"We must join together"

Let me transport you back in time. With my first year as a Student Nursing Associate behind me, I was looking forward to what 2021 had to bring - knowing that this would be the year that I graduated and qualified as a Registered Nursing Associate.

Picture me. All smiles and full of hope.

Cut to the 23rd of March.

"Each and every one of us is now obliged to join together. To halt the spread of this disease [...] And therefore I urge you at this moment of national emergency to stay at home, protect our NHS and save lives" (Boris Johnson, 2020).

An immediate feeling of dread and fear of the unknown. I found myself checking BBC news every few minutes, looking to see what changes had occurred. It became so bad that I had to turn my phone off and put it away for the day. From that day on I said I would only look at the Trust communication briefing, to ensure that I was up to date with policies and procedures. Anything else would just scare me un-necessarily.

R and I had a serious conversation about whether or not I should move out of the house so that I wouldn't risk giving him Covid. We discussed whether he should ask his parents if he could move in with them. I was happy to move out, to keep him safe. But he said "no", that he wanted to support me as much as possible. Besides, we would both still be working as his factory had volunteered to make PPE, so we were both classed as 'keyworkers'. I then offered to move into the spare room, so that there was less chance of transmission. But we decided that unless one of us got it, we wouldn't separate. If one of us got ill, then we would re-evaluate.

My work routine got exponentially longer. I was leaving the house earlier so I could get changed before work. After work, I was washing down all of my pens and 'gubbins', changing and washing my shoes before I got in the car. Then when I got home I was wiping my car down, using a cleaning station I had set up by the front door to wash down my shoes and all my stuff again, leaving it all at the door and putting my uniform and clothes straight into a boiling wash. Then it was into the shower for a wash and hair-wash.

At one point my hair started falling out from all the washing. My hands cracked and were so sore I could barely stand to put my moisturiser on. On my days off I would put moisturiser on every hour to try and stop them cracking and bleeding. My face was sore from masks and visors. I found that the foam on the visors made my face itch and become red. I bought myself some over-glasses goggles instead.

As a bespectacled person, one of the great challenges has been finding PPE that fits over and around my specs, and finding that I steam up and can't see anything. 1 year in and I have finally found a cleaning cloth that seems to stop me steaming up!

I believe I have caught Covid twice. At the start of March 2020, I had fevers, rigours and felt unwell, at the same time as an outbreak on the ward. But they weren't testing healthcare staff. When they finally started testing for anti-bodies, I was told that if I was only unwell for a few days (which I was), I was likely to only have had a small viral load. This meant that 4 months down the line, I was unlikely to have enough anti-bodies to be picked up if I had them at all.

Christmas 2020, both R and I had Covid. Clearly, I gave it to him as I was working on a Covid positive ward. I won't go into the ins and outs of feeling unwell, because ultimately, I know I am lucky to still be here; to have been more seriously unwell when so many of my healthcare colleagues have died. But R did move into the spare room.

After a year of being a student. I thought I had everything under control. I knew the online system; how the assignments worked and how to get everything signed off for my practical assessments.

Covid has been the spanner in the works I could never have seen coming.

All of sudden, our training shifted. With so many senior staff off sick, it was nigh on impossible to get the skills and interviews - which were so crucial for the university -signed off. An influx of medical students who had signed up to become HCA's meant new staff to train on the job. On the plus side, one medical student said that he was glad he had undertaken the experience because he got a chance to see what nurses had to do. He hadn't realised how much we do, and how vast our skillset needs to be. It was a chance for me to practice my teaching skills though. Trying to explain to a new member of staff why, when we check a patients pulse or respiration rate, we don't just count for 30 seconds and then double it; made me realise how much I actually knew.

We also had third-year student nurses who had opted in to work; so I felt like I had a chance to tap into their knowledge and skillset. Mostly they were pleased to be paid for their clinical placement.

Difficulties in learning aside, working on a Frailty ward, where the majority of patients have a cognitive impairment, made lockdown a huge challenge.

Trying to explain why visitors couldn't come in, why I was wearing all my PPE, trying to help them to hear me through my mask.

Trying to support someone who was confused and wanted to walk around, why they couldn't leave their side room.

