Life, Death and Biscuits by Anthea Allen

Author:Anthea Allen
Language: eng
Format: epub
Publisher: HarperCollins Publishers
Published: 2021-12-24T11:19:59+00:00

November 2020

1 November

Our makeshift Critical Care spaceship is up and running. It’s like stepping back in time. I am in charge today. My first shift back at the helm since we closed in July. Some of the incredible support team have popped up again, ward staff, uni students and ex-ICU nurses. This time we have the army to help too.

The patients are all Covid-positive. Some are improving and some deteriorating. An elderly man, an ex-pilot, said to me, ‘The nurses here are so amazing it actually makes my heart ache. I am 81, alive and better. And I will make the very best of the time I have left. The positivity here is like medicine.’

The day is going fast, the team efficient and brilliant, making decisions about each individual patient and what we can do to help them improve. We discuss curative and supportive care. There is no definitive treatment, but we now know what may help: which drugs, which therapy and even which pressures to set on the ventilator. We give steroids to reduce pulmonary inflammation, anticoagulant to reduce the chance of a blood clot, and anti-viral therapies, while frequently needing to paralyse and sedate patients (induced medical coma) to manage their respiratory failure. We deliver high-quality clinical care.

The medical team today are on fire: up to date on the latest Covid research, adjusting medication doses and interventions to maximise the best treatment; involving other specialists and taking time to do the best thing for each person. I am in awe of the expertise and knowledge. We work as a team. Input from everyone is valued and considered.

The Covid-19 pandemic led to an unprecedented surge in hospitalised patients with viral pneumonia, but we are learning how to treat this and when to stop. There is a threshold, and once a patient reaches this on the ward they are transferred to Critical Care so their worsening symptoms can be managed and supported in a timely manner.

Patients are scared, especially if they see others around them deteriorate or die and wonder if this is their trajectory. We do all we can to help them feel safe. Currently we have approximately 20 patients on the Covid ward and 11 patients on Covid ICU. But this changes day by day and sometimes hour by hour. Clinical trials continue to add to the body of knowledge.

The most severely affected patients were middle-aged men last time, often of black and Asian minority ethnicity, and those with comorbidities (pre-existing illness or ill health). This time, however, I am surprised by how many of our patients are women. Who knows how this virus chooses its pathway; perhaps this is just for this week.

One of our junior nurses is dealing with many issues at home. She has a parent with mental-health challenges, and I am in awe of her work ethic and attitude while also committed to supporting her parent.

Another nurse works all day and returns home to her husband with MND (motor neurone disease). She takes over from the carer at home, having been a carer all day herself.

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