TWO OF A KIND by Jo Henwood

Nursing is a challenging job at the best of times. The past year has meant drastic changes to the role. MC Magazine talked to two nurses, working in very different areas of the profession, to find out how it was for them.

Liz Owens is a ward manager on the acute respiratory ward, at Liverpool University Teaching Hospitals NHS Foundation Trust. She is based at the Royal Liverpool hospital and her ward is now requisitioned to treat patients with COVID-19.

Liz Owens, ward manager on the acute respiratory ward at the Royal Liverpool Hospital.

Maria Murphy is a community care practitioner for Mersey Care, visiting patients in their homes.

Maria Murphy is a community care practitioner for Mersey Care NHS Foundation Trust

WHAT’S YOUR TYPICAL DAY?

LIZ: “As a ward manager my priorities are staffing and patient safety. I check infection control measures are in place and that we are safe, clean and tidy. As a respiratory nurse I’m used to wearing personal protective equipment, but now I put on a surgical mask the minute I enter the hospital.

“Our ward round brings together everyone involved in someone’s care: the consultants, the doctors, the physios, the pharmacists, senior nurses. We discuss everything about the patient and what they need. Then we get on and do it.

“I try to take breaks, for a drink at least. I always encourage staff to take comfort breaks though. They work long shifts and I’m mindful that they need a few minutes to themselves.”

MARIA: “No two days are the same. My day starts the night before, when I electronically check my case list for the next day. By 7.30am, I’ve checked my PPE and supplies so I’m ready for my first patient for 8.30am. Lunch? I never have a fixed time for lunch.

“My first priority is people who need vital medication, such as insulin or heparin to thin their blood. Sometimes we have to visit a patient more than once in a day; you get to know them and their carers.

“There’s a strong link between health and social care. We have to get both right, so the patient can live either in their own home or a place they choose. My job is to help people manage conditions and prevent them needing to go into hospital.”

HOW HAS THE PANDEMIC CHANGED HOW YOU WORK?

LIZ: "The biggest change is how much more time we spend making sure patients and families stay connected while they can’t see each other in person. I’m so committed to making sure patients and their families stay connected. It’s a lot of work but it’s so important. Families are sometimes frustrated by the situation. I try to be as kind as I possibly can, let them vent their frustrations and explain that the guidelines are to keep them safe."

MARIA: “PPE! My car now resembles a stock cupboard. Before the pandemic we would only wear gloves and an apron to carry out a procedure. Now we carry full PPE. If someone has tested positive we’ll go into their home wearing a long-sleeved gown, a fitted mask, a visor and gloves. It’s different but people are fine. I read of people who were not kind to staff in nurse’s uniform but I’ve received nothing but support."

“A big change is how we meet as a team. We’d get together at our office but now we ‘huddle’ electronically. It works, in some ways it’s more effective, but I miss the social element, the peer support and bouncing ideas off each other.”

WHAT’S THE MOST DIFFICULT PART OF YOUR JOB RIGHT NOW?

LIZ: “I was taught never to give people bad news over the phone. Now I have no choice and it’s very tough. I want to give relatives a hug, hold their hand, and offer them a cup of tea. We’re well supported by our senior nursing team, but it’s still difficult. What helps is the positive feedback from the public, and to see and hear from patients who have survived the virus – that’s what keeps us going.“

MARIA: “I support people with mental health issues. It’s been hard to know what to say when we were scared too. I nursed during the AIDS pandemic, that’s how it felt at first. We didn’t know if we could pass it to our families and our colleagues. Now the difficulty is the complexity of some patients' care. I’m caring for people who may have been discharged from hospital perhaps earlier than normal because beds have to be freed up for COVID-19 patients. Some are quite poorly, which puts extra pressure on us. Others, particularly those with underlying health conditions won’t go into hospital even if they need to because they’re afraid they’ll die."

WHAT POSITIVES ARE YOU TAKING INTO 2021?

It helped me that people took the time to stop and thank the NHS.

LIZ: “A stronger team. We’ve learned a lot and it’s brought us together. At the start morale was low. People were frightened and anxiety was really high. I tried my best to support staff, and now we see more and better treatment and better outcomes for patients. Morale is higher. We’ve welcomed four new nurses to our ward. They’ve settled in well and are part of the team."

MARIA: " Technology! Virtually everything can be done remotely. It’s been a steep learning curve in an already challenging environment, but now I can recognise the positives. There’s nothing better than being face to face in a room, but it works. The Trust instigated something called reflective practice, which gave us time with psychologists to discuss how we were feeling. I’ve benefited a lot from that."

Working remotely has been a steep learning curve, but now I can see the positives.

HOW DID YOU FEEL WHEN THE NATION WAS CLAPPING THE NHS?

LIZ:"We cheered too. My son loved seeing the neighbours cheering – it felt like the whole country was behind us. It helped me that people took time to stop and thank the NHS."

MARIA: "I was a bit embarrassed, as nurses we’re not used to that sort of thing! But it was nice to be recognised."

WHEN LIFE RETURNS TO NORMAL, WHAT ARE YOU MOST LOOKING FORWARD TO?

LIZ: "A holiday with my son Thomas."

MARIA: "To be able to celebrate my 50th birthday with my friends and family."