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After 23 years in intensive care, nothing has prepared ANTHEA ALLEN for war in her London hospital

Senior sister Anthea Allen has been a nurse for over 20 years and thought she had “seen everything” in her long NHS career. Then came the pandemic of the coronavirus.

When it hit, she was – still – one of those in charge of the intensive care unit at South London’s St George’s Hospital, one of Britain’s largest clinical educational institutions. Now it is in the eye of the Covid-19 storm.

Even in the days before the closure, some hospital stores refused to serve nurses in scrubs for fear of infection. The intensive care staff found they couldn’t buy cookies or a chocolate bar to get through 12 hours a day.

So Sister Anthea, a mother of two, called on friends of the family. She was soon overrun with food donations. A Twitter funding page called @CriticalNhs has been launched, raising nearly £ 100,000 to date.

She also started a weekly internet diary – to share with several dozen employees. Now she has agreed to have parts of her journal published exclusively in the Mail, a poignant and deeply moving account of NHS life on the front line.

Senior sister Anthea Allen (pictured in her PPE) has been a nurse for over 20 years and thought she had “seen everything” in her long NHS career. Then came the pandemic of the coronavirus

WEEKS 1 & 2: THE COLLECTING STORM

MARCH 19 TO APRIL 6

I am so proud of my colleagues. Before this happened, nurses were pushed to the limit; now they are under enormous pressure and are exposed daily to the threat of Covid-19.

There is not enough space and not enough people to deal with this rising storm, so we are opening other areas to care for the seriously ill and employing personnel.

I’ve seen tears, anxiety, and exhaustion in colleagues who work long days, skip breaks, and take an extra step to make patients feel safe – while wearing this strange, cumbersome protective gear.

Yet there are sun rays in the dark. Friday, a friend delivered a huge box of donuts to the nurses in my ward – they were gone in an hour!

One evening, when I returned home exhausted, there was a tin of homemade chocolate brownies at the door with a card saying, “Thank you, nurses.” I have no idea who made them, but thank you too. A local school has sent an email with the offer to arrange delivery of sandwiches.

The kindness of strangers, the spirit of the community and my dear friends have warmed my heart. I wasn’t expecting this answer: trash bags full of cookies, chocolate, cake and cereal. We’ve had pizza, curry, homemade bread, cheese, and huge baskets of fresh fruit.

The intensive care staff is kept afloat by this support and we share what has been donated.

Everyone here performs out of duty; doctors, nurses, reception staff, community workers, porters, cleaners, security, nurse educators, technicians, lab technicians, blood bank staff, pharmacists, dieticians and many others, including the fantastic volunteers.

A nurse said, “We’re like the band in the movie – we keep playing while the ship goes down.” But this ship is not sinking and we will continue.

When the coronavirus struck, Sister Anthea (far right) was one of those in charge of the intensive care unit at St George's Hospital in South London, one of Britain's largest clinical educational institutions. Now it is in the eye of the Covid-19 storm

When the coronavirus struck, Sister Anthea (far right) was one of those in charge of the intensive care unit at St George's Hospital in South London, one of Britain's largest clinical educational institutions. Now it is in the eye of the Covid-19 storm

When the coronavirus struck, Sister Anthea (far right) was one of those in charge of the intensive care unit at St George’s Hospital in South London, one of Britain’s largest clinical educational institutions. Now it is in the eye of the Covid-19 storm

WEEK 3: KEEP CALM AND CONTINUE

APRIL 7-11

It’s like being in a sci-fi movie; personnel dressed with visors, masks and headgear. Of three intensive care units with a total of 30 beds, we now have 147 beds in seven areas.

Highly trained nurses who usually care for one intensive care patient now have three to four, with nurses in the ward. Many have never set foot in an intensive care unit (ICU).

It is heavy. It is claustrophobic in Personal Protective Equipment (PPE). We are always thirsty; 12 hours in the same room, the only escape is to eat or visit the toilet.

It’s raw and real, and we also have our non-Covid intensive care patients. Accidents, illness, cardiac arrest, stabbings still happen.

Recruiting nurses is part of my job and the young people call me ‘Mama Anthea’.

