In February, during the time the world started talking about this new virus we now know as COVID-19, I remember discussing with some colleagues about a hospital in China that had been built in less than a week or so we heard. During the same time, my boyfriend asked me just how much I knew about the virus since it was everywhere. I confessed that I knew very little and had to go and read up bit more about it. Little did I know that a few weeks later, it would not be a news headline but our lived reality.

The COVID-19 infection rate was rising steadily and the death toll was running in the hundreds. I was existing in a continual state of shock, what on earth is going on in my world. One day my Lead Consultant came to me and instructed me to stop going into the ward because everybody was a potential carrier. At that time, the safest option was one of tactical of avoidance. It was a time of deep fear and uncertainty. During that period, I distinctly remember turning up to work one Friday and my Nurse Manager saying “It’s all hands on deck”. She explained that a previous instruction to avoid the ward had was no longer viable as the situation was evolving so rapidly. The situation had reached a point where the wards needed all the help they could get thus all specialist nurses had to be brought on board and necessitated a plan for redeployment.

To my horror, initially she advised me that I was either going to the COVID Positive ward or go up to the Intensive Therapy Unit (ITU). I remember telling her that I would not go on to the ITU as I would just not know where to begin with the specialist equipment they use in the department. I had not been ward based in years and would not possibly manage in ITU. In all honesty, I hadn’t worked in a ward since 2013 when I left to become a specialist nurse. I didn’t think I had the up to date clinical skills to provide the necessary care required for ITU patients.

Due to my apprehension about working in the ITU, she said I would likely be deployed to a COVID positive ward but since things were still up in the air, nothing was immediately confirmed. By that afternoon, I had received an E-mail saying I had to go onto another ward in a different site. As opposed to a COVID Positive ward, the ward I was to report to was a Rehab ward for discharged patients that were either waiting placement in care homes or needed more physio or some sort of additional occupational therapy input. I remember getting home and thinking, “Thank you Jesus I am not going onto a COVID positive ward.” All was right with the world. Well, in my little world anyway. The weekend came and I successfully stuffed the whole business in the furthest recesses of my mind. I did not want to think about it because that would make it real and my nerves would get the better of me. Instead of being worried about COVID, the one concern that dogged me was wondering if I was expected to be the nurse in charge since I would most likely be the most senior nurse in the ward.

On the Monday morning I woke up with the thought of Abraham’s servant on my mind. In Genesis 24, Abraham sought a wife for his son, Isaac. He entrusted this duty to his lead servant, making the man swear that he would not find Isaac’s wife among the Canaanites who were idolatrous and so unlike Isaac. After crossing the desert, he began this prayer, "O LORD God of my master Abraham, please give me success this day, and show kindness to my master Abraham.”  I adjusted it a little that morning to say “God give me success today and show me kindness.” After my Morning Prayer and preparation, I drove over to the hospital dressed in my immaculate uniform with the belief that I would go straight to the ward and start working straight away. As I was walking down the corridor I came cross a colleague I worked with in the same team previously. We had been deployed to the same hospital and ward so it was pleasant to see a familiar face. My pleasure was however overshadowed by my shock when I realised she was getting changed into scrubs. As if that was not enough she further put on full PPE (Personal Protective Equipment) compliment. I was not expecting at all to put on full PPE because this was just an ordinary rehab ward, so I walked up to her to enquire what was going on. She told me it was a COVID Positive ward with End-of-life care. I literally felt the earth collapse from under me. I could have just walked back to my car and driven away. That’s exactly what every fibre of my being was telling me. But in the midst of the thick haze of fear and confusion, a voice reminded me that I turned up for work and was expected to be present. I just had to gather myself off the floor and get on with it.

