Newly qualified nurses

Newly qualified and working in ICU: what I’ve learned amid the COVID-19 pandemic

Supportive colleagues have made all the difference in my first critical care role

Newly qualified nurse Jesse Boxall-Steeden in full PPE in a critical care unit
Wearing full PPE on a critical care unit is demanding 

After graduating from Canterbury Christ Church University in September 2019, I started my nursing career in a medical high dependency unit.

I knew that working in critical care as a newly qualified nurse would be a baptism of fire, but I really enjoyed my critical care placement as a student and relished the opportunity. Little did I know we were about to face a global pandemic.

I learned to think on my feet – and ask for help when I need it

Being newly qualified in critical care was much as I expected. I had to think on my feet and learn new skills, while adapting to the increased responsibility, accountability and expectations of a staff nurse.

Initially, I struggled to find the confidence to be autonomous, fearing that as a newly qualified nurse I did not have the knowledge or experience to work efficiently without double or triple checking things I was unsure of.

‘If you don’t understand something the first time, do some research, ask again and ask around – no one will fault you for wanting to learn’

My confidence grew in time, but this taught me a valuable lesson; there is no shame in asking for help or checking things twice, even three times. 

If you don’t understand something the first time, do some research, ask again and ask around – no one will fault you for wanting to learn, and it’s imperative that you do not act without a clear understanding of the results of your actions.

Nursing with conviction will make your patients feel more at ease, and you will feel more confident and comfortable as a practitioner.

Coping through this pandemic means celebrating triumphs, however small

The COVID-19 pandemic has meant a lot of changes in my area, from ward moves to unit merges and staff redeployments. I am working in the intensive care unit for the first time, which has meant a huge increase in pressure.

Newly qualified nurse Jesse Boxall-Steeden with a colleague, both wearing PPE in a critical care unit
Jesse Boxall-Steeden, right, with a
colleague on the ward, both in full PPE

There is also a lot of anxiety due to the uncertainty the situation has created, but I am trying to use this as an opportunity to motivate myself and others – if we can work on the front line of this once-in-a-generation pandemic, what can’t we do?

I am encouraging my patients to stay positive, trying to keep their spirits up by making small talk and celebrating their triumphs, however small.

I’m also phoning relatives with updates, putting the phone on loudspeaker or encouraging FaceTime or other video app calls where appropriate. This is a great morale boost for patients and their family members, who are not allowed to visit.

Unfortunately, we are sending a high volume of patients to be intubated, with uncertain outcomes, and also having to phone relatives to break the terrible news that their loved one has died from COVID-19.

It is physically and emotionally draining work, but we are lucky enough to have full personal protective equipment (PPE); due to the increased risk of aerosol-generating ventilation methods and procedures, we are kitted out will full hazmat suits, masks and visors.

The difference supportive colleagues make when you’re newly qualified


Facial bruising and sores often
accompany PPE use over long periods

With no fans or air-conditioning allowed, it gets hot and sweaty very fast. I have finished shifts with open pressure sores to my nose and ears, as have my colleagues.

Writing our names and roles on the front and back of our hazmat suits has made communication easier in emergencies, and printing photos of ourselves to stick on our suits helps us identify ourselves to patients, hopefully making us seem less threatening when they are weaned off sedation and extubated.

I found the week-long critical care foundation course I attended when I started my new role invaluable, and it seems even more so now. As well as learning more about the interventions we make and why, the course covered how to support ourselves and our colleagues mentally during difficult times, which has never felt more important than it does now.

I am lucky to work with an amazing team. We regularly check in on each other, and the team have been hugely supportive as I adjust to my role as a newly qualified nurse in a high stress environment.

View our COVID-19 resources centre

Peer support has helped me deal with the pressures

It is easy to take stress home with you at the end of a 13-hour day wearing full PPE, holding the hands of dying patients and having to share worrying or sad news with their relatives over the phone.

I have found solace in my course mates from university – we are all newly qualified and each of us has had to step up to a new role. Checking in on each other regularly has proved vital in helping us cope with the emotional strain.

I have been using video messaging to do pub quizzes with friends and family, which is a a great way to boost morale and keep in contact from a distance.

The most important piece of advice I would give to other newly qualified nurses, or students going into practice to help on the front line, is to make sure you have a debrief after work and coping strategies such as these to help you switch off.


Jesse Boxall-Steeden, a staff nurse in critical care Jesse Boxall-Steeden is a staff nurse in critical care at Medway NHS Foundation Trust in Kent 

 

 

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