Updated: May 9
I have one patient. I looked after only one patient for the first time in six weeks. I may have squealed slightly when they said, Hannah - bed four. I also have a student nurse shadowing me. What is happening? It feels like a normal shift. As I don my personal protective equipment (PPE), I quickly remember it is not. Although the numbers are slowly decreasing, we still have coronavirus positive patients, and they remain in the majority.
I walk into the bedspace, ready for handover and quickly realise why they want a student nurse with me. My patient was very sick. I will need all the support I can get. They are sedated and ventilated, therefore a machine is breathing for them. They require medication to keep their blood pressure up. They also require a machine that filters their blood as their kidneys are not working (see picture below). At one point I think I counted eight or nine infusions of medication running at once.
What scares me the most was their heartrate. It is forty-five beats per minute (bmp). I know it is said that super fit and healthy people have resting heartrates of forty to fifty bmp, but in the average person, it scares me. I quickly ask for some medication that helps increase someone's heartrate, in case it dropped further. I did not want it going under forty. I feel I am staring at the monitor. We quickly work out the patient was having a bad reaction to an antiemetic (anti-sickness medication). Once this is stopped the heartrate began to go back up. I can relax, but only slightly.
We need to start the filter. The machine that would filter my patient's blood. I am not going to pretend looking after a patient on a filter is not daunting. High amounts of training is required to look after one. I never go into it lightly. It is strange when you start it. Slowly you see the blood pulled out of the patient through a large line in their neck or groin. Soon it fills the tubing in the machine and it passes through a large membrane. Then goes back to the patient clean from all the toxins. Like I said daunting but incredible too. I cannot even begin to fathom the brain that invented that machine. We can do some incredible things in intensive care.
We are able to have our full breaks again. The doctors started to help relieve breaks, but we are able to cover each other much more easily now. I go to have a nap in the new sleep pods. I do get a shock, after I put the headphones on and press play, when the lights change, ocean waves start sounding, and the whole pod tips backwards. I go and nap in the armchair instead.
The sun now rises around 5am. It was as beautiful as ever over the London skyline. I feel a sense of sadness as my patient can not see it. We give them a morning wash. I brush their hair and clean their teeth. It feels like a lifetime since I have done it myself. I have gotten used to overseeing people do it. I feel so proud when we finish. Only if their family could have seen them.
I decide to send the student nurse home a little bit early. They had worked so hard, not just that night but throughout the time they had been with us during this pandemic*. They deserve so much more, but it is the best I can offer. As they leave, they thank me for teaching them so much that night. I realise, it has been so manic the past few weeks, nobody had had the time to sit down with them and go over things.
During this pandemic we have done our upmost to provide the highest quality of care, however it has been hard and I often leave feeling I could have done more. Overseeing non-ICU nurses and the care of multiple patients is difficult and something none of us ICU nurses ever expected to need to do. It feels good to do the type of nursing that I became a nurse to do. I leave my shift on time.
I like to play music for my patients. Turns out, this patient has a particular love for The Beatles. I managed to find a five hour mix of their tunes, so I played them most of the night. Let It Be began to play. Some lyrics jumped out to me: For though they may be parted, there is still a chance that they will see
There will be an answer, let it be.
*Student nurses have been incredible during this pandemic. They have stepped up to a level far higher than anyone could ask for. They all should be so proud of themselves for the work they have done. When this is all over and you graduate, you will be awesome nurses.