‘I’m a nurse for the NHS and this is what it’s really like right now’ – harpersbazaar.com

Sarah is a Senior Sister in Intensive Care in London. Heres what she wants you to know:

This week I had to move my usual Intensive Care Unit to another part of the hospital. My ward has now been turned into a Covid positive area to take additional patients who have tested positive for Covid-19. But soon I think thats all that there will be it will be everywhere.

The area for Covid positive patients is known as a Red Zone, and when youre working in there you have to wear your Personal Protective Equipment (PPE) at all times - so thats gloves, a long-sleeved long gown, shoe covers, hair cap, mask and visor. Youre basically wearing that for the 12 hours of your shift, aside from during your hour break, which is divided into two. If you have a break, or need to go to the toilet, you need to take everything off, wash your hands, go outside, wash your hands again, and put an entirely new set back on. We have set donning and doffing areas where you put on your PPE and take it off its very specific. And everyone has to wear it; all the nurses and doctors, pharmacists, physios, healthcare assistants - everyone. It means you have to be really organised and make sure that youve got everything you need before you go in because all the meds, the fridge, the equipment room etc are all outside the Red Zone and you cant keep going between the two.

The shifts are intense; theres much less time to sit down for five minutes, or have a glass of water, even. If you want to pop out for a glass of water, youre going to be gone for about 10 minutes, instead of being gone for 30 seconds, which it might usually take. You have to take all your PPE off and put everything back on again. You cant leave a patient without having someone watching them, so trying to arrange something as simple as having a glass of water, or going to the toilet, is almost like a military operation; youve got to make sure youve got enough people watching the patients because theyre continuously monitored.

"Trying to arrange something as simple as having a glass of water is like a military operation"

Morale from a teamwork point of view is really good everyones working excellently together, but behind all that everyone is also really tired. This has been happening for at least two weeks in some areas of the hospital, so some nurses have already been doing this for two weeks now and they are struggling to see the light at the end of the tunnel; its constant. Its extra difficult knowing that things are only going to get worse.

Everyones working really well together, especially those who are on the ground, but people are definitely frightened. Theyre also scared for their own health and their families a lot of NHS staff have children, or live with elderly parents, and thats definitely a worry. But most people have a just get on with it attitude; you do just have to get on with it. People have been coming into work, not knowing what theyre coming into. But they turn up, they work for 12 and a half hours, theyre exhausted, they go home and go to bed, then they get up and come back the next day.

Its the junior nurses who are literally with these patients 12 hours a day, looking after everyone. Our normal nursing ratio in intensive care is one-to-one, because people are so sick, but because of the volume of patients coming in, were being told to prepare for the fact that we might have to start nursing up to one-to-four so, one nurse for every four patients, which is a huge stretch of resources and of a junior nurses skills. It makes the senior nurses like myself even more important, helping to support the team in these roles and trying to make sure that everything thats supposed to be happening is happening.

"The whole point of social isolation is to slow down the spread"

The whole point of social isolation is to slow down the spread, because when people have it and theyre very unwell, they are unwell for a long time. If you do get really poorly from it, and you need intubation and ventilation in intensive care, you could be in intensive care for 10 to 14 days. The problem then is that if 10 people come in who need intensive care in one day, and youve only got 10 beds, they are then going to be in those beds for up to two weeks. But if youre getting 10 new patients every day for two weeks, thats 140 people...

The figures predict that we need to multiply our bed base by 10. The bed base where I work for example is 50, and they predict well need 500. A lot of planned surgeries, or anything thats not an emergency, has been cancelled, so other areas of the hospitals are being turned into Intensive Care Units, like cardiac units, coronary care, recovery, paediatric because children arent getting as sick with it basically wherever they have the monitoring ability and space to fit people, they will fit people. Thats what were planning for at the moment.

Im trying not to look too far into the future from where I am you dont know whats going to happen from day-to-day at the moment, things change so much, constantly. You cant plan too far ahead because you dont know whats going to happen. We know more people are going to come into the hospitals because of this, but we dont know when its going to stop.

"You can't plan too far ahead because you don't know what's going to happen"

Seeing big groups of people socialising outside does upset me. One of my friends is a respiratory consultant and she sent a message round to all her friends and family which I thought was really good it basically said, Im not going to be able to see you all for a while, this isnt a joke and Im not going to put anyone at risk. Please stay in and look after yourselves. Its all to do with the spread and transmission. If people dont stay at home its going to overwhelm the health service as it is already. Some areas of London in particular are so densely populated, it can spread so quickly, which means the hospital could be overwhelmed very quickly. Seeing people hang out in big groups is upsetting, because they dont know what the consequences of their actions are and they may never see it. I get it, if you dont understand the consequences and you cant see it its not changing your life then its easy to ignore. But when people are asking you to stay at home, its selfish not to. Its frustrating to see.

Coronavirus recovery tips and advice

I work directly with patients who are Covid positive. I dont know if I might have it, even though I feel fine, so Im not going to put other people at risk. Equally, I dont want to be around loads of people and put myself at further risk, because I need to go to work. I havent got time to be unwell right now whether thats from Covid, or regular flu or anything else. I cant not be at work at the moment, thats not an option.

I feel sad that Im not going to be able to see people for a while. I waved at my mum from the end of her driveway this morning, which was nice, but Im not going to get to see my sisters, or my nephews, or my husbands family for a while. The thought of that is really upsetting. Its difficult when youve got Mothers Day and Easter and important family occasions coming up. We were supposed to be going away for my dads 70th birthday but were going to have to cancel it which is such a shame but isolating is so important.

"When people are asking you to stay at home, its selfish not to. Its frustrating to see."

Social distancing and hand hygiene are the most important things anyone can do right now. Its going to spread. If you go out with your friends and someones got a cold, within a couple of days, everyones got it. This is even more aggressive in the way it can transmit. But if people arent near each other, then it cant get anywhere: youre stopping it from spreading. The whole concept behind social distancing is to allow the healthcare system to cope and look after the people who have it.

Italy were not prepared and they are so overwhelmed right now. The videos emerging from their healthcare workers are heartbreaking. Theyve run out of resources and space. You cant imagine how they must feel. We need to try and stop that happening here. Some hospitals in London are already at capacity - theyre close to breaking point. We dont want to get to that. We want to be able to treat everyone in as controlled a manner as possible. So, we have to slow down the spread. You have to stop people from seeing each other. Its not forever, but youd rather stay at home for however long you need to if it means saving someones life. Its important to try and put that in context to someone who cant grasp the severity of the situation, or who might think youre being dramatic those 200 people who decide to go to B&Q on a Saturday afternoon, for example It might not ruin your life but it could ruin someone elses. Its closer to home than you think. Its selfish to think that youre the only person that matters in this situation; this situation is about being selfless and doing things that you might not want to do for the sake of others which right now means staying at home.

As told to Sarah Karmali.

Flatten the curve: what does it mean?

The information in this story is accurate as of the publication date. While we are attempting to keep our content as up-to-date as possible, the situation surrounding the coronavirus pandemic continues to develop rapidly, so it's possible that some information and recommendations may have changed since publishing. For any concerns and latest advice, visit the World Health Organisation. If you're in the UK, the National Health Service can also provide useful information and support, while US users can contact the Center for Disease Control and Prevention.

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'I'm a nurse for the NHS and this is what it's really like right now' - harpersbazaar.com