NHS nurse Joan Pons Laplana, one of the faces of our New Europeans Green Card campaign, tells journalist and New Europeans media advisor Else Kvist what it’s really like fighting the coronavirus on the frontline.
The father of three came to Britain 20 years ago after struggling to find a job as a nurse in Spain,where he ended up delivering pizzas for six months after finishing his studies.
One sunny day, sitting on a terrace, he spotted a newspaper advert saying the NHS needed nurses.
Soon after he landed a job at a hospital in England and was on the plane to Luton with £50 in his pocket. Since then he has risen through the ranks of his profession and become a digital manager, and was named Nurse of the Year in 2018.
But the coronavirus crisis has seen him volunteer to return to the frontline at an NHS hospital in Yorkshire.
Sitting in his car inside at a supermarket car park, before going into to do the shopping on his day off, Joan opened up to us about what he is experiencing and how he is coping after first being deployed to the testing station and now the intensive care unit filled with patients on ventilators.
Could you describe what you normally do and what your job now entails?
I’m a quality improvement nurse and digital manager. I normally ensure we can deliver good quality care with less money and resources. We're trying to bring the NHS into the 21 century by making the hospital paperless and connecting GPs with the hospital. But all that has now stopped because priorities have changed with the coronavirus.
They need people and I used to work in intensive care 15 years ago, so I felt I needed to return to the frontline.
I've been through refresher courses to make sure my skills are up to date and shadowing nurses in the unit, and Thursday I had my first patient. The unit is getting very full and we have a back up plan to increase capacity. But it's going to get worse and worse. I’m feeling a bit sad!
How many coronavirus patients have you got at the moment?
The ICU is just for coronavirus patients now. The capacity across our NHS trust would be 120 people on ventilators and we’re getting there. We can also divert staff from theatre and from recovery wards - they have quite useful skills.
Worst case scenario, we can go to 240 patients on ventilators. But the problem is not just space, it’s also staff levels, we are short of nurses and doctors. My hospital has made a big effort to adapt.They cancelled a lot of operations and we are using staff from there to make sure we support the ICU as best we can.
I’m only working three days a week doing 12 and a half hour shifts, but that can change at any time, if they require more nurses.
The infection ward below us is full - that is the ward with patients that are still OK breathing by themselves. They have people in single rooms with high temperatures, who get antibiotics and various drugs. It’s basically like self isolation at home but for people with more severe symptoms. The majority get better and go home after seven days or so.
On my ICU ward we have 27 beds, and when I left on Thursday we had 20 patients, and when I go back on Monday it will probably be full. And some of the patients sadly passed away and new people have come in.
What is it like working on the ward?
It's very hard both psychologically and physically going in there. We wear the mask and protective clothing, and cannot have the air conditioning on.
I thought we would have a lot of elderly people, but yesterday I was taking care of someone who is 48 - that is three years older than me - and he was a dad. He is diabetic, but otherwise fit and well.
These people are alone with no families able to come and support them.
I feel quite emotional with relatives and imagine what it would be like, if I was lying there and my family couldn’t come and speak to me. The only way I can communicate with relatives is over the phone once a day and tell them how their family member is doing.
It is very difficult to tell them that they are not improving because a lot of them stay the same, some of them recover, but some don’t make it. How do you tell someone that your husband is not improving or that their dad is in exactly the same condition or worse. I always believed this kind of news should be given face-to-face and never over the phone, and suddenly I don’t have any other option.
I’m still quite new at the unit so I haven’t yet had to tell someone over the phone that their loved one has died. But soon I may have to as the hospital has a no visitor policy because the risk is too high. Only doctors, nurses, and others who work there are allowed on to the ward. But people understand and have been quite good about it.
How are you and your colleagues coping on the ward?
You work three to four hours in full protective clothing and then you come out for a half hour break and you need to go back in.
I have seen a lot of my colleagues go on breaks in tears and it is hard because you have to pull yourself together to go back in.
We cannot hug our colleagues. You just have all these emotions bottled until you come out, then you clean yourself, and then you go to the staff room and everyone is sitting there in silence.
Everybody is trying to cope the best they can and we have phycological support available, and we all try to support each other. But it’s hard! This coronavirus has dehumanised our care because we are not allowed to be emotional.
How exactly do you go about treating patients?
We take over their body by completely sedating them.
We give a lot of drugs to help the heart and all the organs, and also very strong medication to fight the coronavirus. Quite a lot of people pull through and survive, but I haven't been on the ward long enough to see that yet. It’s not a quick recovery, some of them stay three to four weeks in intensive care.
I just see the names and the ages, some of the ages of people who have died have really shocked me. They are not necessarily in their 70 or 80s, some of them are in their early 60s and mid 50s.
You go home and all the beds are nearly full, and then you come back and there are more empty beds. So you think they must have died but nobody talks about it.
I'm seeing the worst cases, because the other cases are one floor down in the infection control area.The majority with coronavirus come to the eight floor and they recover quite well and they go home. So phycologically that is probably an easier ward to work in.
The majority of the minority, who end up in intensive care, a lot of them have underlying conditions like asthma, diabetes or heart problems. They are the ones whose body cannot function with the virus and who end up in our unit on ventilators. And who are fully sedated to make sure we fight for them as their body cannot fight. But ending up in intensive care doesn't rnecessarily mean you are going to die, some will pull through and survive.
What do you do to try and keep morale up?
At the end of every shift we have a huddle and we speak as a team about the good and the bad, and try to make sure everyone is OK. We then have a bit of a clapping moment and go home. It is the small things that matter. The good thing is that we are all in this together and we all support each other.
What’s it like coming home after a day like that?
When I finish at 8pm I’m absolutely exhausted. But I’m not finished. When I go home I basically strip myself down and stay half an hour in the shower because I feel dirty and my biggest fear is that I will pass the coronavirus on to my family.
And that causes me a lot of anxiety because if my family, my son or daughters or any relative gets poorly I will feel very guilty. I’m divorced and my three children live with their mum. We decided that my two eldest won't visit until the coronavirus goes.
The youngest one still comes because she has special needs and she gets quite agitated, if we don’t follow the routine. For a week she didn’t come and that was very distressing for her. My two eldest I haven’t seen for three weeks and that is also making me quite sad.
Yesterday my son turned 18 and it was very emotional, as I wasn’t able to be there. Instead we had an online Birthday party with my family in Spain. I try to rest as much as possible mentally and physically on my days off.
I refuse to watch the news. If you put the news on you see all the people dying and also hear of doctors and nurses dying.
I try to concentrate on my family and be happy at home, and disconnect psychologically from the unit. I go for a walk with my wife once a day. I watch series on Netflix, murder series like CSI, and talk to my kids and friends on video call.
I also listen to a lot of music and have found myself listening to a lot of Spanish music bringing back happy memories from my youth and childhood.
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