The StN Project

A Nursing Placement in the Time of COVID

In January, I hesitantly knocked on the door of a ‘closed’ COVID ward and introduced myself as the
new student nurse. I was terrified, and that was just because it was my first day and I didn’t know if
they’d remember I was coming or not, compounded with the sheer fear of the unknown behind the
door. Was it going to be full of people struggling to breathe, super contagious, and needing care
beyond my knowledge? The reality was far from this, but you can’t help your mind conjuring the
worst possibilities. I’ve been told before that I’m somewhat of a catastrophist.

The team that greeted me in handover were the most incredible, selfless, and supportive group I’ve
ever worked with. They talked me through handovers containing medical jargon that I hadn’t
revised, because I’d been told this was an orthopaedic ward so had learned the skeleton off by
heart. They calmed me down when I was panicking because the first patient I did observations for had an
SpO2 of 79%, and explained oxygen titration until I knew every type of oxygen delivery system
backwards. I was lucky to have them teaching me, but the patients were luckier to have them as
their nurses.

While I never expected to be training in the middle of a global pandemic – I’m sure no student did –
it has been an opportunity to embrace the best parts of being a student nurse. Patients couldn’t
have visitors except for at the ward manager’s discretion, so many were feeling lonely, and isolated.
Although I couldn’t always independently provide acute care, I make a mean cup of tea, and I spoke
to people about their partners, their children, their pets, favourite holiday destinations, and their
jobs. One patient bought me to tears with jokes that I can’t repeat in this blog. I hope I was able to
bring patients who were scared and acutely unwell a little bit of comfort and human connection.
One of the unique things that student nurses are afforded by their supernumerary status is time.
Of course my experience wasn’t all lovely conversations with lovely people. I spent a day alongside
my supervisor watching a patient deteriorate before our eyes. Critical Care Outreach, consultants,
and doctors ordered constant streams of bloods, cultures, ABGs, swabs, and fluids. We were chasing
an urgent CTPA to see if they had a pulmonary embolism, and awaiting an ITU bed. This was the
peak of the ‘second wave’ and these beds were few and far between. They required 15l of oxygen
through a non-rebreather mask, and their SpO2 was still in the 70s. They were our focus the whole
shift, and nearing the end of the day, a bed in ITU became free, and we rushed our patient there,
accompanied by a doctor, just in case. The next day we phoned for an update, and the amazing team
on ITU had stabilised our patient, and they made a full recovery. I have never experienced
deterioration as quick as I’ve seen it in COVID patients. I was having conversations with patients
whose oxygen saturation’s were below 80%, and there were no signs. The doctors explained that
this is colloquially referred to as ‘happy hypoxia’, because the patient shows no symptoms of their
hypoxia until you stick a stats probe on their finger, or their body stops compensating, and a medical
emergency occurs.

I was surprised to see a wide range of ages on the ward. I helped care for patients aged 18 through
to 97, and one was no less sick than the other. COVID is indiscriminate in who it affects, and I called
families who were shocked that their otherwise healthy 47 year old relative could be acutely unwell
with a virus reported to disproportionately affect the elderly, and those with underlying conditions.
I will never forget the things that I experienced on this placement; applying suction to the airway of
a man that would not have been in hospital had he not had to go to work, piles of Venturi valves on
top of every pod locker from titrating oxygen to it’s highest level, and the sounds of family members
sobbing when they realise their relative who was admitted following a fall now has COVID and won’t
recover. These experiences will make me more empathetic, more resilient, more adaptable, and I
am convinced they will influence my entire career.

Charlotte Huet (@charlottehuet) – Second Year StN (Adult)

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