Trying to help them contact their loved ones when we didn't have a ward telephone. If you have an elderly loved one in hospital, I would urge you to get them a cheap telephone, even if they can't use it independently. The staff will be so glad to help, and it will ease your loved one's mind if they can talk to you.

Working with older people, I have relied a lot on a tactile approach. I am an expressive person, and I have found it very difficult to limit holding my patient's hands and to not be able to show my emotions on my face. I think my patients have found it hard too. You can see the change in response in their eyes.

There is one occasion that sticks in my mind. Looking after a patient who was at the end of her life, who was becoming exceedingly distressed. I was trying to support a patient who needed 1:1 nursing care due to her dementia, but couldn't bear to see another patient who was so alone and so afraid. When my patient said she wanted to have a sleep after lunch, I took the opportunity to sit with my other patient. I brushed her hair, I put some music on and sang to her. She started to appear calmer but wasn't entirely settled. I sat with her and held her hand. This didn't seem to work. I decided that what she needed most at that moment was human contact. I knew I would wash my hands well afterwards so I took my glove off and held her hand.

She died a few hours later.

I told her daughter that I had sat with her and held her hand. She cried as she said, "thank you".

There was one week, a few months later, where I was working a few long shifts in a row, and then would have a stretch of days off afterwards. I remember thinking when I finished that last shift, that I was glad I was off the next day because I didn't think I could perform last offices again, or watch any more patients die that week.

Honestly, 2020 was a complete blur. The university did an amazing job, seemingly springing into action to put our lectures online and provide support both in terms of the lecture content and in using the technology. I'm sure there were a lot of late nights, early mornings and frustrations behind the scenes. I will be eternally grateful to the amazing team that adapted so well to get me through my course.

Studying online was, in some ways, a blessing. I didn't have to get up so early, worry about parking or train times...and there were times when I studied in my PJs!

For the most part, I found that the lecture content was easily adaptable to learning online, and it meant that I could repeat a lecture, or re-read something if I needed to go over it. And all the lecturers were available for support in any way - academically, clinically or personally. I think there were only a couple of classes that I wished I had been able to undertake in person, but when I emailed with some queries, I very quickly got a response. And when I started to panic about an essay and emailed the lecturer, I got an invite to a Teams meeting and some good support to bring me back down to earth.

I found that the university had some really great innovative ideas about how to keep our learning as interactive as possible...Including making a paper boat!

The 1st January 2021 - a new year, a new job. I had stayed in the same ward I had completed the majority of my training on - Frailty. Please read some of my other posts to see my experiences of this, and how I have now changed wards :)

Being a newly qualified RNA in the middle of a global pandemic was not how I imagined things to be when I signed up for the course. But it was the hand I was dealt, so deal with it I did.

Ordinarily, as a newly qualified member of staff, I would have had a catch up with the practice development team, who are responsible for overseeing all newly qualified nursing staff to ensure they are confident and competent to undertake their job role. They also help you to settle in and provide you with your preceptorship for your first year. A preceptorship is a time where you are supported by senior staff, undertake training relevant to your job, and transition from a student, to newly qualified, to not so newly qualified.

Luckily our practice development team were great too. They set up teams meetings every week where we could 'drop in' as needed (unfortunately I was working all of these!) but also made sure we knew where they were if we felt we needed any support in the initial months.

I'm now 2.5 months into being newly qualified. I have cried, laughed, been indignant, wondered what on earth I thought I was doing and decided I have made the best decision ever. Studying and qualifying during a global pandemic has been so challenging that I don't think there is a word for it. At times I wondered if I would ever be able to achieve what I set out to.

The thing is in the NHS, particularly in my Trust, that no one is truly on their own. Sometimes we feel lonely, desperate and hopeless. But when you tell someone how you feel, there is always someone who says "me too, let's do something about that". And all of a sudden you are not alone. I am grateful to my Trust for having a well developed psychological support for its staff.

I am exceedingly lucky. I have had Covid and recovered. My family and friends remain safe. I have known loss due to Covid. I have cried in the chapel.

But I hope that as the world moves forward, and we learn to cope and recover from this virus that will never truly disappear; all of this will make me a better nurse than I could ever have hoped to be.

Stay safe x