A Nurse’s Tale 2020

Jess looked at her in disbelief, “Mum, please tell me you’re not serious, do you know how dangerous this can be, especially at your age, please, I beg you, think about your family, what about your Grandchildren?”. Jess had walked in as her mum was looking at an email, her welcoming smile disappeared as she looked over her mother’s shoulder at the screen, she saw the words ‘We would love to welcome you back at this time of crisis, please attend your local ICU at St Mark’s in Chancery Square, tomorrow at 11.00am’.

Anne looked at her daughter, she knew she was right, but she also knew that it was something she had to do, they needed her. The request hadn’t come as a shock, she knew how dire the situation had become, so she’d applied for the work a few weeks ago. That morning as she opened the email her heart pounded, she had nearly deleted it as spam until she noticed the NMC logo. It was a long-awaited reply from the Nursing and Midwifery Council, she had been reading it and reminiscing, unawares that Jess had walked in with the children.

Anne had retired from Intensive care back in 2016 when her husband David was diagnosed with prostate cancer. Seeing the logo brought back so many bad memories. She recalled how angry she had been with herself, why hadn’t she picked up on the number of times he went to the loo, why hadn’t she seen the signs. She should have made him go to the doctors the day after their Silver Wedding anniversary, he had felt poorly all day but insisted it was just a tummy upset, it certainly wasn’t worth stopping the party for. The problem was that he had been far too independent, and Anne had been too busy wrapped up in her own little world and career, too busy to even look after the man she had loved for nearly thirty years.

“Mum, are you not listening?” the anger in Jess’s voice cut her off cruelly from her memories. “Yes dear, I have thought about all the consequences” she sighed heavily, “it’s just a pity we hadn’t thought more about the consequences four years ago”.

Jess looked hurt, but knew she was right, if she too had been more attentive back then -well – her dad would still be here, they had all known that there was something wrong, but as long as she got her jobs done around the new house that she and Andrew had just purchased then it was fine, besides he was stubborn, when he winced in pain and she showed concern he would brush her away and make light of it, ‘Your mother’s lasagne playing my tummy up’, the other thing was that he couldn’t be doing with doctors or hospitals, Jess couldn’t remember him ever being ill, he exercised regularly and enjoyed life to the full – until that night – it hit them as hard as it had hit him. That evening they had asked her to ‘pop around’ with Andrew, she knew something was wrong, her suspicions were aroused when her dad insisted that they come without the Grandchildren, Jess remembered sitting in the lounge staring at the picture of her mum and dad’s wedding day, she remembered thinking how young he had looked 26 years ago. But all she remembered after that were the words ‘prostate’ and ‘cancer,’ the rest was a blur and still was to this day, the only other thing she remembered was Andrews comforting arm around her shoulder and that desperate and silent drive home. Less than twelve months later they were stood in a church singing the words to ‘Abide with me’.

“I let your dad down” Anne said, “I just feel that I owe something, I need to give something back”, her words fell on deaf ears, she didn’t even hear the grandchildren’s ‘bye nana Happy Easter’ as the back door quietly closed. She didn’t blame her daughter for being upset, Jess hadn’t even wanted her to go back to the hospital. But David’s death had left a big hole in Anne’s life. Last year she had told her daughter that she was going to do voluntary work in a charity shop a few miles away, but in reality she had secretly returned to work at the hospital in another clinical department.

After a three year break from hospital work, where she’d mostly been in intensive care nursing, Anne had been thinking seriously about a return to clinical work for some time. But Jess would have been dead against it, even so, Anne had joined her local trust’s nurse bank in December the previous year and had secured a part-time post in endoscopy.

When the COVID-19 pandemic hit, it seemed obvious to her that she should first find out whether her rusty intensive care skills could be useful to the local trust. She searched online and found an application form, but it had been three weeks and she hadn’t heard a thing – until this morning.

Returning to intensive care after a four- year break was going to be so daunting, she stared at the email again, trying to convince herself that it was the right thing to do. Anne didn’t sleep too well that night, it wasn’t the thought of a new job that kept her awake, it was the way Jess had left earlier.

