An open letter penned by an intensive care nurse who cut short her maternity leave to help out in the battle against Covid has gone viral after being published by a nursing news website.
Vicky Neville, who works at Warrington Hospital, put pen to paper to describe what a day in ICU looks like in a letter that is considered a ‘must-read’ among those who have seen it.
WOW. This incredibly powerful, moving, inspiring & at times desperately sad piece by Covid-19 ICU nurse Vicky Neville is a stunning read.— Piers Morgan (@piersmorgan) December 6, 2020
Covidiots who refuse to take the virus seriously should read it – then shut up.
Thank you Vicky & every NHS hero. https://t.co/XNdJyyAdyz pic.twitter.com/g6hLp4ANCN
Starting her shift at 7.30 in the morning she opens up about the rollercoaster ride that will see her through the next 12 hours until she finishes at 20.30 at night.
Returning home to her newborn child and husband she writes:
“I get home, I strip off in my downstairs toilet, I sanitise anything I touch, my clothes go straight in the washing machine, I shower, wash away the tears, sweat and any infection.”
Read the letter in full below:
This year, 2020, has been recognised as the year of the nurse, I’ve fortunately had the pleasure of being a nurse for 10 years.
My last five years of employment have been as an intensive care nurse at Warrington Hospital, gaining the sister post two years ago was one of my career goals and a huge opportunity.
Last year, I gave birth to my son, I set on taking nine months off work to bond and make memories.
I looked forward to having my first full Christmas off in 10 years, being able to wear my engagement ring and I planned day trips and holidays in my head, not having to worry about having enough annual leave to cover them.
When Leo was five months old, our nation was thrust into the limelight with increasing daily numbers of Covid-19 victims, we started to hear of the intensive care unit (ICU) admissions and the volume of deaths was unthinkable.
With a heavy heart and long conversation with my partner, I decided to go back to work five months early, leaving my five-month-old baby at home.
Some call me crazy and question why I did it, some think I’m brave but in all honesty the thought of sitting at home and watching my colleagues suffer was too much.
Being an ICU nurse isn’t for the faint hearted, especially one working through a pandemic, the job is hard enough let alone wearing full personal protective equipment (PPE).
I’m fortunate that I work in a fantastic place, a place that throughout the first and now the second wave have shown resilience and perseverance.
We have saved many lives and unfortunately lost lives along the way including our own staff.
Many people think ICU nurses sit at the end of the bed all shift long recording observations, I can’t remember the last shift when I have sat down and, if my role is to record observations, let me just clear that up for you.
I start my shift, my day shift at 7.45 but I’m in the handover room 15 minutes early.
We work 12.5 hours, which includes two 30-minute breaks, but due to the PPE we need more regular breaks but don’t always get them.
We work the same through the day as we do nights. A misconception is that the night team have it easy, they don’t.
At the start of my day shift, I’m allocated the team leader’s role and an ICU patient; they have Covid-19. This means I’m working in the Red area, my usual area, not the escalation area in theatre.
I don’t know what is worse, being in full PPE in my own area or in the escalation area in a standard mask but unfamiliar with my surroundings – it changes daily.
My patient is incredibly sick; they have a tube keeping their airway open, sedated, ventilated, paralysed, needing multiple inotropes, severely septic needing dialysis, who needs to be proned, as they are needing 100% oxygen.
I take a detailed handover, I then record my observations including ventilator, dialysis, patient vital signs, medication rates and anything else that needs documenting.
Then I receive a handover from the team leader; I jot down outstanding jobs and hear a brief handover of the other 15 patients.
Various patient needs and staff abilities are noted in my head – thinking of ways I can support them and support my patient.
I carry out safety checks, checking I have emergency equipment, enough oxygen, that my lines/tubes are in the correct position; I check the drugs they are on – date, time and how long until it runs out.
They have tubes feeding them, helping them pass urine and lines into large veins, so we can give the vast amount of drugs we need to keep them alive.
I write a full A-E assessment including a body map; I check their pupils for reaction, I listen to their chest with a stethoscope for air entry, I palpate their stomach and listen for bowel sounds, I look at the visible pressure areas and continuously observe them.
