Last week I duly paid my £120 fee to the NMC, marking a year since I first joined the register as a Registered Children’s Nurse. I had put it off for a while because the thought of having been qualified for an entire year was beyond belief to me.
Last winter, I started my position as a Staff Nurse in a busy acute medical ward in a children’s hospital. It was a baptism of fire, thrown into an environment totally different from the one I had trained in. And I had a huge amount to learn. I’m not one to sugar coat and will freely admit it was at times overwhelming and exhausting to start in such an intense environment – but I embraced every opportunity to increase my skills, knowledge and competencies as a Registered Nurse. I was also lucky to start my position at a similar time to a group of other NQ nurses on the ward. We were able to rely on each other, figuring out this strange new world of learning together. By the spring, I started to feel as if I had found my feet on the ward, I was trusted (and trusting myself) with more responsibility, and my confidence was growing.
By the end of February, we were starting to hear more and more about what we now know as Covid-19. The talks of PPE, social distancing and self-isolation sounded alien to us all – particularly in paediatrics where we were perhaps less exposed to the realities. At this point, it was not something I was worried specifically about in respect to myself. We knew so little about what the virus entailed and how it may affect the children we care for, and that was my main concern.
Every question was answered with an, “I don’t know”. But spirits were generally good, and we got on with the job in hand.
As we went through March, we were still relatively ‘untouched’ in paediatrics except for an eerie sense of calm and anticipation – with far fewer A&E attendances and subsequent admissions. When Boris Johnson announced that the country was going into lockdown, that was the first time I sat and thought about my own vulnerability.
NHS workers were being hospitalised after contracting the virus, and many sadly passed away. I knew that my track record with respiratory viruses wasn’t good – I had developed asthma aged 17 after a chest infection. And over the next five years, I had two more bouts of pneumonia, and my asthma symptoms considerably worsened, getting to the point where I couldn’t get through a simple cold without high dose oral steroids.
I suspected I would probably become very sick if I did contract Covid-19. That worry sat in the back of my mind quietly for a few more weeks, until one day I got the letter through the door. I was officially ‘clinically extremely vulnerable’ and required to shield from Covid-19. While this was a huge relief in some respects, it was also mentally very challenging.
I had only been working for four and a half months; I was still an NQN with a considerable amount to learn and so much to give. I hated the fact I was sat at home whilst my colleagues worked through it, the public clapping for the NHS I too should have been working for. I felt guilty for not ‘pulling my weight’, and worried about deskilling as I was stuck indoors.
My confidence as a practitioner plummeted. In total, I spent 17 weeks at home before shielding was paused. Returning to work at the end of July created a mixture of emotions. Mostly, I was over the moon, but also I worried about managing the hours after shielding caused physical deconditioning, the toll of over four months at home caused me mental health struggles. The underlying threat of Covid-19, of course, remained, and I was worried about remembering how to be a nurse!
Like many people in the ‘shielding’ category, I had never considered myself vulnerable in my life before. My chronic cough was a running joke amongst my friends, but severe asthma had never stopped me doing anything I wanted. It certainly had not affected my work as a student and then NQ nurse. I never worried about ‘catching’ anything from my patients, I’d never thought twice about the impact nursing might have on my health. Then I was back at work and finding myself second-guessing everything I was doing, anxious about going near patients with a queried Covid-19 diagnosis, trying to maintain social distancing, and being careful without appearing over-cautious.
Honestly, my confidence was shot to pieces, which seemed to get worse instead of better as time went on. This lack of confidence resulted in me having to take more time away from work to sort out, but I’m starting to feel better now. Unfortunately, the uncertainty of Covid-19 remains, and the threat has continued to rise by the day. It may be that I must shield again in the near future. But I hope if this is the case, things will be different. I hope that NHS staff who have to shield are remembered and supported to maintain our skills and confidence. I hope in general that ‘clinically extremely vulnerable’ people are looked after by the government and their communities so that their mental health doesn’t suffer.
In hindsight, although it’s been a strange old first year as a nurse for me, spending more time within my own four walls than at work, I do think it’s also been a valuable personal learning experience. It will make me a better practitioner. I will greater appreciate the isolation that families I care for may face. I will even more so embrace the opportunities I am given within the NHS, and how lucky I am to be able to call myself a nurse.