COVID-19: amid fear and anxiety, we must look after each other

An emergency nurse’s experience of coping with the constantly evolving coronavirus crisis  

Just when we thought emergency departments (EDs) could not become any busier, COVID-19 comes along.

While every ED will be different, the changes that have affected the department where I work will be familiar to most emergency nurses.  

Currently, there is some satisfaction that our workforce has been supplemented by staff who have worked in our ED before and patient attendances may be down slightly.

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Fear makes me interrogate every slight symptom  

But, if you are anything like me, there is also the fear – fear that we will become infected or that we will infect our families; that our colleagues will become sick or that the stories we hear from other countries will become our stories.

Then, after a shift, you start to wonder whether that shortness of breath, headache or other vague symptom is anything to worry about. This is a question only you can answer, perhaps after a discussion with your manager.

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COVID-19 is a test of our resilience

There are a few key things that emergency nurses need to do during this pandemic. First, do your jobs to the best of your ability. Because of the numbers of patients, the severity of their illness and our sadly limited resources, the next two months are going to be very difficult and will test everyone's resilience.

We will need the emotional support of our colleagues, friends and family – and I suspect our colleagues will become as close as family.

‘After a shift, you start to wonder whether that shortness of breath, headache or other vague symptom is anything to worry about’

The second thing, but equally important, is to trust that everyone is doing all they can to make the situation better. Due to clinical commitments I have not been able to attend all the meetings at my trust, and there have been many because of the ever-changing picture of the pandemic.

Behind-the-scenes planning is constantly evolving

But there has been painstaking planning in this process, with numerous contingencies being drawn up. Dividing the department into red and green zones, for example, with potentially infected patients in one zone and non-infected patients in the other. Additional supplies have been prepared so they can be put to use quickly when it is necessary to open a new area or change a ward or process.

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I know that our hospital, like most others, has had walk-throughs or simulations of almost every eventuality for every type of patient – someone with confirmed COVID-19 having a myocardial infarction or a stroke, for instance, or going into labour; and new care processes we might need to follow to improve outcomes such as turning a ventilated patient onto their front, commonly referred to as ‘proning’.

The frequency of meetings makes it feel like there is an information lag. News reports I hear before I go to work announce the latest government policy or procedure but it only becomes the official way of working four or five hours later.

This can be frustrating for emergency nurses who are used to adapting quickly. But the whole NHS must pull together; it is important we support the process and do not jump before getting the go-ahead. 

In desperate times, we need to look after each other

The other main frustration is that due to the frantic pace of events there can be frequent changes to processes – even in a single day. But again, this is because plans have to evolve, so please bear with managers who are trying their hardest. I know some that are working more than 14 hours day.

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As emergency nurses, we are privileged to be among the first people to help patients in the most desperate of times. But please, more than ever, look after yourselves and your colleagues.

And protect yourself and your family by wearing suitable personal protective equipment. Importantly, get familiar with putting it on and taking it off correctly. It could save your life.  

Justin Walford is senior practice development nurse, emergency department, Royal Sussex County Hospital, Brighton