The Night Shift

Updated: Apr 7

I leave my flat at 7.30pm. I've managed to have a two hour nap earlier today. I am grateful the evenings are getting lighter. Going to work in the dark and leaving in the dark isn't fun. The streets are still quiet, except for the occasional empty bus. Not the norm for a Saturday evening. I see a queue of people outside the local corner shop, each person two metres apart. I pass the emergency department, no more endless lines of people. What people think is an emergency appears to have changed.

There are too many people in the lift. I take the stairs and climb to the fifth floor. I regret the decision by the second floor. I pick up a set of blue scrubs. After I've changed, I walk to handover with some friends. The amount of people at handover increases everyday. More and more ward nurses are being sent to help us on the intensive care unit (ICU). We have ex-ICU nurses also joining us. Some haven't worked in ICU for ten years.

We now have twenty-seven patients who are suspected to have or have tested positive for coronavirus. Twenty-four are ventilated (supported with their breathing). We have sixteen ICU nurses. I am assigned to take a new admission. I also listen to the handover for the adjacent bed space. I need to support the ward nurse looking after the patient. It's their first shift ever on an ICU. It's their first time ever looking after a ventilated patient. They are nervous. I reassure them, I will be there for them throughout the whole shift. They won't be left alone.

We don our PPE (personal protective equipment). The whole of our ICU and theatres is now officially "the Red Zone". We have to wear PPE throughout. We may have to wear our PPE for up to twelve hours.

My new admission arrives. They have coronavirus. They need to be ventilated. They are only fifty years old. No past medical history. They arrive with the tube already in their throat and attached to a ventilator. I settle the patient. I take down their observations. I take bloods and swabs. I make the patient comfortable. An intensive care doctor comes to review the patient. The patient's oxygen levels start to drop. The amount of air going into their lungs starts to drops. I notice the tube in their mouth appears to have moved further down their throat, too far down their throat.

We call for help. I give the patient 100% oxygen via the ventilator (this is the maximum amount of oxygen we can give). More doctors arrive. The patient is stabilised. But the tube is still in the wrong place. As a team, three doctors and I find the tube is also kinked. However we are able to move the tube back and remove the kink. The patient is now ventilating well. It's an interesting start to the night.

I help the nurse next door with medications, observations, and the documentation. They are still apprehensive, but their confidence is growing. The physiotherapists come and help us reposition the patients. It's midnight by the time we finish. I manage to get a sip of water. Someone has brought some pain au chocolat. I take one, and put it in a safe place to save for later.

All the patients have high temperatures. Some creeping as high as forty degrees. Paracetamol doesn't help. We make up ice packs and place them around patients. They melt within the hour.

There are two of us ICU nurses overseeing a further three ward nurses and their patients. Although the nurse in charge comes to help, they also have to help with the other twenty-two patients, so we don't get a break. I feel my eyes getting very heavy.

Only problem is that there's no toilet in the red zone. So we'd have to doff (take off our PPE) to go, but their isn't enough PPE for when we go back in. Luckily we manage to find some hazmat suits. They are far too big for me. I feel like a marshmallow. You can hear me rustling a mile off.

5.00am arrives. It's time to take morning bloods, give morning medications and start washing the patients. I wash my patient with cold water, in the hope of bringing their temperature down. It works, but only a little. I help next door. The nurse is doing a great job. I try to convince them I'll make an ICU nurse out of them yet.

I sneak off the have my pain au chocolat. My safe place was near a sink so my pain au chocolat got splashed. It's ruined. I was really looking forward to it.

8.00am and it's handover time. I haven't managed to refill my bed space with equipment for the day shift. We've run out of a lot of stock. I thank the nurse next door for all their hard work. They leave feeling proud of themselves. I leave on time (for once). I head home and have a shower. I quickly call my parents while having breakfast (if you are wondering, I had porridge; no pain au chocolat for me). At 9.00am I go to bed, ready for another shift that night.


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