can’t work out how to wash and dress myself after a shift?

I am an idiot.

Wednesday 15th April

I’m on ITU now. There are ‘donning’ areas where we put on PPE, our armour, and the others laugh nervously as they wrestle with hats, masks, goggles, gloves, gowns and aprons. I struggle trying to stabilise my respirator hood over my theatre cap and glasses. I can’t quite believe how noisy it is! The initially reassuring whirr of its motor now deafens me and the exhaust tube down my back and battery pack and belt around my waist feel restrictive and cumbersome. It’s taken me 15 minutes to get this lot on and now I need a wee. The ‘donning officer’ helps me secure everything and puts a sticker on me with my name and the word ‘nurse’ in bold letters. I don’t know why, but this word calms me. This is what nurses do, isn’t it? This is what I’m here for.

I realise that I can’t hear a word anyone is saying, but they seem to understand and shout patiently at me. The regular critical care staff are friendly; they welcome the help. The machines hum and beep with the tidal flow of the ventilators in the background like waves on a beach. Everything is alien and this distracts me from really seeing the patients.

This is a blessing.

Thursday 16th April

I arrive home to find my husband has
prepared breakfast for me. He is self-employed now but has no work at the moment. His job is looking after me. He prepares all my meals for work, to ‘fuel’ me. He listens to me, holds me and calms me. He was a firefighter. He understands what it is to feel fear. He is my rock.

I am loved.

Tuesday 28th April

I need to make a will. Why have I left this till now? I feel that this is a pressing priority and one that I can’t afford to leave any longer or to pay a lot for. My son can only get work in his university town and is going back there tomorrow to his empty student house. To start a new job. On his birthday. I hug him as often as I can (without alarming him) and breathe in his unique smell. He is tall and my ear rests against his chest. I can hear his strong heartbeat.

I wonder when I will get to do this again. My friend was supposed to be getting married today and I send her a message. The weather is scorching.
This should have been a wonderful day. I make a will using an online service and deal with it in a businesslike manner, then go upstairs and cry.

I am a mess.

Friday 1st May

I ask the donning officer for an extra sticker for my respirator hood. She looks puzzled. I ask her to write ‘I can’t hear you’ on it so people will understand; I’m practically deafened by the motor noise. She smiles and sticks it on for me.

I’m more used to it all now and have got into a routine. This involves not drinking much of anything and definitely nothing containing caffeine for the whole of the shift. We have two breaks on a 12½ hour shift and if you need to go to the loo, it takes ages to doff all the PPE, run down the back stairs, along the corridor and up the front stairs to the loos and to the donning area again. We learn that we are most likely to contaminate ourselves when we’re doffing so only do it when absolutely necessary. I now have superb bladder control and have lost a bit of weight!

I am invincible.

Sunday 3rd May

I work night shifts as that’s when we are most short-staffed and do the three or four shifts in a row so I can develop a routine. The weather is glorious and a lot of the girls at work have amazing tans. I can’t sleep well and today I had about 3½ hours’ sleep and then some short dozes. I look pale and sickly next to the girls in the changing room.

One of the patients I’m caring for is Polish and I google some phrases on my phone so I can say a few words to them. And I chatter to one of my female patients about anything and nothing. She is sedated and unaware of me as most ventilated patients are, but I feel I know her as I read the lilac-coloured pages in her notes that document the conversations the doctors have had with her family. I find her comb and perfume in her beautiful rose-patterned toiletry bag and dab the tiniest amount of fragrance on her shoulder after I’ve done her hair. Maybe she will recognise the familiar scent. I realise after a few minutes that I can really smell the perfume and I’m not imagining it.

I have a different type of respirator hood on tonight and later, when I step out of the room, someone tells me that my ‘red light is on’. This means that I need to change the battery. I don’t know how long it’s been like that because I can’t see it. I dash to the doffing area and try to doff calmly so I don’t contaminate myself. On my break someone tells me that those respirator hoods are quite unreliable.

I am panicked.

Saturday 23rd May

I read the lilac pages in my patient’s notes and find that he likes Frank Sinatra. He is in a room on his own so I find the music on my phone for a bit of karaoke and sing to him. I think he would probably like Dean Martin as well so sing some of his songs too. This reminds me of my dad, who liked Dean Martin and loved to sing. I miss him. I’m reminded, yet again, that I can’t wipe my face under this hood and I’m a mess of snot and tears and have to go to break early. Later, I notice a nurse taking two visitors to the doffing area. This can only mean that their loved one has died. I recognise the rose-patterned toiletry bag that one of them is carrying.

I am broken.

Near the staff room in ITU, someone has painted a Tree of Life on the wall. Along the branches there are heart-shaped stickers with our patients’ names who got to go home. The Frank Sinatra fan is among them.

I am hopeful.