I'm sorry, I can't hear you!

Updated: May 20

I like to think I am good at communicating. I can be quiet and soft spoken, but I am good at getting my point across. However a few weeks ago, I was struggling.

I was looking after a patient who had a breathing tube down their throat and needed to be ventilated. We did not have enough space in our intensive care unit (ICU), so we had to use our surge capacity. We were caring for this patient in recovery and we were using an anaesthetic machine to ventilate the patient. Anaesthetic machines are a type of ventilator used to ventilate people when they have operations. They are not designed for long term use, therefore certain pieces of equipment need daily changing.

That afternoon the anaesthesia machine started to alarm. I went to look at a part called the D-Fend. It has a little cup underneath it to collect water. The cup was full. So I needed to change it. I was relieved that this was probably the reason the machine was alarming, so it was an easy fix. Only problem was, I did not have a D-Fend and I could not leave the patient. So I went to the door and grabbed the runners attention. "I need a D-Fend!" I shouted through the door. I got a loud "What?" in return.

Welcome to my life for the last couple of months. Personal protective equipment (PPE) keeps me and my patients safe, however like I mentioned in a previous blog, it is tough to wear. One of the greatest challenges is communication. Those masks that keep us from getting sick, make is so very hard to be heard. Everything anyone says comes out completely muffled. I find myself shouting. I hate it. I am not a shouter. I am often repeating myself or asking others to do so too.

I never realised how much I read people's facial expressions. Read people's lips. I have no idea sometimes what people are trying to convey. I often find myself smiling and quickly realising no one can see. I am known for always smiling at work. Often smiling too much.

I find it upsetting my patients cannot see my smile. I had one patient the other day who has mild autism and schizophrenia. I can only begin to imagine how scary day to day life normally is for them. They would struggle daily with expressing themselves and understanding others. Now imagine, you have been critically unwell, sedated for over two weeks, and you wake up in a new environment you are not used to. You would not feel safe. You would be terrified. On top of that, the only people you can see are head to toe in blue and all you can see is their eyes. They kept telling me they were scared. I could not smile at them, to put their mind at ease. My presence probably scared them more. So I held their hand and reassured them for a couple of hours until they fell asleep. Although they would not let go of my hand for most of the night.

Communication is so important in nursing. It is one of our Six C's, and rightly so. It is important for all healthcare professionals. Communication is vital between us and patients. It is vital between us and relatives, which now can only happen over the phone. Updating a relative

about a critically unwell patient over the phone is challenging. We now have a relative liaison team who updates the family. I miss connecting with patients' relatives. It was a part of the job I really loved. There is no better way to learn about a person than through the people they love. However communication between healthcare professionals is also vital to our work. Simply, good communication allows effective teamwork.

We quickly learnt we would need to adapt. We started writing our names on our gowns. We also wore different coloured stickers which stated our roles. Introductions suddenly became a lot

easier. Leaving notes on the door for runners became the norm. We got wipe boards so our patients could write to us and we could write to them. I made rattles out of specimen pots and bungs so patients could quickly grab my attention.

The NHS is resilient and adaptable, so when faced with this challenge we rose to it. It still is hard. I still have to shout sometimes, but people say its because I am so quiet. But it is easier with the small changes We made.

So did I get my D-Fend? After lots of back and forth with the runner, I finally wrote on a piece of paper, spelling out D-Fend and held it to the door. "What's a D-Fend?" the runner replied. *Face palm*

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