l leave the hotel where l am staying, near the East London NHS Nightingale, at about 7.30 AM. l like to walk by the river on my way to work. I began working at the treatment centre after two days of it opening and have been there for the duration. l started off in the admissions unit; for the day shifts, you get in at 8 AM and leave at 8.30 PM and the night shift runs from 8 PM to 8.30 AM.
When l arrive at NHS Nightingale, l sign in, scrub up and get changed into my full PPE gown before the daily PPE debrief begins and we discuss what's happening. After the debrief, l go to my area and call operations to find out if any patients are due to arrive. If there are, l stay in admissions for the full day, but if not l go to the ward to help. The beds are set out down the length of a long ward. Usually, when you work in a hospital, you have separate bays. At NHS Nightingale, you walk in and you see a line of patients set out along the entire ward. l was daunted in the beginning. When l understood how things worked, l became calmer. Everyone is there to support each other.
I feel like we are the quiet in the storm. There wasn't a day when it was chaotic and even when things became hectic, it was all still felt very controlled. l felt very impressed by it all. At times, l felt worried about my health working at the centre, but safety is paramount. I had my PPE made to measure and people help you when you don the full gowns, inspecting that you are wearing everything correctly. Everyone felt very protected.
Once debrief is done and l have been assigned my patients, l take my handover form the ITU nurse who oversees a total of four nurses. The shifts are fairly routine: we administer medications, check basic observations every hour (blood pressure, oxygen saturations, pulse rate, breathing rate, temperature, blood gases and blood sugars) and conduct equipment checks. We turn the patient every four hours to avoid pressure ulcers, read the blood gases every two to four hours, carry out suctioning and, if the patient is uncomfortable, deliver a bolus [dose] of pain killer.
At NHS Nightingale, they encourage staff well-being. If you ever feel like you need a time out, you signal the T, and no one will hold you accountable – it's not like a hospital in that way. People have come together from so many different areas and backgrounds. There isn't a hierarchy and you can speak your mind, ask questions and feel respected. After you've been for your break, you check back in.
Sometimes you feel like people can't hear you shouting through your suit; I've lost my voice now and again from that. We used a lot of sign language; If you want the ITU nurse to come over to you, you beckon and they will just come close to you so you can speak. When we're in there, we don't need to distance two meters because we are wearing PPE. The whole thing felt similar to a controlled war zone. You're working in a makeshift space which is not a purpose-built hospital.
You have some patients that you are so worried about, but somehow they do well. It's difficult to make an individual prognosis. Every day there needs to be small improvements and every patient is different. We have patients with no past medical history who had COVID and then patients with all the medical history in the world who are just as ill. It doesn't make any sense.
l stopped watching the news. It just felt like a death count reel every day. Every patient who comes through the door is incubated (enabled to breathe using a ventilator). On the unit, I remember the first patient we successfully extubated (removed tubing attached to the ventilator). Everyone was crying and we clapped them as they went down to the step-down unit. The patient didn't recognise their surroundings. When they woke up, they looked confused but relieved. Everyone was wearing heavy protective gear and the lights are so bright, the patient was disorientated. All the nurses bonded with their patient so much. The family can't visit, but there are ways for families to communicate with their loved one's through the family liaison service, which is lovely, really.
When l finish my shift, I go and change back into my own clothes. The way the unit is set out, you have the clean area and a dirty area. You remove your gowns in the dirty area then you go out of the hospital to a whole new area. There's a nice walk home and I reflect on the good stuff, thinking about that patients who are doing well. Some patients don't recover, but some do.
I try to offload when l go to bed, but you feel so high with the adrenaline running through you, it's hard to sleep. The NHS Nightingale is like nothing l have ever experienced before, and l don't believe l ever will again. I haven't been home in five weeks or seen my family. I have just been swabbed, so if l'm negative l can go home and finally see them all. My dad is very excited.
I came across some real professional talent at NHS Nightingale, and they were all so humble. I am a Band 7 clinical nurse specialist working in nutrition, but this experience has changed me. l would like to go into leadership myself and look at the structure of the NHS as a whole. l know I can make a positive change. l want my voice to be heard.