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The reality of fighting Covid, by an ITU nurse

Every day there is talk of transforming yet another ward into a critical care unit, writes Charlotte Miller. | PA Images

Charlotte Miller, ITU Nurse

5 min read

Morale is devastatingly low. Hospital wards are being turned into ITUs to cope with demand, but there simply isn't enough staff to safely look after the increasing number of patients.

Empty desks, phones ringing non-stop with no-one to answer them, boxes full of oxygen delivery equipment in the corridor, hand gels everywhere, coughing or intubated patients in the bays and a tired workforce. This is the current situation experienced by nurses and doctors across my Trust.

It’s not the difficulty in providing effective treatment for Covid-19 that puts such a strain on the NHS, but the sheer number of patients and lack of resources.

Normally an ITU nurse looks after one or two patients, but now we are faced with double that. Hospital wards are increasingly being turned into ITUs to cope with demand, but there simply aren’t enough specialists to safely look after the increasing number of patients coming through A&E doors. 

Everyone with clinical skills has been pulled onto the old and new “temporary” ITU beds in the hospital. Difficult patients from neighbouring trusts are being transferred to us and every day there is talk of transforming yet another ward into a critical care unit.

We simply do not have the staff to man all these beds. 

Experienced nurses from other specialities have been redeployed to ITU, but with no training in this area they have been left in a difficult situation. As a result, ITU nurses have been tasked with supervising those redeployed, but this strategy has left the hospital even more short staffed.

As a ‘band aid fix’, the Trust has started offering more money to anyone taking extra shifts. But can you really put a cost on a nurse’s physical and mental wellbeing? Our shifts are already long – with doubled workloads and the inability to take a break it can feel even longer.

Morale is devastatingly low. Just yesterday we lost another colleague to the virus.

I love my job, but I’m starting to question whether it’s worth putting my physical and mental wellbeing on the line for

With increased knowledge of Covid now, we can administer better care, but complications from the virus are still deadly. This is and will forever be the saddest part of my job. When a patient is dying, as a nurse I only get one chance to make it right. Not just out of respect for the patient’s life, but also for their family. The trauma of watching a family’s loved ones go into hospital and never return home cannot be overstated.

Covid has made goodbyes impossible. Virtual video calls have helped, but don’t take away the trauma of not having those last moments with loved ones. No final words, no final kiss, no final goodbyes. As an ITU nurse, I’ve lost count of the number of deaths I’ve seen like this. It makes me feel like I was unable to do my job right, unable to give my patients a dignified death, unable to support families in their mourning.

Mark (name changed) was one of the many patients that never got to say goodbye to his wife. He was hospitalised a week ago, but due to complications on top of his Covid diagnosis, his lungs couldn’t deliver enough oxygen to his blood. I was there when the doctors made the decision to stop treatment. There was nothing else we could do after a week-long battle. Over the phone his wife told me that all she wanted was a hug, but couldn’t, as she was isolating following a positive test herself.

Sometimes there is a cult-like culture in the hospital, particularly in A&E and ITU. Staff are made to believe they are a more “resilient type of person”. One that can keep pushing forward no matter how bad things get. If you can’t do it, it’s because you are doing it wrong.

A colleague once badly injured themselves at the beginning of their shift. Without telling anyone, he carried on working the rest of his shift. When I asked him why, he told me he didn’t want to let his team down. I love my job, but I’m starting to question whether it’s worth putting my physical and mental wellbeing on the line for.

Many people join the profession because they feel a strong responsibility to help people. The government knows this and has exploited it for too long.

As the vaccine is rolled out, there is now light at the end of the tunnel. I am lucky enough to have already received both doses. We’ve all seen the anti-vax campaigns, and while everyone has the right to make their own choices, this may be the only route out of this mess. How many more will we have to bury before people realise that? 75,000 is already too many. The government should have acted sooner.

Will the Prime Minister apologise for not taking the situation seriously enough back in March last year? What measures will he take now to support health care workers in the upcoming months? After seeing doctors and nurses dying, how will the NHS trust the government again? How will we trust them again?

When talking to a nurse or doctor, do not ask them how the situation on the wards is, because they are conditioned to say that it is fine. Ask them anything else, anything that isn’t Covid related, starting with a simple, “How are you?” At first, they’ll lie, but ask them again.


Charlotte Miller is a pseudonym.

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