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The Day Shift

Updated: Apr 6

6.40am my alarm goes off. I do not appreciate the fact the clocks went forward last night. I'm still recovering from the day shift yesterday. I somehow stumble out of bed and make myself some breakfast. By 7.30 I have left my flat. Luckily I live right by the hospital so my commute is exactly two minutes.


The street is empty. Normally on a Sunday morning you find the beginning of London’s notorious traffic, but today no one. I pass the Emergency Department (ED) on my way through the front entrance. It too is also empty. It’s normal to see lots of people waiting to be seen, usually due to an exciting Saturday night. It seems people have stopped abusing the ED.


I make my way to the top floor of the hospital where the Intensive Care Unit (ICU) is. I get some blue scrubs from our scrub vending machine (yes, we have a scrub vending machine), and go get changed. I see some of my friends are already getting changed. Minutes later one nurse enters the room. She is excited, she can go home, turns out she mixed up her shifts.


Handover has been moved into theatres. There’s more room there for all the additional staff. Staff from theatre, recovery and other wards have come to help us. We have twenty patients, nineteen are ventilated. The nurse who mixed up her shifts is asked to stay, it turns out we are short an ICU nurses. Of course, she says yes.


I am allocated to our High Dependency Unit, which has been converted to a giant isolation room for COVID-19 positive patients. There are four ventilated patients in there. I don my personal protective equipment (PPE), alongside a fellow ICU nurse, another ICU nurse from a different hospital, and a ward nurse. Deep breath. Together we go in.


I take handover for two patients alongside the ward nurse. One patient is proned. This means they are lying on their front to improve their ventilation. It is usually a last resort and is required when you are very sick (we are finding we have to prone a lot of patients with coronavirus).


After a tidy up and wipe down of the surfaces, safety checks and patient assessments complete. The ward nurse is happy to lead the care of one of the patients with me overseeing (as we are getting more and more ventilated patients, ward and theatre nurses are starting to take over the care of ventilated patients while an ICU nurse will oversee two to four of them).


Time to unprone my patient. It takes seven people to flip them back over. Thankfully it was uneventful. But I’m now starting to get really sweaty.


As a team of four we do observations and medications. Physiotherapists come and help us re-position our patients.


It’s lunchtime and I can finally breathe. My nose is red and sore from the mask. One of my colleagues presses my nose where it hurts. “It’s okay, it’s blanching,” they say. My colleagues are sad as there is only diet coke in the food donation box. #bringbackfullfatcoke


I bring back a bag filled with syringes, medications, and linen so we don’t have to keep banging on the windows. Everyone’s very busy. There is a new admission coming. My colleague is pulled from HDU to take them and I take his patient. There are now three of us for four patients.

We repeat, like we did before. We do the observations and medications. We even manage to change everyone's tube ties and re-position them.


One of the patient’s takes a turn for the worse. Their heart rate is still really high. I can see the discomfort the tube in their throat is causing them. We start an infusion to help their heart-rate. I increase their pain relief. The patient is able to sleep and the heart-rate starts to return to normal.


It’s coming up to 7.45pm. The night staff have arrived. I handover and say thank you to the two nurses in HDU with me today. They were so kind and helpful. A fantastic team effort. I can’t apologise enough during the handover for the mess (so much for tidying this morning). The night staff say, “Don’t worry, we get it!” At least the patients are comfortable and tidy.


I doff my PPE. My nose is still red, my hands are raw, and my scrubs soaked through (it’s definitely a look). I spend the next hour finishing off my notes (probably took longer than it should as I was chatting away to friends).


I leave at 9.00pm…and I really need the toilet.


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