AN ICU nurse says she’s witnessing deaths that are “against our human nature” due to Covid-19 as patients die without their loved ones by their side.
ICU clinical nurse manager at Cork University Hospital, Theresa O’Brien, said the huge influx of patients with the deadly virus has had a devastating impact on staff, patients and their families, particularly during end-of-life care.
She said: “With Covid what we are finding is that we are communicating with families on the phone, which goes against our human nature to have no face-to-face contact with the relatives and the families.
“The patients can’t have any contact either. Even though a lot of the patients wouldn’t know their families are there, maybe there’s a level of instinct that the patients do know.
“Now when people lose their mum, their dad, their grandparents, their brother, their sister, they are coming in and saying goodbye for ten minutes and then leaving, with the nurse sitting with the patient holding his or her hand while they die because the family cannot be there for infection reasons.
“They can’t sit there for hours because we don’t have the time or the staff to look after the relatives and so they are usually saying their goodbyes on WebEx. Sometimes they don’t even get to say goodbye.
“I think if the public knew what families go through, that they can’t even be with the people they love most in their lives, they would stay at home during lockdown.”
Theresa and her team feared the worst after Christmas when more than 100 nurses became unavailable for work due to Covid illness or having to self-isolate.
Anticipating a huge influx of patients, she made a public plea for help from medical professionals.
She explained: “My worst fear is that I might not be able to do my job and save a life because I do not have a pair of hands to help do that.
“Since New Year’s Eve we started to feel the pressure and it has escalated since, every day. I put out an appeal on my Facebook page on New Year’s Day for the public to stay at home.
“I have been running ICU for up to 15 years and I got worried when I saw the way nurses were being exposed and we were down over 100 nurses in the whole hospital because of exposure to Covid.
“Then the patients started to come in at a rapid rate.
“So I put out an appeal to the public to stay at home and to help us because when one of our nurses looked out the top floor looking across at Wilton Shopping Centre from Level 5 she could see Wilton packed to the gills in December.
“That’s when the worry started for me but then last Friday week (January 22) we had to put out a national appeal to anyone with any medical experience to volunteer to come in and help us as I did not have enough staff to nurse the patients.”
The response was astonishing, with GPs, dentists, radiologists and radiographers among those who volunteered their services.
Theresa was particularly worried that CUH would replicate scenes in the Royal London Hospital where one ICU nurse must care for two Covid patients.
She explained: “I have friends working in those hospitals who are telling me they are losing patients because they cannot give the care to the patients and that is not something we want to see happening here in Ireland.
“My greatest worry when I put out my appeal in January was that I didn’t want to be in a situation where I didn’t have a second pair of hands that I could call on so that I could go and help a patient that I knew needed my help because I was already with a sick patient.
“In CUH we are doing one to one care which is best practice and safest for the patients. Now we have non-ICU staff looking after patients and an ICU nurse looking after the patient next to them.
“So the redeployed member of staff or one of the volunteers are looking after the ICU patients, with us guiding them through it while we look after a patient as well.”
She said the emotional impact of the pandemic is so severe for traumatised nurses that some of them are thinking of leaving their jobs.
She explained: “I know at the end of this and if Covid ever does end, I could end up losing a lot of ICU nurses because of the emotional trauma they are feeling. They could be gone in two years’ time and leave ICU nursing for something less emotionally traumatic.”
Describing the enormous toll on staff, she added: “I don’t think people realise the consequences of Covid on medical healthcare professionals in a couple of years.
“Even now they are suffering from Post Traumatic Stress Disorder and we are referring nurses to the Employee Assistance Programme and to Occupational Health.
“We have seen nurses who have broken out in skin rashes due to stress. They are not sleeping at night or they can’t function by day so they work nights.
“Their faces are being ruined by wearing masks and most of my nurses have had to go to dermatologists because they contracted dermatitis from the masks resulting in them being on antibiotics from five up to 13 weeks. Their noses are breaking down.
“It’s hard working in ICU. You are in PPE. You are sweating, you are working in clothes you have never worked in before.
“Then you are showering every single day in order not to bring it home to your family. So there is that worry on them as well.
“Some of the nurses are living in hotels so that they are away from their immune-compromised families.
“So they are isolating themselves in order to look after their patients. That is huge for someone to give for people that they don’t even know.
“That is why I am so proud of the nurses in there. They are so amazing and every time I have asked them to come in to swap a shift and come in at very short notice to cover a night shift they do it.”
Theresa is now noticing big numbers of patients in their 40s and 50s, in contrast to the first surge in April, which mainly affected patients in their 70s and 80s.
Describing this development as “extremely scary”, she said she now fears what will happen if there is a fourth surge.
She’s also particularly conscious that patients who recover still have a long road ahead of them once they leave ICU, as it can take several months to control blood pressure as well as the damage to skin, fingers and toes.
She said: “We have had a patient who had an amputation of a leg. He was a Covid patient and it was a combination of Covid, him being so sick, and the combination of the multiple drugs we were giving him.
“We saved his life but he has had another nine months of recovery. To lose a leg is a huge thing for him and he was a man in his early 60’s.
“We are still learning so much and it’s going to be a long time before we know everything about Covid. This virus is transmitting so fast compared to the flu and that is why it is hitting the world so fast.”
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The dedicated nurse is calling on the public to heed the current restrictions by staying at home so they can avoid adding to someone else’s grief.
She said: “I have lost a brother in ICU, I have lost a grandmother in the ICU I work in. If I hadn’t been there to hold their hands and say goodbye I think it would have broken me.
“So if the public could just understand this is what could happen. Please help us to help you by staying at home. I know lockdown is really hard but it’s not going to last forever.”