#Covid19ResearchVoices: Diary of an ICU nurse
Diary of an ICU Research Nurse…during a pandemic
Lauran O’Neill is a Senior Research Nurse in Great Ormond Street Hospital’s (GOSH) critical care research team. She’s worked at GOSH for around 15 years in total but has never been busier and prouder of her colleagues than in the last six weeks. This is her experience of COVID-19 so far.
Late March 2020: Okay, what just happened?
There’s a strange, expectant atmosphere at GOSH. In our team there’s massive uncertainty about what we’re going to be doing. Most of our research studies are suddenly on pause, except ones that are part of essential treatment.
Because most of us have backgrounds in intensive care nursing, it looks like we might be deployed to clinical areas to look after patients.
Early April 2020: COVID research explodes
The intensive care units ended up being well staffed, so we weren't needed in clinical roles. We started migrating back to our research roles and thank goodness we did, because suddenly the COVID research studies are coming in thick and fast.
There are loads being set up across GOSH, some part of national studies - including those supported by the National Institute of Health Research (NIHR) - and others more bespoke to GOSH.
It’s intense, but the team have been amazing. They're used to working at a fast pace anyway, but they’ve had new information brought to them so quickly and they’re getting things in motion in record time. In the future, I think this will be something to look back on and be incredibly proud of.
Mid-April: A typical day
We’re beginning to settle into a strange new normal. The mornings are particularly hectic. We come in at 7am and use our electronic patient record system – EPIC – to find any new patients that are eligible for the COVID-19 studies we’re running.
We give them information about the study but leave them for a couple of hours so they can think about it. We make sure we give the information in a way that they can digest and understand. Later we come back to see what they’ve decided. It’s very much a conversation, making sure the family understands the research and its risks.
For those who choose to join the study, we go back pretty quickly to get the first samples. The samples need to be in the GOSH labs by 3pm, so it’s an intense turnaround with loads of different teams involved.
Early May 2020: Smiling with your eyes
On some wards, we need to wear full PPE as we consent patients and take samples – that means mask, visor, gloves and full gown. The heat is unreal when you’ve got all the kit on. I was trying to talk to a parent today and thinking 'try not to pass out'. I don't know how some of the clinical staff are doing 12 hours in this kit.
It has changed a lot for us, day to day. Little things you usually take for granted, like eye contact, body language, touching a mum’s arm or them seeing you smile. It’s not as easy to rely on those now to connect with families, comfort them or put them at ease. I find myself doing these insane smiles when I’m in PPE. I’d look absolutely crazy without the mask on! But because they can only see my eyes, I want to be sure they can see that I’m smiling.
It's five o'clock on Friday right now and I haven't seen anyone else from my team today. We’ve been running all over the hospital consenting patients for studies. But I’m smiling because I’m looking at some beautiful, knitted drawstring bags that have just been delivered to the nurses on PICU. Some amazing people have sat at home and hand sewn them. A nurse can pop their uniform in this bag, go home and put the whole thing straight in the wash. In the midst of everything that’s happening, the generosity and support of absolute strangers has, for me, been the most astounding thing.
Supported by NIHR guidance, Lauran and her team at GOSH are now carefully planning to resume some of the studies that were paused due to COVID-19. Read more about how the NIHR is supporting the restart of paused research activities across the UK.
The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR, NHS or the Department of Health and Social Care.