NHS nurse Joan Pons Laplana, face of our New Europeans Green Card campaign, tells journalist and New Europeans media advisor Else Kvist what it’s really like on the COVID19 frontline in North England and shares his hopes for the future.
This is the second part of a two part interview.
Read first part of interview, here
You haven’t had PPE for all that long. How do you feel about that?
The protective gear is only for intensive care. When I was at the testing station we were only wearing a surgical mask, a plastic apron, and gloves. That is what the government was asking us to do but I didn’t feel safe. I was testing staff who were in contact with patients and the chances of them testing positive were quite high.
At ICT my patients are all sedated and ventilated, and it’s a controlled environment. But when health workers go and see patients with coronavirus at home, you cannot control when the patient might cough.
I believe the chances of contracting coronavirus, just wearing a surgical mask and apron are higher, than for me in intensive care.
Full PPE should be available for every health worker from paramedics to doctors. It is not the hospital’s fault, it’s down to the government.
The infection rate among health care workers is around 15 to 20 per cent. We are doing something wrong if one in five workers are getting infected. It means the protection is not good enough!
How do you go about testing staff?
We are also only testing staff with symptoms, who have fevers or colds or who live with someone with symptoms.
The reason is that we were running out of staff. If we kept following government guidelines about self isolating we would struggle to cope with demand on the wards. Suddenly we were missing nearly 25 per cent of the workforce, who were self isolating, and you cannot sustain a hospital like that.
We have two testing stations just for staff and the result comes back in 24 hours, and we can tell staff whether to self isolate.
We have been following advice from the World Health Organisation (WHO), instead of government advice, and been testing staff for the past three weeks.
Not following government advice has helped our hospital deliver good care.
That is why, if you look at the statistics for England, the number of cases are high in some parts of the country where people have been tested.
People say: ‘Oh, that is a hot spot.’ But that is not necessarily the case! Other places may have a lot of cases but the government advice was not to test everyone for coronavirus.
I’m on a new unit so I barely know anyone but I can see that some of the people, who worked with me the previous week, are no longer on duty because they are down on the sheet as medically unfit. So I presume it’s because they have tested positive. That also scares me as maybe I’ll be next.
But I love what I do and being back on the frontline as that is what I used to do.
I think from time to time it’s good to leave your management post and come back to the frontline and experience what people do. But this coronavirus is quite extreme.
Should you be testing all staff?
Yes, but we have quite a small lab and we don’t have the capacity. But we’re doing our best. My hospital has also been quite good and training staff and developing back-up plans. I’m quite proud of my hospital and my transition from my old job to this.
I’ve been paired with someone, who has more knowledge of the unit, and gradually been learning a lot. And I’m now able to offer care and be ready when the worst comes, probably next week.
The government needs to put their money where their mouth is and test everybody and give PPE to everybody who needs it.
It was madness, you have WHO saying we should test and Italy and Germany testing staff, and here in England we haven't been doing that.
Sometimes I get suspicious, if you don't test, is that because you don’t want people to know how bad it is? It’s a false picture. That is why I’m angry that the government put the economy and their image before people.
How do you feel about the public clapping NHS workers?
I have mixed feelings about the clapping because a lot of the people clapping now are the ones who were telling me to go home just a few weeks ago. And some of them didn’t stay at home when the government asked them to.
I would like more than just clapping every Thursday. I want some action from the government, such as giving us EU citizens a Green Card and not just extending the visas for nurses from third countries for a year.
The government needs to change the narrative and be open and honest with people, and tell them that migration is good. - Because it is good!
Coronavirus has shown that we are dependent on the world and the better connected we are with Europe, the better the outcome will be and less people will die. Britain cannot do it alone.
I love the clapping, keep clapping if you want. But you can do a lot more than clap, stay at home, support people, if you have a neighbour who cannot come out, give them a call or something, and make sure everyone is OK and have what they need.
Do you see any parallels with Brexit and what are you thoughts on moving forward?
I’m trying to think of the positives coming out of corona. And I think some humanity and solidarity has returned to society, we’re more together now battling the virus.
I’m no longer being asked where does my accent come from or any of that. I’ve not had that for a month, everybody is so happy to see me. Before I always felt I was a bit of a foreigner, now that is all gone.
I hope people realise this togetherness needs to stay afterwards. Because that is the country I fell in love with 20 years ago rather than the narrative of the past ten years sowing anti-immigration sentiment.
Hopefully the virus will expose the racists and misogynism, and everyone will stand up for each other and move forward as a nation.
I feel British and I love this country. And that is why I went back to the frontline because this is my country.
My children are British and my country needed me, and I decided to respond. There were plenty of times, when I wanted to pack my bags and go back to Spain.
