After almost a year battling the pandemic, many NHS staff have been left exhausted. Healthcare workers, from GPs to paramedics, who spoke to the Guardian a month ago give an update on how they’re coping as coronavirus rates in the UK decline.
The intensive care nurse, London
I’m not new to caring for someone in the process of death, but in the past we had ways to dignify it
In ICU, families are not able to see their relatives, so they can’t really see how sick they are. Sometimes they can’t acknowledge that we’ve reached a limit in the treatment, so we get patients staying on full support even though there’s nothing we can do.
I’m not new to caring for someone in the process of death, but in the past we had ways to dignify it, and that’s something I’m really missing, being able to hold a hand, or show our entire face. Even though I know what it is to look after someone dying, I find it much harder with Covid.
During the first wave of coronavirus, I lost family myself, and because they live overseas I couldn’t go home. That got me very stressed and overwhelmed, and there was almost too much to think about the imminent death of most of my patients. Now I’m feeling better about that, I have the space and time to look at what’s happening here, and I feel really sad. It’s quite tragic to be the only person a patient is going to see before they die. The way they go is so sad, they’re really lonely. Sometimes they just have video calls with family and can’t really say goodbye.
Everyone is exhausted, but we’re a bit more optimistic in terms of our personal lives. We’re seeing restrictions potentially coming to an end sooner rather than later, the weather is improving. Work hasn’t got any better yet, but personally I’m feeling a bit more hopeful.
The GP, the Isle of Wight
The mental health calls have skyrocketed since the last wave
We see the wider effect of Covid. I never thought the NHS would get to this, having to put coronavirus above cancer, with patients having their potentially curable operations cancelled. Outpatients get cancelled so patients call me frustrated, and I can only apologise on behalf of my hospital colleagues. There’s a lot of patients who had Covid in the first wave and are struggling with fatigue and acute tiredness, so I’m writing a lot of sicknotes. You can see the ongoing impact it’s having on a person.
The mental health calls have skyrocketed since the last wave. There’s been overdosing and people made homeless due to debt as a result of redundancy. I think people are just struggling now, with the lack of interaction or being furloughed, and it’s winter. In the first wave, there was optimism and a sense that we’re in this together. Now, it feels like there’s no end in sight. There’s a lot more low-lying depression and anxiety. That probably makes up most of my work, but I’m listening on the phone and knowing how little I can do with mental health services burdened.
Our older patients are more frail, but seem to be more resilient. There’s a sense of, ‘well, we survived the war’. Younger people are a lot more fed-up, and more likely to fight the public health measures. It’s generally younger patients who don’t want to wear a mask, or give a bit of aggravation at the front door.
We’re all tired. With all the mental health and the grief and bereavement you can’t help but take it on. We try to find the positive in things, and keep smiling, but it’s still sad.
The cardiac physiologist redeployed as ICU nurse, Birmingham
We only had one day of training before we started, because they were desperate for extra staff to help
A few weeks ago, my manager emailed to ask if any cardiac physiologists could be redeployed to Covid wards. There was redeployment during the first wave, but the 10 who went last time came back traumatised. They watched people of their own age dying on ventilators and I know that they can’t do it again. It felt only fair that I go, as I didn’t last time.
Redeployment to the intensive care unit had been the hardest thing I’ve ever had to do. Even as someone who works in the NHS, I had no idea what it would be like. In a way, I can understand why people struggle to get their head around it, because they’re so far removed. It’s so physically demanding. When I finish three longshifts, every single muscle in my body hurts.
Most of the things I’ve been doing are new to me. We only had one day of training before we started, because they were desperate for extra staff to help. I didn’t feel very prepared, but I was willing to go in and try my best. These nurses have had to cope since the first wave, so the last thing they need to see is people who don’t want to be there. The patients need us too. Visiting isn’t allowed, so we are all that they’ve got.
