Originally published at bhf.org.uk, written by Lee Kettle
Vanessa Smith, a senior cardiac nurse at the BHF, is carrying out a two-month secondment at the Imperial College Healthcare NHS Trust.
Vanessa shares her experience so far on the NHS frontline, where she has cared for patients affected by both Covid-19 and heart and circulatory conditions…
As the Covid-19 pandemic started to grip the nation, it felt right to offer my help to go back to the wards and put my clinical skills back to use. Within a fortnight, I’ve seen some of the lows of losing loved ones too soon due to this virus, but also the feeling of relief and joy for patients whose health has improved and will hopefully get to return home.
I previously worked at Imperial NHS Healthcare Trust and I was supported by my colleagues at the BHF to return to the cardiac wards. Walking into the coronary care unit on my first day, it was clear that the hospital has put stringent measures in place to separate people needing treatment for Covid-19 from people with other conditions.
One area of the unit — known as the ‘red’ area — is an acute respiratory area for Covid-19 patients, providing support for patients with many different underlying health conditions and who require additional oxygen and often have complex nursing needs. The other — the ‘green’ area — is for patients without symptoms of Covid-19, who require treatment for the likes of heart attacks, heart failure and heart rhythm problems. This means they can still receive the best possible treatment whilst reducing their risk of contracting the virus.
On my first day, I was assigned to the acute respiratory area. It was exciting jumping straight back in the deep end, but I also felt quite anxious, as this meant I would be looking after some of the poorliest patients with Covid-19. The first step was to get dressed into PPE, which meant donning a gown, apron, mask, gloves and hood to fully protect myself. The hoods made it difficult to hear and very difficult for the patients and staff to identify me, so we have our names written on the hoods. All the extra layers and tight face masks make it very hot, so we rotate every few hours so we can have breaks to drink water and have food.
During my first week in the unit, we had a mix of patients, of all different ages, backgrounds and medical conditions — some of which I had never had the experience of looking after in my 10 years of nursing. It’s been a learning curve, but the nurses and doctors have been extremely supportive in teaching me new things, helping me understand their conditions and helping me refresh my knowledge.
Proud to be there for patients
Sadly, one of my patients I was caring for was coming to the end of life. He wasn’t improving on maximum oxygen, and the plan was to make him as comfortable as we could in his last days. As there were no visitors allowed due to the risk of contracting Covid-19, we had set up a Skype call so his family could be with him towards the end. This meant they could talk to him and say their goodbyes, and that he could hear their voices before he sadly passed away. It was humbling to hear the family say thank you for looking after their loved one. I also felt proud that we were there for the patient, and that he wasn’t alone when his family couldn’t be there.
Other patients did have better outcomes and we were able to get them off high volumes of oxygen and back to the main ward to recover. I’ve seen first-hand how much the virus can affect people who previously were independent and working and, though recovered from the worst of the virus, have been left extremely weak and having to need assistance with basic things such as having a shower.
Seek emergency care
I’ve also carried out night shifts on the ‘green’ area of the cardiology ward, where — during a ‘normal’ night — they would usually see three to four patients presenting with heart attack symptoms and requiring urgent care. However, it’s been much quieter.
Those who have been coming in have reported having chest pain for days and some admitted they delayed calling an ambulance because they thought it was ‘only heartburn’ or that the symptoms would go away. Others have admitted being afraid to go to hospital, because they fear getting Covid-19. One patient came to hospital too late and is now living with severe heart failure due to the damage caused by the heart attack. That’s why it’s so important that people continue to seek emergency care and treatment if experiencing possible heart attack symptoms.
Huge emotional impact
Due to social distancing measures and colleagues being redeployed, cardiac rehabilitation classes have been cancelled. I’ve found that the BHF booklets and online resources have been great for patients who have been admitted with a heart attack. It can often be a challenging and anxious time for patients after they are discharged, so the materials we’ve given them have been a good source of support. Many patients have been thankful that they have this support available.
Looking back at my time on the wards so far, it’s been tiring — it’s not just long shifts, but it’s a huge emotional impact seeing such highs and lows, often all in one shift.
However, it’s been great to give support to fellow staff who have been dealing with the increased workload and working through this pandemic since day one. What has certainly helped pull me through is seeing everyone pull together and support each other. Everyone is still smiling and giving the best possible care to all their patients, despite feeling anxious themselves in the surreal times we’re living in.
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Originally published at https://www.bhf.org.uk.
On the NHS frontline: Vanessa’s story was originally published in British Heart Foundation on Medium, where people are continuing the conversation by highlighting and responding to this story.