I have become a temporary parent for some, mopping tears and hugging those who miss their families. I am also proud to have recruited my daughter Claudia as our new departmental employee until she can return to Bristol University.

It is difficult for us, but more difficult for the patients without visitors and afraid of this vicious virus.

WEEK 4: ‘IF THIS IS DONE, I AM EVEN’

APRIL 12-20

Attention to detail at the ICU is high on our list. I have friends who carefully label each jar in their pantry because we are so conditioned to label medicines and equipment to make sure we are aware of the expiration date, what a specific medicine is and its dose.

We keep a diary for patients so that when they recover, they can know their journey. If they don’t survive, we know these diaries are a comfort to the family.

We brush patients’ teeth, we change their position, we talk to them even when they are unconscious. We explain it to family, we wash her. We sneak a dog in to visit, we put a favorite teddy bear in bed.

We respect religion, race, sexuality. I moved a bed to Mecca and dropped a valentine for an elderly patient’s wife.

Sister Anthea (pictured with her daughter Claudia) started a weekly internet journal - to share with several dozen employees. Now she has agreed to have parts of her diary published exclusively in the Mail, a gripping and deeply moving account of NHS life on the front line

Sister Anthea (pictured with her daughter Claudia) started a weekly internet journal - to share with several dozen employees. Now she has agreed to have parts of her diary published exclusively in the Mail, a gripping and deeply moving account of NHS life on the front line

Sister Anthea (pictured with her daughter Claudia) started a weekly internet journal – to share with several dozen employees. Now she has agreed to have parts of her diary published exclusively in the Mail, a gripping and deeply moving account of NHS life on the front line

We are a competent, very knowledgeable, friendly, caring group of people who pride themselves on being nurses.

But now it is different. We are in a growing storm. We’re just fighting to do everything we can to keep someone alive, to try to help them defeat this relentless deadly virus. The personal approach is impossible. A nurse said to me, “I don’t even know my patients’ names.”

We all have trouble sleeping and many of our regular nurses (who come from all over the world) want to go home. They will probably do it after this has happened. We are broken.

But there is hilarity amid the madness. We laugh and cry and support each other. We have counseling offers but are too busy.

Our priority outside the department is eating, sleeping and taking a very long shower.

We feel miserable and exhausted while at work, and guilty when not at work.

I walked through one of the ICUs a few days ago and gave kisses to the nurses I recognized under pieces of cloth, plastic and paper. Today I got a text from one of the Italian nurses: “Please come by and send me flying kisses again.”

The level of anxiety increases every day. It is especially difficult for the junior staff, who are suddenly expected to lead and guide from other areas.

We go on and on and more and more patients arrive, sick and scared.

A man said, “Please don’t let me die.”

This is another way of nursing. Unknown, with no end in sight.

There are many NHS workers, some unseen, who struggle. For example, the morgue staff – our morgue is full.

There are laboratory technicians who process the flow of cotton swabs from patients with Covid-19 symptoms, as well as routine blood and sample testing.

Our technicians must maintain and clean the fans – some are over 50 years old. The pharmacy keeps track of the supply of medicines. Recruitment processes new, transferred and temporary employees.

A junior doctor told me, “If this has happened, I will do the same. No amount of money can make me stay. “

Week 5: Death creeps up on my ward

APRIL 21

If this is the front line, we are going to wage a war without weapons. One of our doctors who has worked in Afghanistan says he somehow finds the ‘dramatic level of trauma’ worse than what he experienced there.

This monster is worse? But yes, in this Covid war, the enemy is unseen, and all we have is our dwindling supply of PPE, ostensibly to protect us.

On Sunday I cared for patients in an improvised and stuffy ICU in what is usually a neurosurgery unit. Cables running across the ground, monitors balanced on top of fans, and my patient’s emergency oxygen supply attached to another patient’s bed with coils of green hoses that look like a garden hose hanging from the end of the bed.

Stitching the PPE. It’s hot, it’s tight. I have a cut above my left ear from the mask elastic. We have to shout or we can’t be heard.

At one point, I felt an overwhelming desire to break free and tear it all off. To lift my visor and just breathe. My nose was blocked, my throat hurt – but then an alarm went off. A patient became unstable and I was distracted.