Despite the lack of sleep, she was up at 6.00am, she had a light breakfast and seemed to take an age sorting out her old uniform, she tried it on, she was pleased that she had kept her figure and hadn’t put on weight.

By 10.00pm she was in her car and on her way to the hospital, it was only a few minutes away but after four years she wanted to familiarise herself with it once again, the endoscopy clinic had been a good stop gap, but it couldn’t compare with the hustle and bustle of the hospital.

Yet it was very quiet, but then she realised it was Easter Monday. As she walked around there were a few familiar faces, a few nods of the head and a few smiles, it was 10.45 as she entered the outer doors of the ICU, she thought how ridiculous it was to have butterflies in the pit of her stomach at her age, then the faces became more recognisable, except for the masks and PPE, even under all that she had recognised old friends, but she couldn’t help noticing how tired and stressed some of them looked. When she reached the rest room a large group of old friends welcomed her with open arms.

After a few catch-ups Anne reported for duty, she put on scrubs and was orientated to the unit. The first part of the brief induction was a ‘fit test’ for her personal protective equipment (PPE), which involved trying on a face mask and a protective hood.

An aerosol was then pumped into the hood and she had to move around and pretend to talk to a patient. The aerosol had a bitter taste and the idea was that if it got through the mask, the wearer would taste it and know that the PPE is not working properly.

As the day went on, the gravity of the crisis hit her. Elderly women and men openly cried as they lay there completely alone except for the strangers in masks and hoods bustling around and now and again surrounding them as it took six to turn them over on to their stomach to allow easier breathing. At one stage she felt so tearful that she had to go out and rest, she tried to call Jess but there was no answer. She was sad as she returned to the unit prep room, once again she donned the unfamiliar equipment. It took seven minutes to test the mask. Anne learned to ‘don and doff’ the full PPE, undertook simulations to correctly place patients in the prone position and refreshed her knowledge of how to react to a cardiac arrest. The rest of the day was confined to basic nursing which was firmly embedded in her mind, by the end of her shift it was as though she had never been away.

Anne sat in the comfort of her lounge reflecting on the day’s events, the tv was on  but it was just background noise, a bit of company,  she still had that tight knot feeling in her stomach, would she cope on the unit tomorrow, or would she be overcome by it all, her thoughts turned to Jess, she had tried her phone twice but just got the recorded message, why wasn’t she answering, her thoughts were shattered by the doorbell.

As she opened the door expecting to see Jess, she had looked almost disappointed,

“Oh, Hi Andrew, come on in, is everything alright, are the children ok – is it Jess?”

“Everything’s fine Anne, calm down”, the three grandchildren came bolting in behind him, each giving her a cuddle as they passed and headed the well trodden route to the sweet cupboard in the kitchen.

“Where’s Jess, is she ok?”

Andrew took her hand in his, “She won’t come, you know how stubborn she is, she’s so upset by your decision, how did it go today by the way?”

Anne brushed the question aside, as she filled the kettle, the children were excitedly looking through cupboard doors, “Your eggs are in the lounge cupboard kids” She noticed that Andrew seemed a little on edge. “What’s going on Andrew?”

He looked sheepishly, hesitant to speak, “It’s er,, well we’ve decided to go to my mum’s for the Easter holiday, Jess has 3 weeks off so we thought we’d take advantage and go while we could”.

Andrew’s mother Harriet, lived on her own in Truro, Cornwall, she had been put on the extremely vulnerable list, she suffered from COPD after a lifetime of smoking 60 a day.

Andrew felt uncomfortable, “Sorry Anne, haven’t got time for tea, so much to do, you know, packing and things”

“When are you going?”

Once again Andrew hesitated, “Er, about five in the morning, it’s a long drive”. Andrew pecked her on the cheek, “Come on kids, say bye to Nana”.

