Reflections on redeployment during the pandemic
COVID-19 FEATURE
Roisin Quinn reflects on her rapid , but ultimately brief , redeployment into the NHS Nightingale Hospital London
In April 202 , Roisin Quinn received a call one Saturday evening ,
asking the question : ‘ Can you start tomorrow morning ?’ By 8am on Sunday , she was having her mask fit test and about to enter the rapidly-created intensive care unit ( ICU ) at the NHS Nightingale Hospital London , to look after her first patients as a clinically experienced worker .
‘ The next few weeks flew by in a flurry of tears , friendships , and 50-hour weeks ,’ she explains , ‘ all to end abruptly when the hospital was closed with almost no warning .’
She reflects : ‘ I gained a great deal from my brief time there . My role involved taking blood from arterial lines and running blood gases , providing mouth , eye , and personal care regularly , as the patients were mostly sedated , proning , turning , and suctioning patients .
‘ When patients were coming off their sedation medication – known as a sedation hold – I would chat to them , orientating them to their surroundings and reassuring them that although we looked strange in our Personal Protective Equipment ( PPE ), we were there to look after them .’
Roisin remembers that she ‘ was in awe of the eternally-calm ICU nurses , who never made me feel bad for asking yet another silly question ’.
She says : Other occupational therapists taught me oedema management and range of movement techniques . The culture was one of learning and compassion , and I made some friends for life with whom I laughed and cried .
‘ I devoured Youtube videos , Health Education England training , books and articles . Systems and procedures evolved daily and suggestions or improvements were listened to and enacted rapidly .’
She goes on : ‘ It ’ s hard to summarise the complex interplay of emotions I experienced whilst there . I will never forget the horror of walking on to the ward the first time , taking in bed after bed of unconscious people .
‘ Donning PPE felt like mental and physical armour . Each 12 and a half hour shift I was assigned between one and three patients , who were also under a registered nurse and an ICU nurse ; my assigned patients would change daily .
‘ Each shift was a rollercoaster of destabilisation . There was a traffic light system above each bed , and I ’ d find myself checking up on patients from the previous day , feeling a pang of worry if their colour had changed for the worse .
‘ I was acutely aware of the wider political , logistical , and ethical debates around the efficacy of the Nightingale model , and this worry was fuelled by offhand comments others would make about the few patients that were there , relative to the projected 4,000 beds .
‘ Reading about moral injury ( distress resulting from feeling you have transgressed your ethical code ) resonated , and although I always felt supported , I worried about “ unknown unknowns ”, in which I may have unwittingly done something wrong .
‘ Having photos , summaries and heart-warming messages above each patient helped to humanise those we were providing care for , although at low moments I wasn ’ t sure that was a good thing .
‘ The highs of seeing a patient successfully taken off sedation and sitting up in bed were countered by the crushing lows of sedation holds that revealed brain damage , or upon hearing the cardiac arrest call .’
Ultimately Roisin says that the experience benefited her greatly when she returned to her normal psychosis service job .
‘ I was able to speak to a client who had been on an ICU , and felt I could use my mental health skills in supporting him to manage this distress , with the added bonus of greater empathy , the ability to explain the gaps in his memory , and knowledge of how COVID can affect people post-hospital .’ she says .
‘ Recently , when accompanying a client to A & E , I was able to monitor his physiological observations , and quickly and confidently seek help when I noticed his sats dropped .
‘ I found redeployment a useful addition of knowledge , skills and awareness ; as occupational therapists are dual trained in mental and physical health , I felt able to absorb this knowledge for use in my future practice .’
She concludes : ‘ I ’ ve since started a new role in a veterans ’ mental health service . While I felt nervous at first , having no previous veteran or service-personnel experience , I went into the job with the confidence that I could handle it , no matter how out of my depth I may feel .
‘ The Nightingale taught me that my occupational therapy training means I have adaptable , broad , core skills , and I am proud of the perspective this affords me . Although I was disappointed to take off my full set of PPE for the last time , I feel I have grown professionally and personally more rapidly and intensely in that month than any other period of my life .’
Roisin Quinn , clinical specialist occupational therapist , works in a Veterans ’ Mental Health High Intensity Service
© GettyImages / Juanmonino
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