COVID-19: What Will The Lasting Changes Be For ICU Nurses

"We will get through this but the end is not yet in sight."

With many desperate to return to ‘normal’, ICU Deputy Charge Nurse, Suzanne, looks at some of the lasting changes to ICU wards, and highlights the growing anxiety among Nurses about the coming winter.

Topics covered in this article

Introduction

Things Are By No Means Back To Normal

Elective Surgeries Have Started Again

PPE Has Become The Norm

The Public’s Reaction Has Been Varied

ICUs Have Been Supported By A Wealth Of Great Relief Staff

The Reality Is, We Are In Very Uncertain Times

Introduction

As the Covid-19 lockdown starts to ease and daily routine starts to resume for many of us, how has life in an intensive care unit changed following the crisis?

The early pressure and panic of the Covid-19 outbreak may have subsided but it will stay in the hearts and minds of our Nurses and NHS staff for years, if not the rest of our careers.

It has been the most challenging period we will hopefully ever have to face.

We should all be extremely proud and supportive of the fantastic service every NHS worker has shown this year.

Things Are By No Means Back To Normal

Life in an ICU has improved in the last couple of months but by no means is back to how things were before Covid-19.

Changes have been made that will stay in place for months to come.

Things have changed from week to week during this summer and we are all still adjusting to a “new normal” in our daily roles.

Many changes we have seen in our ICU’s in recent months will remain in operation until there is a definitive end to the crisis, and nobody really knows when this will be.

Full PPE for example isn’t going to end anytime soon.

Everything that can be disposable is now disposable, a needed safety precaution but also a huge increase in materials and disposal.

Elective Surgeries Have Started Again

Elective surgeries have started again and this brings a new challenge and way of working to our ICUs.

These patients now need a protected pathway while under our care.

This includes pre-admission Covid-19 testing, isolation and shielding while in on the unit, repeated testing while under care to ensure infection has not taken place, and follow up testing after being discharged from the unit.

This is the new normal for an elective surgery patient: more planning and more testing.

Lots of the changes in our ICUs are the same as everywhere else.

PPE Has Become The Norm

We are all getting used to the new ways of working.

PPE has become the norm, one-way systems are in place everywhere, meetings and handovers must be socially distanced.

All these changes come with little problems and extra requirements.

What would have been a simple five-minute meeting last year is now a logistical challenge.

The impact of masks and PPE reaches further than just our safety.

Effective communication through masks is a learning curve for us all.

Life in an ICU is full of emergencies and sudden intervention.

At these moments a Nurse may find themselves needing to call for help, a mask will muffle this call and make it harder to be heard.

It’s also much harder to read people's facial expressions when hidden behind a mask.

A big part of an ICU Nurse’s job is caring for the relatives of our patients.

This aspect has radically changed, it has been hard for people to accept and adjust.

We are often present for a person's last goodbyes with their loved ones, now all these emotional moments are taking place remotely via technology.

This change brings an ICU Nurse into the situation in a very hands on role, holding up a tablet for someone to say goodbye to their loved ones is not an easy task.

These moments will stay with us.

The Public’s Reaction Has Been Varied

I’ve seen quite a range of different public reactions during the outbreak.

Out of work I have been strictly social distancing so have not mixed with anyone out of my daily routine.

Many friends and acquaintances have been extremely supportive, as they are aware of what I do.

Around work I have seen some less supportive reactions from the public.

Recently a team of us were transporting a very sick patient for a CT scan.

While passing through the department an individual who was also waiting for a CT scan made a number of comments implying that my patient must be infected with Covid-19 as our team were all wearing facemasks.

This individual's comments and reaction was ignorant and insensitive.

Firstly, it would be completely unethical for me to discuss a patient's condition with a stranger.

Secondly, my team and myself would be wearing full PPE no matter what the patient's diagnosis was.

The real absurdity of this incident was that the complaining individual was wearing a mask themselves.

A very sick patient’s experience was impacted by this individual's ignorance.

ICUs Have Been Supported By A Wealth Of Great Relief Staff

During these hard months we have been supported by a wealth of great relief staff.

It’s been amazing to see so many people stepping up to help.

As these people start to return to their normal department and roles, many of them are leaving us with a new appreciation for what we do in ICU.

These Nurses will take the experiences they had back to their own departments and work.

I don’t think many will forget their time with us.

A number of relief staff have had their horizons opened, and been pushed into roles they may not have had the confidence to perform otherwise.

Stepping out of your comfort zone and taking on a new challenge can be tough.

Sometimes people just need a push.

I’m overjoyed to see as many as 30 of our temporary relief staff applying for full time positions in ICU as a result of their time with us.

It’s encouraging to know that even in the hardest of times, people can be inspired to take on the role of an ICU professional.

We will all benefit from adding these people to our team.

The Reality Is, We Are In Very Uncertain Times

The reality of the situation is we are still in very uncertain times.

The situation is still changing and the threat is still out there.

Apprehension about the coming winter is starting to build among staff.

We don’t know how long the changes will be in place, if the “new normal” will last forever, or what the next few months will bring.

Every time I see a call for bank staff, I think ‘is this the start of a second wave?’.

Lockdown may be coming to an end but we all still need to be vigilant and responsible.

The threat is still here, the danger is still real, don’t take chances.

We will get through this but the end is not yet in sight.

Let me know in the comments your thoughts on the changes in your workplace and what I've said about ICUs - let's chat there!

Oh, and please Like this article to let me know you enjoyed it - thank you!