A man died. He was 60 and, besides diabetic, a working husband and father.

A junior nurse and I held his hands when he died; we talked to him, talked about the photo of him at his daughter’s wedding last summer. I put that photo in his hand. There were no curtains around his bed, no family with him. Another victim of Covid, taken from life. The young nurse had tears on her face. “It shouldn’t be like that,” she said.

Later I spoke to his daughter on the phone and I could hear her pain as I tried insufficiently to describe his last moments and reassure her that he was not alone when he died.

The dying man was numb. It is difficult for conscious patients because they cannot see our faces. But I hope they can see us smiling at them from behind our mask. We touch their faces and hands so they feel reassured that we will do everything we can to help them.

I recognize a patient – one of our own nurses. He had initially refused to be ventilated because he was afraid.

Now I program his fan and give him medicines. He is doing well and I hope he will recover completely.

A patient who was ventilated for 21 days left critical care today. As he was being driven out, the staff were clapping along the corridors and he smiled and waved his arms to victory.

A fantastic moment – patient and NHS employees united in success.

We are shattered and doing what we can to ensure we all have the space to drop a tear or to have time to eat and drink.

Hospitals seem to have been designed with just an inch of space, but the genius who designed the Atkinson Morley Wing in St George’s has added a large balcony.

We can eat warm lasagna from @CriticalNhs and for a moment we sit face to face in the sun and feel that the world is back to normal.

I got a text from a Portuguese nurse: ‘I need some chocolate, cola and a new hair cover. Is there a pink? “I was able to fulfill all three requests!

We are brilliant, and to quote my daughter Claudia, where I enjoy working alongside: “The nurses are beautiful, hilarious, tireless heroes.”

I found one of our young nurses sobbing in the dressing room. I hugged her as she cried and wondered what horrible thing she had just been through. After a few minutes, she simply said, “I miss my mom.”

This is normal and we are adapting to a new way of working until we have won this war.

Week 6: THIS MOTHER SHOULD NOT DIE

26 APRIL

I haven’t cried at work for years, but yesterday I felt a deep sadness that stayed with me all day. I cried during my lunch break. I came home and cried in the shower. I then cried again. I took a large glass of wine and cried a little more. My patient died. I am proud of my end-of-life care, but I never thought I would stick my iPhone with Hansaplast on an IV pole and rotate it so that the camera looked at my patient’s face, so that her husband and children ‘with her could be “when she died.

It was the best I could do, but far from good enough. Usually families are with a patient who is holding their hand, brushing their hair and even lying next to them.

This felt so wrong and rude.

This woman should not die. She should nag her children at home to do their homework or brush their teeth. Discuss with her husband what she should have for dinner. Normal mother and family items.

I am a marathon runner. The sheer exhaustion I felt in those last few meters to the finish line is how I feel at the end of a shift on a Covid ICU – without the excitement and the smile on my face. But the support of the public and the kindness of strangers is the same.

Today, the new and amazing community network started by emailing me to ask for cookies gave one of my lovely European nurses a flat to live in for a few weeks. No rent, no bills, just a set of keys and the WiFi password.

It is quieter in the hospital now, but a crazy level still fills the air. I miss the old way of working, the routine, the familiarity.

Yesterday I didn’t recognize a friend in her PPE and when she spoke I couldn’t hear her because my hazmat suit was covering my ears. We laughed and bumped elbows.

How I took our cool navy cotton scrubs for granted and saw the faces of colleagues.

The tide has changed slightly. Staff resilience has blossomed and we are used to our new standard.

We have fewer shots, but none of us want to relax because the invisible monster can lift its ugly head at any moment.

We can only do our best and the employees with whom I have the privilege to do so and much more.

We have many employees from all over the world, from Europe, India and the Philippines. These dedicated and wonderful people help keep our healthcare up to date.

We have the strength to continue to fight this battle. We go to work – you stay at home.

  • The Daily Mail made a donation to @CriticalNhs. To help @CriticalNhs, which provides meals and many other items to support St George’s staff, click the link below. https://paypal.me/pools/campaign/ 113431121376689453.

Additional reporting: Simon Trump

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