The situation regarding Covid was manageable until around three weeks ago when numbers suddenly shot up. In the space of a week, Covid admissions doubled.
Our Covid isolation unit has expanded and another one has been set up. Each unit is supposed to hold 15 people. A few months ago, we were using a third of one unit, but last week there were around 50 patients in there with some patients on chairs.
What’s sad and frustrating this time round is that a lot of the patients who require intensive treatment are not vaccinated. It’s difficult to understand why people choose not to take something that will help them and, in most cases, prevent them from going to the intensive care unit and potentially dying.
It’s not just Covid we’re contending with though. People are coming in with other problems. We’re also seeing a lot of patients who should not be seeking emergency care. GPs are overwhelmed and so many people come through our doors as a result. One patient was sent to us to be started on diabetic medication – that is not an accident or an emergency, which is what A&E is for.
There is overcrowding every day. Patients are waiting for more than 24 hours in the emergency department for a bed on a ward in the hospital. Meanwhile, we also need to cater for the influx of new patients seeking emergency care.
On top of this, we have a massive shortage of staff and more are calling in sick with Covid every day. This week, there was an emergency meeting among all the consultants to talk about what to do. Many of my colleagues have already left, citing burnout. Others have gone to work in other specialities because all the pressures made them feel they couldn’t give the care they wanted to patients in A&E. None of us can give the care we want to give in A&E at the moment.
Every day messages go out asking for people to come in to work. Shift rates for locum staff have been increased to try and get more to help out. We’ve been told we have to be on the ward floor doing clinical work on all our professional development and study days.
We knew this winter would be bad. Every year winter is difficult, but this time round we’ve had no respite or break. Summer felt like a normal winter. I did a block of three night shifts in September and was the only clinician along with two other nurses in the minors section of the department. We had around 50 patients to tend to. I didn’t take a break on the first night and on the second and third nights, I took 10 minutes. When I did the handover each morning there was a 14 hour wait to be seen. I got home after the first night shift and cried. I felt I’d let my patients down and that it was unsafe.
It’s worse now – there are still far too many patients and the ratio of nurses to patients means treatment is taking longer or is delayed. My worst fear at the moment is making a mistake. I’m worried harm will come to one of my patients that could have been avoided. It feels like something bad is waiting to happen.
If it’s like this now, I dread to think what the rest of January and February – the peak of winter when we’re traditionally the most stretched – hold for us.
On Tuesday Prime Minister Boris Johnson’s said the NHS “may be overwhelmed” in the coming weeks and months and that we’ll have to “ride out” the wave. I would like to invite him to do a shift with me so he can see how “overwhelmed” doesn’t begin to cover it. He doesn’t know what it feels like to be overwhelmed in a healthcare setting. It’s people’s lives at stake and that is what our prime minister is not acknowledging.
It’s hard to know what we should do. If more people were vaccinated, fewer individuals would end up in the intensive care unit. If there was another lockdown then that would reduce the surge in numbers but I’m not sure that’s the answer and it may well be too late now anyway. Long-term the NHS needs more funding but for now all I ask is that everyone looks after themselves so that we in the health service can look after the most in need. We have to learn to live alongside Covid but we have to do more to protect our most vulnerable.
Louise Curtis is an advanced clinical practitioner in the NHS writing under a pseudonym. Louise’s book A Nurse’s Story: My life in A&E during the Covid crisis, written with journalist Sarah Johnson, is out now.