“I feel like I’m on the outside looking in”: treating regular patients during the coronavirus pandemic

| Rachel Campbell

In the space of a few short weeks, the coronavirus has turned the world inside out. We know that times of crisis can also be fertile breeding ground for radical change, but what happens next will be determined by the stories and the truths we choose to tell. A door has opened, and there is a chance to reimagine how we relate to one another. This blog series will explore what those opportunities for change might be, told from the personal perspectives of people working alongside communities, no holds barred. 

This blog is written by Rachel Campbell. Rachel is a nurse working in a district general hospital that serves a population of around 480,000 on the outskirts of Manchester.

I sat looking out of the window today. It looks like the hustle and bustle of life is creeping back, with increased traffic and people exercising and although exercise is great, it worries me as I feel we are not ready to slip back to normality. For the last three weeks there’s been an urgent calm and a surreal sense of unpredictability – especially at work.

I am an inflammatory bowel disease advanced clinical practitioner (I know, mouthful of a title isn’t it). My lovely cohort have autoimmune conditions with a lot on added immunosuppressant therapies. This makes them vulnerable and me nervous given the current COVID-19 pandemic. My IBD family is a large one, around 2,000 with varying degrees of active disease or if they are lucky, remission. I am very protective of my IBD lot. I’ve had them for the last 26 years and during this time of the COVID-19 virus, want to keep them out of the hospital where I can.

I am lucky, I have continued to be there for my ‘IBDers’, to support them psychologically as well as practically and up to now I have not been asked to volunteer for the COVID wards. I am in awe of how my colleagues have responded though, pulling together as one big team and facing the uncertainty of it all with humour, grace and grit determination. It’s strange to think before all this you could walk down the hospital corridor, which I have for many years, and not acknowledge or know your fellow colleagues. Whereas now they are coming together, dancing (what is TikTok?!) and raising each other’s spirits using all kinds of social media and general comradeship.

I feel like I’m on the outside looking in, but only because my own circumstances with being a single parent to twins and no family within 500 miles, means I need to try and distance myself from the potential of getting the virus. This makes me feel incredibly guilty. Last Sunday I was in a reflective mood whilst sat in my garden. The weather was glorious and I welcomed the gentle breeze. I reflected on this feeling of guilt, realising that actually sometimes you do need to be a little selfish to protect others. Who would look after my twins should I fall ill and be hospitalised? Although they are 16, one is autistic and changes to normal routine would not go down well at all (all changes have to be processed over a long period of time to be accepted).

Reflection in practice is something that has become second nature after over two decades in the NHS. It helps me mentally and gives me strategies for coping with what life throws at me. I feel I use the term ‘lucky’ a lot, but that’s because I am lucky I am also resilient, grateful and optimistic especially in my professional role.  What also helps at the moment is my past experience in mental health. I find myself supporting not only patients, families and carers but my wonderful colleagues – my door is always open, my phone is always on and in turn it helps me with my own mental health.

The phone has taken over from face to face conversations with patients. I miss seeing facial expressions, gestures and body language. You don’t realise how much you miss it until you are in a position of trying to manage complex patients by just hearing their voice. We don’t have Skype or other visual forms of media for patient consultation so decision making is based on conversation and being able to effectively ‘interview’ the patient. The other challenge has been bringing in our patients that need medication via a cannula direct into their vein as an infusion. They need the infusion to keep their condition under control as having a flare of Crohn’s disease or Ulcerative colitis can be detrimental to their health, ending in possible surgery or even death. With many different angles in the media about the virus, effectively communicating the risks to the patients has been key in them feeling safe to continue treatment given that we are lowering their immune system further.

I had a challenging but enjoyable infusion day this week, as I have a patient who is deaf that comes with his mum. My signing is limited but I am learning more as time goes on – but put me in a mask for personal protective equipment and I was suddenly aware and worried that he wouldn’t understand me. He signed to me that he could tell I was smiling by my eyes and that he felt safe – well I melted. My other frustration as well is that I’m a ‘hugger’, on mutual terms of course, and the restriction of being two metres away makes me sit on my hands at times so I am not tempted to reach out to patients.

There are highs and lows to each week, we are still here, marching on through the uncertainty, making best of situations and overall getting on with things as ‘usual’. We wait for the official updates on whether the lockdown can be ‘relaxed’ but are we just seeing the tip of the iceberg in terms of how this virus is behaving?  Our numbers of positives are escalating; more dedicated wards are opening trying to contain the patients in one block with matrons doing an excellent job of staff juggling – now there’s a talent!

Follow Rachel on Twitter @ibdnurse

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