You can’t help but bond with your patients, as you spend such long hours with them, chatting to them and their families on FaceTime, but that makes it so much harder if they need to be ventilated or sadly don’t make it. I’ve found that quite difficult. It’s someone’s mum, dad, brother, sister, friend, and most of them would have had a lot of life left to live if it wasn’t for Covid. Seeing the family receive that awful news over the phone is heartbreaking. I find it hard to switch off at home when I’ve been looking after a patient who is deteriorating or who recently passed away. We’re slowly seeing the patient numbers go down, we talk about it a lot on the wards. We have to stay positive, because it’s a difficult situation if this is all there is.
The paramedic, east of England
We’ve seen a massive increase in the number of patients dying at home
The delays have improved a little bit now. We have the police and military working with us now, so there are more crews on the road. Normally, ambulances are double qualified, with one emergency medical technician and one paramedic, but now one is going out with the police, or member of the military, who’re driving the ambulance. But despite this, we’ve seen a massive increase in the number of patients dying at home. Lots of people still aren’t making that 999 call because they’re petrified of going into hospital, especially knowing they would have to go in alone.
On a personal level, it’s a struggle. If anything, it’s getting worse. The vast majority of healthcare workers have realised we are just disposable to the government. It doesn’t feel like it matters if we live or die, or have the right PPE. I only got a personal issue filter mask three weeks ago, almost a year into the pandemic. I think the hero worship of NHS staff is really dangerous, because heroes are invincible. Heroes don’t need all the right stuff. Don’t get me wrong, it’s a lovely thing for the public to do, but it’s dangerous to think that.
I still haven’t seen my family for months and months, and neither have colleagues at work. Relationships are breaking down. It’s having a very, very deep impact on us to step up and have to deal with this situation. I stopped looking at the news, I can’t bear it. Politicians are arguing against the lockdown as if it’s something political, but the virus is apolitical, it’ll kill you either way.
The midwife, Greater Manchester
The attitudes to Covid from patients does seem to have shifted
The number of women with coronavirus seems to have reduced in the last couple of weeks. I’ve had my vaccine, which does make me feel safer, but I know it doesn’t necessary stop transmission and might not be as effective against some strains. I look after someone who is Covid positive, and then a few days later I’m in a bay with other women. We could be passing it on to newborns, or women who’ve just had a baby. That’s my main fear, transmitting it to the people I’m looking after.
The attitudes to Covid from patients do seem to have shifted. Last time we spoke, a lot of people were saying Covid wasn’t real. But there’s been some media coverage about some ladies passing away from Covid after their pregnancy, and I think that’s affected people. There have also been more deaths in the UK, and so the number of people who know someone who’s had Covid has increased too. Now when I say, I’m really sorry, visiting ends at 6pm, they seem to be more amenable, saying, oh I understand, I know someone who died.
I think myself and a lot of my colleagues are still worried about the state of the masks we’re being given. There’s a lot of lobbying going on, but the government take no notice. In other countries, they’re sending out high spec masks to vulnerable people, but here, you can go into a room with someone who’s coughing and sweating and the government seem to think you’ll be alright. There is more Covid in ICU, but they’re better protected. That makes me feel more unsafe than anything.
The junior doctor, Wales
We still wear full PPE now everywhere in the hospital, and I suspect we’ll do that for a long time
I’ve been moved from a Covid ward to a non-Covid ward, because incidences of Covid in the hospital have reduced. I think we were ahead of the general UK trend. It’s a massive relief for everyone that the pressures that come with the virus are a little relieved, and it’s offered some hope. Mentally, it’s a lot nicer going into work and not constantly worrying that your parents will deteriorate quickly.
We still wear full PPE now everywhere in the hospital, and I suspect we’ll do that for a long time. For us, that means a plastic surgical gown, surgical mask and gloves. With Covid patients you add a visor. It’s still difficult that families can’t come in to visit patients. That has a massive impact on patients both with Covid and without, especially older people with cognitive decline who really benefit from familiar faces.
I’ve had both doses of the vaccine now, and I think morale is improving. We’re all a bit wary, if a patient gets a cough or a temperature everyone worries a but, but that will be the case for a long time. We have to bear in mind that some patients will develop Covid regardless of how many precautions we take. It’s something we’re going to have to get used to. We’re becoming more familiar with treatment as it is currently, and the steps we take if we suspect someone has Covid. The general process is becoming quicker, smoother, and probably safer.