Working in a Care Home During Covid-19 – a Personal Reflection
2 November 2021 | Marisa Spice, Queen's Nurse
I want to share my experiences of what was like working in a Care Home during the Covid19 pandemic, having a change of role and volunteering myself for a role that would change my world as I knew it.
Long Covid as a condition is different for every person who experiences it, but I am going to share my journey and my experiences in this blog. I have over 25 years of nursing experience, including managing Nursing Homes. I am currently a Learning and Development Manager supporting 15 care homes (mixed Nursing and Residential) and Operations and Compliance Manager for 3 of them.
Coping with Covid in a Nursing Home
In January 2021 I was aware that one particular Nursing Home I supported and had previously managed was becoming short-staffed and struggling with demand due to Covid19. I immediately volunteered to be ‘helping hand’ to the team on the ground. I revised my medication management and relevant topics prior to my first shift.
I attended my first shift aware of the staffing issues; many members of the team had tested positive (therefore isolating), other members of the team were exhausted. I did everything I could within the first shift to help: I knew this home, I had been here many times, however, the place I found myself in was so different – doors shut, a sullen atmosphere as Nurses ‘donned and doffed’ between patients. It was palpable – the change in the care home environment from what I knew and love.
I volunteered my support as ‘hands-on help’, however with my background and knowledge I found myself considering more managerial issues, do we have enough PPE out for tomorrow? Shall I check the orders? Are the staff all ok? I’ll check in with them and take some PCR tests to people at home. A regular comment I heard people saying to each other: ‘stay safe, please don’t get it’ – we wanted each other to stay well, to stay at work – we knew we needed to help and be at work. The level of teamwork and comradery was a small but memorable positive from this situation. We had a lot of agency staff coming to help, due to permanent staff members testing positive – brave and courageous to attend an unfamiliar environment and support us during the pandemic.
That first shift in, I cared for a friend and colleague’s mother, a resident in the Home – I’d supported her with her first wash in the Home several years earlier and here I was helping in the Home on what was to be her last day with us. The lady died and I spent some time with her to say my goodbye – this was a particularly low point for me.
I felt that we were all working at our fullest capacity and trying hard, but it didn’t seem to matter what or how hard we worked. The situation we were in felt impossible and that day I cried.
The manager of the Nursing Home tested positive, so I knew then I needed to step up and take more of the managerial role – whilst worrying about my colleagues and checking in on them regularly in between shifts. There was a lot of anxiety that staff would leave their shift ‘okay’. I was strict within my routine; infection control was paramount – my family supported me and helped me keep to this routine. I had been in touch with the infection control team consistently for the Nursing Home.
06.45am, my birthday. I turned up to support the team for another day, another member of staff had tested positive, we were another nurse down. My biggest worry during this time, after all these years not doing a full medication round, was being the only nurse left and here I was. Thankfully, I had been able to shadow the nurses in previous days in anticipation of this situation. That morning I had a Zoom meeting with our operations team – it was a surreal moment when I heard ‘happy birthday’ being sung to me via Zoom whilst I was in full PPE. The teamwork and support got me through that day and those weeks, feeling genuinely cared for and the statement again: ‘stay safe, please don’t get it’. We had momentum going now, we were doing what we could; I felt tired but who wouldn’t in the circumstances? After 12 long shifts in a row, I was feeling drained. My test showed positive for Covid on day 13, I felt guilty as I knew I now needed to go home. For the first few days I continued to work from home, I had been completing return to work interviews for those staff who were now well enough to return to work. I had set up a break and relax room so staff could feel supported in returning to work and keeping self-care as a priority. My colleague, a senior manager who had stepped in to cover nights, previously tested positive, was now returning to work and could take over from me.
My Experience of Covid
I was mindfully aware of how the Home team were doing whilst I became more and more unwell. The support and checking in messages from the team were messages that helped me when I was struggling, even agency nurses who had supported us and worked with me, I didn’t know too well, messaged to send their thoughts.
By now I was feeling extremely unwell, having the nursing knowledge I had, I was ‘assessing’ my own symptoms and looking for ways to self-remedy them, so I could remain at home. My bedroom became a prison, a place I was trapped in, lonely - it holds a lot of my Covid memories, some negative and some positive.
One day when I was feeling extremely unwell and seriously worried about what was going to happen to me, I saw a shadow at my door and although I felt death had come to find me, I believed if I was to go into hospital I would not come out. I preferred the idea of dying at home. Paramedics came and assessed me, and I asked, ‘please can I remain at home?’ My breathing was shallow, laboured. My cough seized all my muscles, temperature and fatigue thrown in, also losing handfuls of hair some months later. I desperately wanted to feel better. I questioned why am I not feeling better yet?
As I started to stabilise, I welcomed flowers and candles in my room, I felt calmer in my room, as I had before. I had walked to the lounge, which took a lot of energy – to sit with my children and husband was my motivation. I talked a little about my experience to friends or colleagues, but not too much. I was aware of the tragedy within the world, my friends and family were suffering loss of their own. The psychological impact Covid19 has had is huge, and quite widely unrecognised.
Four and a half months off work, I started to feel that I wanted to try to go back to work. I felt supported by my team and manager. Prior to returning to work I had attended accident and emergency twice as I didn’t feel right (bad chest pains) and was directed there by my GP. I could not understand why I was not feeling better yet. Contacting my General Practitioner for a referral to the Long Covid assessment team was alone not helping me; they were unaware of how to help me. Working for a non-NHS service, we don’t have an Occupational Health team.
I arranged a private X-ray and following this my NHS results were made available to the team – I had been suffering with Covid pneumonia and hadn’t been informed to date. I had something I could understand now; I asked for a referral to Long Covid assessment clinic and spoke to Emma, Nurse Assessor. She listened to me, and provided me with a wealth of support, including psychological support. I feel I am on the right path to recovery now.
Covid has changed many things in my life, most of all my outlook – I now ‘don’t sweat the smaller stuff’ and I focus on my blessings more. I feel that some positives have come out of my experience, meeting some amazing people whom I feel connected to, spending time with my children and overall, a changed outlook. I love being a Nurse, it’s a huge part of what makes me who I am, and I have recently been back in to support another Home with a Covid outbreak (how could I not?!), using my previous Nursing experience to support those going through it for the first time. The personal trauma is still there and may well be for a long time still but, I know that sadly there are millions of people also with their own stories.
Marisa Spice, Queen’s Nurse