There was a nurse from the Infection Controller and she was there explaining how to effectively don the PPE: “… put on the fluid resistance gown first. Then don the surgical gown fully covering torso from neck to knees to end of wrists. You put on the mask securing ties or elastic bands at middle of your head and neck. You place the visor on your face and eyes and adjust to fit. Put on the double gloves extending to cover wrist of isolation gown…” I was sweating already. It was probably a combination of anxiety and the fear of the unknown and now I had to add the layers of protection. Once on the ward, you cannot remove the PPE. The only way was to physically leave the ward and even then there was a procedure just as elaborate as the first one on how to safely remove the PPE and correctly wash your hands. To be honest I only caught half of what she said in those minutes, the other half just went in one ear and came out the other.

All I could do to keep it together was to tell myself that I needed to survive this and continually asking “God, just get me through today. I just need to get through today.” And he did.

The weeks that followed were difficult. End-of-life care is where patients had a “Do Not Resuscitate” (DNR) order were being sent. So literally all we were there for was to keep them comfortable until they pass away. It was all about trying to give them as much of a dignified and comfortable death as you possibly could. It was particularly hard for me as I hadn’t had to deal with dying patients since my training days which had been over ten years past. On my first day on that ward however, three patients died and I had to perform “Last offices”. This is a procedure performed to the body of a dead person shortly after death has been confirmed. This meant wash them, drape them in a shroud and get them in a body bag. To say this was taxing is a gross understatement. It took a massive emotional toll on me and I had to literally disconnect from reality in order for me to perform my duties. I remember a colleague asking me afterwards why I even bothered to talk to them while washing since they were already dead.

I still felt the sense that their spirit was still in the room and it was just out of respect. Even in death, to me this was a human being who once walked the earth and had people who loved them. Somebody's mother, somebody father, Somebody's daughter, somebody's grandmother. So you still have to respect that. I could not just go shoving them in a body bag. I still talked to them whilst I was getting the shroud on. I still talked to them as I put them in the body bag. That first shift took a lot out of me. I got home and tried talking to my boyfriend about it, emphasis on tried. I was so emotional that he could not find the right words to console me. So at a loss, he just decided to focus on other things in the news and I remember crying as soon as he put the phone down. I cried myself to sleep that night.

As time went on I realised that I had to shift my mind-set in order to survive. I stopped taking every death personally. I learned to disassociate my emotions in order to be able to focus on the task at hand. In the three weeks that followed, I also learned to leave work at the door as I walked out. Once I was out of that building and in my car, I was Kate. Not Kate the nurse. Not Kate working on the COVID positive ward. Not Kate working on the End of life care. I was Kate, just another member of the human race. And then when I came back in the morning I focused on the care I needed to give.

A source of buoyancy, though, during those dark days was seeing patients being discharged. That gave me hope that it wasn’t all doom and gloom. The pandemic on the whole seemed like a death sentence.

So seeing patients that had a DNR being picked up by the hospital transport without the need for a body bag was a marvel to behold. Life however was not without the occasional body blow.

I remember one patient I had that was getting ready to be discharged back to her nursing care home. She had been video calling the previous night and when I went in to check on her the morning just to make her comfortable, she had passed on. Just when I was on my road to emotional recovery.

I have since moved from that ward and do not have to deal with death as much anymore. I believe I am a much stronger person today thanks to the experience. There are days when I look back on it and let out a sigh thanking God that I don’t have to go back into that situation ever again. I developed a whole new level of respect and appreciation for all the nurses on ITU or Critical Care or High Dependency Unit (HDU) because I couldn’t do it. Every day I wonder how they still manage to come back day after day because it is not only such an emotionally draining occupation but it is physically demanding as well due to all the PPE layers. On top of that, there is that clear and present danger of contracting the virus yourself.

When people are in their last moments of life, it is imperative that they experience that human connection and touch. This is next to impossible when you are wearing double gloves. When a baby is born, the midwives always place the new born on mum’s chest so the new born gets to feel that human touch. Come to think of it, it is the same at end of life. But with COVID it’s just not been possible because PPE everybody is gowned up you need to protect yourself and you also need to protect all the other patients you are looking after as well.