But no, I had to fight and I'm still fighting because I want the best for this country, like everybody else, and I want a country that my children can be proud of.
What needs to change in our society?
The running of this country is dependent on low skill workers. The cleaners in my unit are amazing. They are risking their lives. They are the first to come and clean when someone has passed away from the coronavirus - every single bit - to make sure I’m safe to do my job.
Without cleaners the mortality rate would be skyrocketing and some of them don’t even get the minimum wage. It's absolutely atrocious.
I think it’s time we start to value all people within society. Let’s have less pay rises for the bankers and give a proper living wage to every key worker.
One of the main claims by the Brexiteers was that we cannot control our borders and yet every European country has now managed to shut their borders.
That shows a big lie from the Brexiteers. The government still have enough power to control borders and who is coming in and out. Being part of Europe, doesn’t mean you lose control. Being part of a family is better but doesn’t mean you have to follow everything and you can still make your own decisions. That is also a key message from me for this virus.
Has international corporation helped in the fight against coronavirus?
We have learned from Italy and China that we cannot wait. -With coronavirus it's the lungs that pack up first, followed by the heart and other organs. If we wait then the ventilation comes too late and the mortality rate rises.
That’s why we don’t mess around. As soon as someone is struggling to breathe we take over and sedate them. Whereas normally you would do that as late as possible.
Now the survival rate is better but we are still learning from all the data, which is helping us make decisions. We have the big advantage that we are two to three weeks behind other parts of Europe. Things are changing on a weekly basis.
Collaboration and information from other countries is a key part of the fight. If we isolate and don’t share information with other people, then the outcomes will be a lot worse.
Will the NHS cope with what is to come?
Every week we are doubling the numbers in intensive care. But there is going to be a point when we can’t keep doubling up. That is why they are building these new hospitals. I don’t understand how they are going to staff these hospitals in Birmingham, Manchester and London, when every clinicians are tied up. The only answer is from another country.
The patients we have in our unit are mostly, I would say, around 50 and over. We don’t have any of the youngest ones so far but I know that in other parts of the country they are seeing younger people. We are doing our best to make sure as many as possible survive. We’re there 24 hours giving 110 percent.
That's also why it’s so hard when somebody dies. It’s personal because you have been there 12 hours trying to make everything possible monitoring the screen and everything, and sometimes that is not enough.
How does that make you feel?
It makes you realise how vulnerable we all are and that it may be you in two weeks time in intensive care. When you read in the news that nurses and doctors have died, you think, it might be me next.
Of course I’m scared. I’m not just a nurse, I’m a husband, I’m a dad, and I’m also a son. My mum and dad, who are in their late 70s, have been in lockdown in their flat in Spain for four weeks. I’m also scared something will happen to them. I talk to them quite often, they say they’re OK.
And now they are worried more for me than themselves. It’s hard to tell your mum that you are going to a place dealing with death and be positive. I’m still her baby and it's hard for her to know that I’m going to work every day risking my life.
Do you see things improving on the frontline?
I've not seen anyone recover yet and go home. I’ve only seen some people getting slightly better, but I've only been there a week. The cases we have at the moment are people who have been in around ten days.
I've seen two deaths on the ward but I know there have been more. Every time i start a shift some of the names are gone of the list from the previous shift.
Normally you would work very closely with your patients in intensive care and you tend not even to know who the other patients are.
The problem with coronavirus is that we can't communicate with people once they have been sedated and become unconscious.
Now 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 most have died but nobody talks about it.
But it may be that some of them got better and have been moved to another ward. We try to keep ventilators free as much as possible
I don’t want us to end up in a situation where we decide who lives and die. I don’t want to play God. My biggest fear is having to tell someone you are not going to have a ventilator and you will die.
I don’t want to have to make decisions like in Italy where in places they have decided not to ventilate people over 60. I find that quite shocking.
What do you think of the way the government has handled the crisis?
The government was very slow to enforce the lockdown. There was a window of two to three weeks where people were still going to the pub and everywhere despite advice from the government.
One person can infect another set of people, who go on to affect others, and end up being responsible for infecting hundreds of people.
That is why the message to stay at home is so important even now. Follow the advice from the government! -I never thought I would say that! But stay at home!
They have opened a new hospital in London and need 4,000 staff. As a nation, we are already short of 43,000 nurses and 10,000 doctors. Where are all the staff going to come from? You can't just bring in volunteers off the street to do what takes a lot of skills and experience. Am I meant to manage five to six patients in the ward, I won’t be able to do that on my own.
We are so desperate for staff and hopefully that will also be a wake up call for the government to attract more people to some here while also providing bursaries for British people to train as nurses.
Government never seems to learn their lesson but I hope they do. Otherwise they are going to get kicked out!