Louise Curtis - A Nurse's Story

His nails were long and stained brown by the countless cigarettes he smoked. I was desperate to give this man a good long soak in the bath. I’d have to make do with changing him into a hospital gown and giving him a wet wipe wash. Just with that he already looked a million times better.

As I was tending to him I began trying to find out how he had got himself into this situation.

‘How has it been at home? Have you been managing?’

‘Oh yes, apart from these last few days I’ve been fine,’ he replied. ‘I don’t like going out so I just stay at home. I don’t have any friends or family so there’s no reason to leave the house.’

‘Who’s been doing your shopping?’

‘One of the people down the road does it and drops it off outside my door.’

‘And who does your cooking and cleaning?’

‘I do the bare minimum. I’ve never really enjoyed housework and it’s only me living there.’

‘Are you able to get to the shower? Do you have a bath?’

‘I’ve got arthritis now so it’s a bit of a challenge,’ he admitted.

‘Do you think you might need some help?’

‘Oh, I don’t know. I don’t think so. I wouldn’t want to trouble anyone,’ he replied.

I wondered how many more people were living in similar situations and lying undiscovered at home. We see recluses and cases of neglect quite often in A&E; they’re almost always older people who have been ravaged by loneliness. I remember one woman who hadn’t stepped outside her front door in fifteen years. Her nephew did anything she needed so she didn’t have to leave home. When she finally turned up at hospital, cancer had eaten half her face down to her eyeballs.

Lockdown would have made it far easier for people to be forgotten, and it would have dragged others who were just managing down into a whirlpool of despair. How many individuals without many friends or family had been forced to stay inside and had now sunk further into a vicious quicksand of loneliness and boredom? As people continued to decline physically and mentally, I thought we would probably see the after-effects in A&E over the next weeks and months.

My patient needed to be admitted for his medical problems. At least that gave us some time to refer him to services and charities that might be able to help and to sort out a care package for him when he returned home.

I had the following day off but I felt time was running away with me. I had dog walks to do, I was meeting a couple of friends in town and had to get the bus there, and I had a load of ironing and other chores to do at home. I also had book club in the evening and hadn’t finished reading that fortnight’s title. What’s more, my dissertation, the last task I had to complete before gaining my MSc in advanced clinical practice, was hanging over me and wasn’t going to write itself.

I was also still trying to make up around nine hours’ sleep deficit from when I was working nights. I woke up and left at 9.45 a.m. to get the bus into town but stood at the stop for ages, waiting. When I got into town, one of my friends was an hour late in arriving so I didn’t get back to the house till 3 p.m. I was relieved when some of the book club members revealed they also had not finished the latest book. I was over halfway through but could not have told you the names of the main characters or the storyline, because it was so bad. The person leading it announced that we wouldn’t have a chat about it that evening which was a relief but I knew I’d still have to finish the blasted thing. The thought of switching on my Kindle and seeing a book 57 per cent completed was too much to bear. I hate not finishing things. Before I could completely relax, the group were asking me for recommendations for the next read. I panicked and left my sister a stricken voice note.

‘Oh my god, I’m panicking. The book club are asking me for a book suggestion because I haven’t made one yet. I need to look good so can you please suggest an up-and-coming – or whatever – really good book for us to read pronto? Thanks. Bye.’

My sister messaged back: ‘OMG don’t panic me like that.’ This year had also been tough for her and she’d got used to people revealing awful things both in her personal and professional life as a journalist. She sent me a load of suggestions which I fed into the group chat. My sister may have a ridiculous, stroppy and hilarious side to her, but she also reads a lot, is opinionated and is usually abreast of what’s coming out, what’s been hailed by critics, as well as various trends.

Back at work the next day I was in the isolation unit again. Just as we’d reduced our capacity and staffing levels for the hot side of A&E, it emerged that new hotspots were popping up in various areas around the country. Leicester was going to be the only city that didn’t lift existing restrictions on businesses, including pubs, opening on 4 July because there had been a noticeable spike in cases there. It was starting to feel inevitable that we also might have a surge in cases again. Was the dreaded second wave that people had been talking about for months on its way? Not only that, but the upcoming weekend with all the pubs opening was making everyone nervous. Some news reports were predicting it would be like New Year’s Eve. I’ve worked a few of them in my time and they can get messy.

It’s always at about 10 p.m. that the trickle of ambulances bringing in drunk patients turns into a steady flow. Patients are either alone and have lost control of all their bodily functions or they come accompanied by a small group of friends. That wouldn’t be happening with current restrictions on hospital visitors in place, though. Instead, the department would be carrying the extra workload created by intoxicated fun-seekers on top of everything else and all the possible Covid patients. People would still be ill, and accidents were almost guaranteed to happen.

The first patient of the day had been feeling short of breath for a week. Her chest X-ray revealed signs of Covid. I explained: ‘It looks like you have pneumonia in both your lungs, which could mean you have the virus.’

She looked at me, shocked. ‘But I haven’t left the house in weeks!’

‘Has anyone come to see you?’

‘Yes, a few people. Family mostly. I can’t really survive on my own at home without help.’

‘It might have come from them,’ I said gently. Here was another person who had fallen victim to this awful virus because she was vulnerable and her family had tried to help and care for her. She was reasonably well though and I wasn’t too worried.

‘I expect you’ll be discharged in a day or so,’ I reassured her before I said goodbye as she was transferred up to the ward.

As I turned around to get on with my next job, my consultant called me to help with a cardiac arrest that was imminent. She was wheeled in by the paramedics, who explained she had had a downtime of just under two hours, meaning that she had been in cardiac arrest for that length of time, needing CPR and not showing any sign of improvement. Her chances of survival were slim to nothing but her heart was in a shockable rhythm and so we kept trying. We got the defibrillator pads out and set them to charge. The jolt as the electricity charged through her body was a harsh and very visual reminder of what a violent procedure resuscitation is. Her arms were strapped in and hugging the Lucas machine as it continuously pumped away at her chest. We gave her three rounds of adrenalin and three shocks but her heart soon went into a non-shockable rhythm. She had been in cardiac arrest now for over two hours. We discussed what to do as a team and the decision was made to stop.

I barely had time to reflect and check in on the two student nurses who had just witnessed their first ever cardiac arrest before another patient was pushed through the doors. They looked a similar shade of grey to the patient we’d just tried to resuscitate. This day was turning out to be really stressful.