I check their blood results and run an ABG, which shows me their oxygens levels are dropping despite being on maximum oxygen and their blood results are showing the sepsis is getting worse.
I bleep the doctors and explain what is happening. It’s not even 9.30.
I quickly check on my staff, telling them if they need me to let me know, as I’ll be busy with my patient. I allocate breaks and who swaps with who, so patient safety is upheld, even on minimal staff.
The doctors come, they decide to prone my patient straightway (fortunately they’ve been washed by the night staff).
It takes six members of staff to reposition them onto their stomach, holding tubes so they don’t get dislodged.
They are now on their stomach, oxygen levels will be assessed hourly for signs of improvement. They give me a list of jobs to do and carry on seeing the other patients.
It’s 10am, medications, nasogastric care and observations time. I make up new bags on inotropes, as they are needing more, their blood pressure has been dropping.
11am, I help turn another patient, check drugs out for another, order some medication that we’ve run out of. I need a drink, my mask is hurting my face and I can feel my face stinging from where it’s dug in.
11am to 1pm, I crack on with medication, observations, the jobs outlined by the doctors and help/support my colleagues. I observe my work buddy’s patient while they are on break.
At 13.30, I have my break, I hand over my patient to my buddy and feel the relief of my mask being off as I doff, I see bloods that need taking to the lab so I take them for my break.
13.45 – my break is the quickest part of my shift. I inhale my food and cautiously drink so I don’t run the toilet every five minutes. Not something you can do in full PPE.
14.15 – I’m back on the unit in full PPE, my colleague tells me my patients support is increasing and they have bleeped the doctors; we start more cardiac medication and take another ABG.
Their oxygen levels are really low and I have nowhere to go with the ventilator setting. I have the unwanted task of ringing my patient’s relatives, his wife.
I explain that their husband has deteriorated and the shift leader has said they can come in. They tell me they can’t come in as they are ill with Covid-19 themselves and there is no one else close enough that can come.
I listen to them cry and I hold back the tears, I tell them I’m with their husband and I won’t leave him. I don’t leave him, I stay by his side for three hours, he arrested.
CPR for 15 minutes, we got him back; he arrested again, no CPR this time, we got him back but the third time it was too much for his body and he died.
I held his hand through double gloves, I placed a knitted heart on his chest, my visor steaming up from tears in my eyes. He was 57, the same age as my mum.
I rang his wife, as the doctors were down in accident and emergency with a referral and another sick patient.
She sobbed, I explained how we did everything and I was so sorry for her loss… quite possibly the worst call I’ve ever made.
She thanked us for trying our best, which broke my heart, as we couldn’t save him and she was alone. I couldn’t hold her hand or comfort her like we could pre-Covid-19.
I go behind the curtain and perform last offices, the final part of care I can give my patient. I tell them the words his wife told me and I hold his hand as I take off his wedding band, I put it in a plastic bag to be given to his wife.
The thoughts of my own partner go through my head and how I need to tell them I love them, and how I want to cuddle my little baby boy so much.
I ring the security team, they come shortly after, my patient goes with them and I feel a wave of sadness.
I can’t sit down and cry; I quickly check on all the staff and patients, my colleague puts their hand on my back and asks am I okay? (No, I’m not ok); I’m fine and I thank them for their support.
It’s now 18.40, evening breaks are in progress and we’ve cleaned the bed space for a new admission, as we will probably get one.
I go for my break and see a blister on my nose from my mask, I put cream on it as it stings like mad.
19.20, I check the CDs with my colleague, all accounted for; I make sure the empty bed space is set up as we are getting a new admission from A&E.
I have a quick walk round to check everyone is okay; they aren’t, various patients are getting worse and the staff are tired but know they are back in again tomorrow. They know they are fighting a battle they can’t always win.
19.45, I hand over to the night staff; I tell them about the new admission from A&E, I tell them jobs from the night before as I’ve been incredibly busy to do them all, leaving me feeling guilty and like a failure.
20.30, I get home, I strip off in my downstairs toilet, I sanitise anything I touch, my clothes go straight in the washing machine, I shower, wash away the tears, sweat and any infection.