Returning to work as an ICU nurse has been a rollercoaster of emotions for Internal Improvement Advisor Jane Ross.
I’ve always been fascinated by people, by wellness and illness and helping them get better. It’s what made me want to be a nurse in the first place. It’s also what made me volunteer to go back to an intensive care unit (ICU) to help out during the current pandemic.
It’s been more than 30 years since I became a nurse, and more years than I care to remember since I was on a ward or in an ICU. I’ve seen a lot of things in that time, working in Liverpool, Inverness, Edinburgh and even Cambodia for a while. I still remember wheeling the first patient in Liverpool to have an MRI scan across a busy main road between the Royal Infirmary and the University building where the MRI was kept. But I never imagined in all these years that I would be helping deal with something like COVID-19.
My last full clinical role was working in the Western General Intensive Care Unit (ICU) in Edinburgh. Since then I’ve worked more on the periphery in nursing education and improvement roles. So when the call came for staff with clinical registration to support NHS boards it felt a natural fit to volunteer to be deployed to the Western to help in any way I could.
Getting ready for the frontline
While I was waiting for a start date in ICU, I spent a week helping interview the hundreds of wonderful volunteers that stepped forward to support NHS Lothian. It was a very humbling experience, speaking to so many people from all walks of life who just want to help in any way they could during this extraordinary time.
“While all the pre-learning and support was wonderful, going back to the frontline on day one was initially terrifying. Yet the moment I stepped in through the doors of Ward 20, I felt held and safe.”
Following this, once clinical upskilling sessions were available, I began an orientation process to a clinical role within the ICU itself. I did a lot of online and face-to-face ‘upskilling’ learning sessions to help prepare me – something I’m continuing to do both on shift and off.
While all the pre-learning and support was wonderful, going back to the frontline on day one was initially terrifying. Yet the moment I stepped in through the doors of Ward 20, I felt held and safe. I was one of many ‘returner’ staff with similar feelings, but from the amazing way we were received by everyone on the staff, we were left in no doubt that we were all going to be alright.
A desire to help
I’m part of a band of deployed returners from a range of different areas. Some come from within NHS Lothian itself, others from university and research roles or, like me, from national organisations like HIS. What we all have in common is a background in critical care and a desire to help in any way.
“I’ve been working 12½ hr clinical day shifts, three per week, with a permanent ICU nurse at the bedside in a mentoring capacity. The basic clinical nursing role is very similar to the one I left – nursing care does not really change. What is very different is the complexity of the care and equipment used.”
My role is to support the permanent staff to care for a huge variety of critically ill patients with or suspected of having COVID-19. I’ve been working 12½ hr clinical day shifts, three per week, with a permanent ICU nurse at the bedside in a mentoring capacity. The basic clinical nursing role is very similar to the one I left – nursing care does not really change. What is very different is the complexity of the care and equipment used.
Seeing our organisation’s work in action
During this extraordinary period, the unit has also taken time to clearly lay out the expectations of all roles and responsibilities for the returners and the unit staff to ultimately ensure patient safety. Caring for patients and their family members in these challenging times has been made all the more difficult with the need for full PPE and the lack of patient visitors. Care is orientated to accommodate such restrictions ensuring quality patient care is the absolute priority.
It’s also been wonderful to see how much of the early improvement work that was just beginning when I worked there is now a mainstay of the daily routine, in particular elements of our organisation’s Scottish Patient Safety Programme (SPSP), which is now an integral part of how care is delivered for every patient, every time.
I want to say thank you to Healthcare Improvement Scotland and the staff of Ward 20 for enabling me to be here. I feel so grateful to the Western General ICU for allowing me to work with them and help in some way. If the world was ‘normal’ I don’t think I would have been able to transition quite so easily. But the world isn’t normal, it’s COVID crazy and these unprecedented times have shifted the axis quite dramatically, which is why we returners are welcomed.
The feeling of coming home
Critical care nursing was where I started my nursing career and I’ve always felt privileged and humbled to be part of it. You’re helping patients, their family and your colleagues navigate complex physical and emotional challenges like no other. It has felt, though I am far older and slower, that I have somehow come home. I am remembering what I have always known, that it’s the little things that can make the biggest difference. I am simply offering an extra layer of support for the permanent staff, the patients and family members during this time. The best thing is feeling at the end of the day that I have helped in some small way.
Jane Ross is Internal Improvement Advisor for Healthcare Improvement Scotland