Louise Curtis: A Nurse's Story

‘Are you all right?’ he asked.

‘Yeah, yeah. Fine.’

He fell asleep again while I lay there thinking and recovering from the horror. I couldn’t imagine how my mum was coping after witnessing him die like that. I must have managed to drift off again because the next thing I knew the alarm was ringing and I had to get up for work.

I’d heard that lots of people were having weird and vivid dreams during lockdown. I was no different. Work was on my mind more than ever and I didn’t have my normal life to distract me. It was becoming painfully clear that my way of dealing with the trauma I see at work was not adequate and that I needed to look after myself a bit more. I was beginning to realize that I needed to become more aware of how the job was affecting me. A lot of the time, those of us who work in A&E will just brush something off; we think we’re tough because we see awful stuff all the time. When we’re at work, we just carry on. But now that memories were penetrating my subconscious and affecting my sleep, I knew I needed to start looking after my mental health more. The next day I found out that there were plans to develop a longer-term staff support and well-being plan in the department. This was something positive to come from the pandemic.

I walked into hospital in the morning sweaty after my overdressed cycle ride. While I’d been off the third isolation unit had been dismantled and was being used for normal A&E patients. Hospital guidelines had also changed and now stated that everyone should wear a face mask in all areas. A bleary-eyed volunteer was holding a box of face masks for everyone who walked through the doors. I wondered what time she had started, considering that I was walking in at 6.30 a.m.

Our regular volunteers had stopped working during the coronavirus crisis. We usually have one woman, Sally, who makes cups of tea for patients and offers them food. Then there’s another man, Geoff, who is simply fabulous. When I used to triage patients, I’d bring them out and he’d be there ready to take them to where they needed to go. Geoff had been massively missed but he was in the at-risk category. He had been receiving treatment for cancer. We were all so sad when he was diagnosed but he still came to work. ‘As long as I’ve got the energy, I’ll still come,’ he said. They are both much-loved members of A&E.

There was another man who delivered newspapers and went round with a trolley packed with sweets and chocolate, cracking the same jokes as he went. He reminded me a bit of Dad with his quips that always made everyone laugh. Another very popular volunteer was the man who came in with two therapy dogs for the staff and patients.

We’ve got a Facebook group for everyone who works at the trust and he had posted ‘I’m missing you guys’ on it. There were hundreds of comments below asking him to bring the dogs in, so he posted a picture of one of them wearing a surgical mask. We’d all noticed the volunteers’ absence and I hoped we could get them back in the department soon.

Later that day I was working on a patient when I overheard a conversation between a man and one of the junior nurses. I couldn’t make out exactly what was being said but it seemed heated. His voice was getting louder and louder. I left it for a while until it was clear the nurse was starting to struggle and he was stopping her from being able to get on with her job. A lot of the newer nurses are softer than those of us who have been in A&E for a while. I used to be like that too but after eight years I’ve grown a thicker skin and my tolerance for bullshit is low.

‘What’s the problem here?’ I asked, seeing a wave of relief cross the nurse’s face at my intervention.

‘This nurse can’t seem to give me a good reason why I should have to wear a mask,’ the man shouted, spitting saliva from the corners of his mouth. He looked angry, with a red face and distended veins.

‘It’s hospital policy that everyone now wears a face mask both for their own protection and for that of everyone else. We are still in the middle of a pandemic,’ I replied.

‘Well I don’t have the virus, so what’s the point?’ he retorted.

‘Unfortunately you can’t be sure you don’t have the virus unless you’ve been tested very recently. You could be asymptomatic. We have vulnerable patients all around you and it’s important that we try to protect everyone during this public health crisis.’

The conversation went on like this until I saw that I wasn’t going to get anywhere. The man was becoming more agitated and taking up too much of my nursing colleague’s and my time. I had five patients on the go and needed to get back to review one who had deteriorated.

‘It’s up to you, sir. We can only do our best to protect our patients, but we can’t force you to do anything.’

With that, the nurse and I left him with no one to have a go at. He stood there puzzled for a while before he went back to his cubicle.

‘Thank you so much, Louise,’ the nurse said to me before she carried on with the task she had been doing before she was interrupted.

‘Don’t worry about it. I don’t mind being shouted at,’ I told her.

My night shift later that week was, dare I say it, quiet. I went in and saw Jim, one of the registrars, at the beginning of the shift.

‘Is this your first night?’ he asked.

‘Yes,’ I replied. ‘You?’

‘This is my third.’

‘How have your nights been?’ I continued.

‘We had two shootings in last night,’ he said.

Shootings have almost become a thing of the past and now we see more knife crime instead. To have two shootings in one night was unheard of. Jim told me that, fortunately, both turned out fine.

I sat down at the computer to see if anyone needed treatment. No one did and so I waited forty-five minutes for my first patient. I was so desperate for work that I went round asking everyone if they wanted help with anything or if any patients needed to go to the toilet. The answer was always no so I sat down again and waited. I sent a few messages to some of my friends who had just given birth because I knew they’d be up feeding babies, ‘I’m on a night shift. If you feel lonely, send me a message.’

Finally, a name appeared on the screen. I beat my doctor colleague to put my name beside it, indicating that I would be in charge of the patient’s care. I read the brief description of what was wrong and discovered that this patient had been found collapsed on the street. I walked to his cubicle only to find no one there. I looked around. He had absconded. This was not a strong start to the shift. He must have made a quick exit because I hadn’t wasted any time in making my way to see him.

The night went on and patients came trickling through, very slowly. There were various people who had taken overdoses, patients with chest pain and one woman had been sent in by the GP and was now hallucinating.

‘I’m seeing people who I know aren’t here,’ she told me. ‘One is standing behind you in the corner, just watching.’

Hallucinations can be linked to any number of medical problems. This woman needed to be admitted anyway for the issue she had originally presented with. She had come in feeling lethargic and confused and had low blood sodium, which could have been a cause of the hallucinations. Now it was a case for the medics on the ward to sort out.

Sometimes patients who hallucinate are so convinced that what they’re seeing is real that they will grab thin air and swat away imaginary objects. They are very difficult for me to treat and there is no point in telling them that there’s nothing there because they won’t believe me. They’re so perturbed that I also get scared but this patient was rational, thankfully.