A tear rolled down Anne’s face as she sat sipping from the mug which said ‘The best Mother in the world’, suddenly the room felt so quiet, she felt so alone, she cried herself to sleep that night.

The next day she was allocated to work with an experienced intensive care nurse, who she shadowed while she was caring for a patient. If Anne’s return to intensive care had taught her one thing, it was that the principles of good nursing care are timeless and constant, and regular and effective communication with patients and the multidisciplinary team (MDT) was even more important now than it had ever been. She was pleased that she’d remembered all of the key elements of the role – checking oxygen and suction, the ABCDE approach, checking lines, most importantly, the thorough cleaning of all surfaces and the urgent need for regular restocking.

Thankfully, the technical sides of the job had hardly changed; the ventilator settings were the same as they were on her last intensive care shift in 2016, as were the hourly checks that frame the routine of the day.

During a short break she phoned Andrew to check that they had arrived safely, they had. She was just wishing that Jess hadn’t left on such bad terms, for the next couple of weeks she threw herself into her work, she worked relentlessly day and night, as many hours as she was needed, she cried many tears, not over her own situation but for the patients she cared for, for those patients that weren’t going to be there on her next shift, after very emotional times at work she found herself going back to an empty and quiet house.

She had also forgotten the stressful and emotional side of the work. The Covid patients weren’t allowed any visitors even when the patients were nearing death, it broke Anne’s heart that she was sometimes the only source of communication between those patients and their poor families who were desperate to hear any glimmer of hope. Sadly, in most cases Anne had no hope to offer, she wept silently every time she had to relay the sad news to the families.

Over two weeks had passed, Anne had been phoning Andrew and the grandchildren on a regular basis, but she and Jess still hadn’t spoken since that night. Then one day – at the end of a particularly traumatic shift when a patient had pulled off her hood and left her gasping for air – the phone rang, she answered it expecting to hear the voices of either Olivia, Emma or Jack her grandchildren. But it was a tearful voice;

“Hello Mum, can you hear me, it’s Jess, I’m so sorry, I’ve been so stupid, can you ever forgive me?”

Anne could feel a big weight being lifted from her shoulders as she too wept, “there’s nothing to forgive my darling”. They spent the next hour catching up with the fortnight’s events, exchanging bits of gossip and Jess even asking what it was like to be back at her own job, “All I ask mum is that you are really careful, please don’t take any risks, promise me”.

“I promise” Anne said, as she recalled the patient desperately wrenching her hood off earlier.

For the next few days Anne had a spring in her step, she was so elated that Jess had called, all was well within her world, the extremely cold weather had left her with a bit of a cough and she had the sniffles, at first she thought the worst but then she thought that she was probably just a bit run down, she called at the shop to buy tissues and was surprised to see that no- one in there was wearing a mask, not even the young man that had served her. Anne was glad to get out of there – didn’t people realise the dangers – she thought as she pulled a tissue from the box and blew her nose for the umpteenth time that day.

Jess would be back next week, she couldn’t wait to see her and decided to get her and the children little gifts to welcome them home. Every shop she went into, there were people walking around, greeting each other with hugs and handshakes and nearly every one of them without a mask. She sneezed and was glad that at least she had been wearing one.

It was the next morning as she was getting ready for her shift, she suddenly felt very fatigued but put it down to the fact that the consistent dry cough had kept her awake most of the night. By the time she reached the hospital she realised that there was something terribly wrong, and the thought in her head terrified her.

Her hands were trembling as she pressed the buttons on her mobile phone, her friend Beth was there within ten minutes and confirmed what she already thought.

Jess was preparing the tea for the family, it had been a good day and she was so elated that she had finally plucked up the courage to speak to her mum a few days earlier, the weather in Cornwall had been quite mild and they had all enjoyed their stay at Andrew’s mother’s house, but in a couple of days they would be back home,  Jess couldn’t wait to throw her arms around her mother, to tell her once again how sorry she was over that silly row. After tea they were sat watching Coronation street when her mobile phone rang, she didn’t recognise the number;

“Hello, is that Jess?”

