Apron… mask… gloves… action… or so I thought as I donned my personal protective equipment (PPE) to help a patient out with their meal. Working through a pandemic can have some bizarre effects on your psyche…
Hello everyone! A quick introduction: my name is Ash and I am a third-year ScotGEM student. Like most of you, I decided to use the lockdown as an opportunity to wholeheartedly dedicate myself to exams and studies. My disposition involved my array of notes sprawled across my bed, my phone hosting multiple social media apps, music playing from a tab somewhere on the internet, Netflix in the background, Cheetos on my left hand and lastly writing this blog with my right hand. I am glad we are on the same boat. However, perhaps somewhat differently, I also found myself working at my local hospital as a healthcare assistant (HCA)… and what an experience that has been.
Why did I go back to work?
When face-to-face teaching was suspended about two-thirds of the way through my second year on ScotGEM, it was a strange but mostly expected situation. I decided to pack my bags and move back home for what would no doubt be until third year commenced. I was grateful and fortunate to be spending some quality time with family as I had not seen them since Christmas, however, I equally felt I had a lot of time on my hands. Sure, lectures were waiting for me to be written up since last August from my Paediatric rotation, but a greater part of me wanted to contribute in some way during this global crisis. It felt only right going back to work for the NHS.
Before this paints the utmost, ideal image of altruism, realistically I needed to start saving for next year too. Like most graduate students, organising finances and budgeting for the foreseeable future is something we are all too familiar with.
Despite arranging a means of income and alleviating some of the financial strain for my next year, that did not ease my parents’ concerns. The decision to return to work was not taken lightly; it did not affect just me but could have some consequences for my family too.
Working as an HCA
I first picked up my role working as an HCA in my gap year between my undergraduate degree in London and starting ScotGEM. During this time, I enjoyed working in the hospital environment and gained invaluable experience. This was a period of great learning for me as I came across several situations that I had not been prepared for; not all your patients will read the textbook!
I learned the basics including how multidisciplinary teams worked and how to monitor patient vitals using the NEWS (National Early Warning Score) chart. However, my role also taught me to be more caring, understanding and compassionate as I encountered individuals from many different walks of life.
What is different about working in a pandemic? The good, the bad, the worst…
Despite my parents’ valid concerns, they helped me find my uniform (it is always the place you least expect) and more importantly, discussed the logistics of travelling to and from work to minimise infection spread. Of course, things were going to be a little different than they were on my last shift as an HCA.
On my first day of work, I had arrived only to find out that the ward I was supposed to be working on was closed. After some searching and finding the appropriate staff, I was reallocated onto the Critical Care Unit (CCU) which was a COVID-19 ward. It turns out they were restructuring the system to better reflect the current circumstances. Whilst I was in CCU, I was assigned as a runner rather than working inside (I yet had to be fit-tested; more on this further below). This mainly involved grabbing items from store cupboards for staff who could not leave the area as they would have to doff their personal protective equipment (PPE) and don a fresh set again otherwise. Most of it was attempting to slide things through the doors which were slightly ajar – some innovative skills were required to say the least. To give you some idea of the internal workings of the NHS, we could not find any foot covers, thus resorted to using aprons and wrapping them around our shoes. I have not worked in CCU since then, so I wonder if they have restocked.
When I worked as an HCA during my gap year, despite it being quite busy, there was a sense of stability. I always worked on the same ward, with the same staff and there was a continuity of care for my patients. However, in present circumstances, no-one can be sure what each day will present with. Some days I was on a COVID ward; where I felt I spent half my time donning and doffing PPE, so much so that I dreamt about it. Other times, I was on non-COVID wards, still taking extra precautions and constantly ensuring I was maintaining good hand hygiene. Dry hands are most definitely a by-product of this line of work. Occasionally, I was even redeployed halfway through my shift from a COVID to a non-COVID ward, it was all quite uncertain and odd at times.
FaceTime and phone messages became a common way to keep in contact with relatives and for updating next-of-kin appropriate care plans. One thing I had hoped was not coming in the way of my care, ironically, was my face mask. As healthcare workers we are so used to providing personal and individually-tailored care for our patients. Wearing all our protective gear can seem like that has been taken away from us sometimes. However, safety and precautions were crucial. I hope I conveyed my empathy towards the patients nevertheless.
Whilst the physical demands were evident, likewise it was also emotionally draining. On the same shift, I could experience the full range of human emotions. On the one hand, I could be holding back tears while facing distressing circumstances. On the other hand, I could be laughing and filled with joy working with the team. To be frank, it was a bag of unexpected situations and no one knows exactly what will happen one day to the next.
Before the pandemic, I was able to unwind by visiting friends, going out and having evening dinners. The importance of social distancing is indisputable, however, it can and has taken a toll on mental health. On my days off when I was not busy rushing around and getting up to date with everything, it tends to all catch up to you. Working in healthcare during a pandemic can be unforgiving, it does not always allow for us to breathe and take a moment for ourselves. I guess this a valuable lesson for me as a medical student to reflect upon and validate my feelings more often since it is so crucial for mental well-being.
Nevertheless, like many other healthcare staff, we have become accustomed and found some order to the madness. The sense of community across the NHS is patent. Staff are working tirelessly to provide patient care, and I have been fortunate enough to be a part of an incredible team.
Did I have enough PPE?
I was lucky to be equipped with the required PPE during all my shifts. On one occasion I had to take a respirator fit test. The fit test essentially checks if the special FFP3 (filtering face piece ‘level 3’) mask fits the individual’s face and whether it can provide protection against droplet particles in the air. This involved wearing a plastic helmet with a hole in it and a staff member spraying a bitter substance into the hole (denatonium). The idea was if I could taste the bitter substance being sprayed inside the helmet then I would not have passed the fit test as that type of mask wasn’t providing me with enough protection. Unfortunately, I tasted the bitter substance and failed the test. Subsequently, if I came into contact with patients who were COVID-positive and were undergoing an Aerosol Generating Procedure (AGP), I needed to wear extra PPE with a machine filtering the mask.
Balancing studies and work
I guess I should probably mention ScotGEM at some point (don’t shoot me). Working part-time and studying can present a host of challenges. However, it is not something new to me, nor am I the only individual doing it. If balanced correctly with time, it can be productive and fruitful.
Under normal circumstances, I usually worked the holidays and kept studies aside for term time. However, since I was back home for term-time due to lockdown, it was a strange environment to be studying in. There is no real advice I can give that you guys probably do not already know yourselves. All I can say is try and keep the balance of the two and keep your head in the game.
Last thoughts
So that was a bit about my experience of working through lockdown as an HCA! I hope you guys found this interesting… or at least cured your insomnia! Stay safe.
