Intensive care angel

It’s early morning in the UK, but Hannah’s already been to a workout class and is eating her breakfast when we chat, her long hair wet from a shower.

‘Busy is probably the word to use for my lockdown,’ she says, inbetween mouthfuls of porridge. ‘I’d go to work and I’d be doing my normal job, but it was the multitude of patients we had to go and see; the number was just ridiculous.’

Hannah works for the NHS (National Health Service) as a Senior Respiratory Physiotherapist in intensive care, and during lockdown was treating COVID and non-COVID patients.

‘It was mainly patients with COVID; actually the worrying thing was there weren’t as many people in intensive care for non-COVID reasons, it was pretty much empty compared to the normal turnover of patients.’

Hannah says they weren’t really sure why, and suggested perhaps people were too scared to get medical help, hospitals now seen as dangerous places, a COVID breeding ground. A lot of planned surgery had also been put on hold, resources redistributed elsewhere, reducing the need for post-surgery intensive care.

‘It was manic, actually. We changed our shift patterns completely, doing longer days over shorter weeks, rather than a standard five-day week. On the COVID ward we were in full PPE, all day. Thankfully we had enough, but it was horrible to wear. Really sweaty.’

She’s referring to the hazmat suits that they had to wear. ‘To start with we wore gowns, and when we ran out of those, we wore the big yellow boiler suits with white masks. You had to press the masks down onto your nose to get a tight fit, which caused a lot of people to get sores. Then it was either goggles or a visor, and gloves.’

She takes a sip of her drink and says, ‘it was like we were going on the Crystal Maze.’ We both laugh, lightening the conversation a little. ‘It was just a completely different way of working. It still is now, on certain wards. It’s hard though, because when patients wake up they see us dressed like that and they’re frightened, because they don’t know what’s happened and why we look like that.’

The peak was in the first week of April, two weeks after the UK lockdown started. Hannah said: ‘We doubled the amount of beds in ICU, which made things so difficult. There were no curtains around any beds, no privacy. We had to get ventilators from random places that no one knew how to use. Nurses came out of retirement to help, and didn’t know how to use the normal ventilators, because they were so different. It was a massive learning curve for us all. We saw doctors we’d never seen, like oral surgeons who’d come to lend a hand because their surgeries had been cancelled.’

The patients being admitted were young-aged between thirty and sixty-and the majority stayed in intensive care for a couple of weeks. ‘I felt a bit uneasy. You just didn’t know how the patients were going to do. The national average of COVID intensive care survival rate was 50/50, and there was nothing to tell us how it would go. They could be old, they could be young, fit and healthy, not fit and healthy, and you just had no idea which patients wouldn’t be there anymore when you came in the next day.’

Hannah says that not enough is known about COVID yet, and that they were following research in other countries to see what worked and what didn’t. ‘COVID patients have severe lung inflammation which means they don’t get enough oxygen, and there’s really not a lot you can do about it apart from let them have a rest on a ventilator. This breathes for them, allowing enough oxygen in, and gives the patient’s body a chance to try and heal itself.’

Hannah said: ‘Two people could have a different outcome; it really was dependent on how their body reacted to the virus. Because there’s no evidence to refer to, it’s almost trial and error, so it’s quite scary. You couldn’t rationalise anything you were doing. I felt a bit useless, like I can’t really help this person.’

They found those who weren’t doing so well were people that had waited to get treatment, thinking they’d get better. Hannah recommends that if you’ve been ill for over a week and you’re not getting any better, please go to hospital. Something not covered on the news, is the fact there are whole wards dedicated to palliative, end of life care for COVID patients. A ward where people go to die.

The lack of curtains and the increased number of beds meant Hannah and her colleagues were often having to treat patients right next to someone who had just died, and it may be some time before they were taken away. ‘It was one of the hardest things we had to see, and for the other patients too, because not all of them were unconscious on ventilators; a few were awake. I mean, I know it happens, and I can’t save everybody, but it’s not something I see regularly. We all took on such different roles. We had to help clean the bodies and put them in the bags,’ she pauses, ‘and put hazardous waste tape over them. That was hard.’

She tells me they’re very much a profession that just goes in and gets on with it though, saying: ‘you do what you need to do. We have counsellors provided for us, so there’s someone available to talk to on a regular basis and we get great support from all the staff, managers and consultants. I was so tired though. I didn’t think I was doing much differently as such, but I’d get home from work and collapse on the sofa, absolutely exhausted.’

Even though the peak is over and the levels of patients are more normal, Hannah is more nervous now, because COVID is still around. ‘I’m scared the country is not prepared for it. We’re sitting and waiting for it to happen again now; when you’re in the thick of it, you can just react. The first time we didn’t know, but now we do know what’s around the corner and you only have to look out the window to see that people just don’t seem to get it.’

I ask Hannah if she’s worried about catching COVID19. ‘Oh yeah. As fit as I am, I don’t know whether my body will be able to fight it or not. Our youngest patient was 30, and I turned 30 during lockdown, and it made me feel a lot more vulnerable that I normally do. It’s the unknown that’s scary; we still don’t know enough.’

Hannah is proud to work for the NHS, and hopes the respect shown for health workers during this continues long after COVID19. ‘The teamwork was amazing; everyone was so supportive and worked really well together. I felt lucky; despite everything, it was still a nice place to go to work even though what was happening wasn’t nice.’