“Yes, who is this please?”

“Hello, my name is Beth, you don’t know me, but I used to work with your mum a few years back, are you ok to speak?”

The TV was up far too loud, Jess left the lounge and went into the kitchen.

“Ok, I can hear you now, what’s happened is Mum ok?”

“Look I don’t want you to panic, but Anne’s – sorry, your mum’s been admitted to hospital with suspected Covid 19, the tests aren’t complete yet of course but I’m afraid to say that it looks more than likely”.

Those few words after Covid hadn’t registered with Jess, she had dropped the mobile on the worktop and struggled to hold herself up, she could hear a very feint ‘Hello, hello, Jess, are you still there’, by this time a concerned Andrew had entered the kitchen, he looked at Jess, there was no colour in her face, he heard the distant voice and picked up the phone;

“Hello, who is this?” A few minutes later jess and Andrew stood holding each other, she was sobbing into his shoulder.

“I told her, I warned her that something would happen, Oh my God I need to phone the hospital”.

Two hours later they were on the motorway heading home, it was dark and the children were asleep in the back of the car. snippets of the phone call to the hospital were going round and round in Jess’s head, ‘She’s in good hands, coronavirus, confirmed, poorly intensive care, ventilator.:

The next day Jess rang the hospital, there was no change, her mum was being supported by a ventilator and had been put into an induced coma, no visitors were allowed but she was free to ring at anytime, it may take a little time for someone to answer though.

Over a week had gone past, Jess insisted that Andrew went back to work, it was senseless the both of them being off, she tried to busy herself, she baked, drank for more coffee than was good for her, and spent a lot of time quietly crying, the children didn’t understand the severity thank God, they assumed that nana was poorly and would soon be better.

A few days later Jess was weeping openly, why on earth had she decided to sort out the family photo’s, there were hundreds of them, memories of her dad, memories of past holidays spent with mum and memories of the children, she was kneeling on the floor when a little hand slipped into hers;

“Are you alright mummy?, please don’t cry”,

It was Freddie, her youngest, he threw his arm around her neck and squeezed tightly, “I’ll look after you till dad comes home”.

Then her phone rang, she looked at the number, it was the hospital, she was almost afraid to answer it.

When Anne woke she was in familiar surroundings, yet it didn’t look the same, there were people all around her, people she knew, was she dreaming, what had happened?

“We’re going to look after you, please don’t worry,” Anne squinted toward the sound of the voice, what was wrong with her eyes, why was she struggling to breathe, she could feel the mask on her face choking her, she tried to pull it off, the young nurse put it back on, she desperately tugged at it again, trying to deprive herself of the oxygen her body so badly needed to survive, it was a few minutes before the team had calmed her down. Anne was suffering from severe delirium, she was disorientated, confused and agitated. Her throat was really sore and it hurt to breathe, even on a ventilator.

“Good morning, is that Mrs Windsor?”

“Yes” Jess  replied quietly.

“This is Dr Kujardi from the ICU, we have some news about your mother”.

Jess’s heart had almost stopped at this stage.

“As you are aware, she has been in an induced coma for eleven days, well we brought her out of it this morning and all the signs are good”.

Jess almost screamed with delight.

“We will have to continue with her ventilator for a few more days as there may be slight lung damage, we are however, optimistic that she will eventually make a full recovery. But you must realise that it is only the beginning of a long process of physical and psychological recovery”.

Jess didn’t care, she wanted to go outside and scream to everyone that her mum was ok, but she had to contend with three excited grandchildren screaming and whooping as she told them the news. This was the sight that greeted Andrew as he opened the front door, for the first time in five weeks they were once again a family.

A few weeks later Anne was being pushed down a corridor in a wheelchair, colleagues, doctors and nurses lined both sides and applauded her all the way to the exit doors where Jess, Andrew and the children welcomed her with open arms.

As they drove past the waving nurses at the hospital doors, Anne was already planning her return to work..

Eric Harvey 2020.