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Fertility nursing in the coronavirus pandemic

4 May 2020
By Debbie Evans
Director of Nursing and Clinical Services Herts and Essex Fertility Centre
Appeared in BioNews 1045

In my 35 years as a fertility nurse, I can honestly say that working during the COVID-19 pandemic has been the most challenging few months of my career. I started nursing because I loved being around people and helping them, but the closure of fertility clinics in response to the crisis has forced me to stay home, away from the people that need me. I need to be with my patients and my staff and look after them in the way I have been trained to. I work in a patient-facing industry and not being able to connect with them is heart-breaking.

When COVID-19 hit us, we had no real idea of the enormity of what was about to unfold. The unprecedented way in which we had to adapt on a daily basis was so challenging. We took advice from our government and our regulatory bodies and made the incredibly difficult decision to cease fertility treatments. No amount of training prepares you for making that call, or for advising your patients that their fertility treatment will not be going ahead, or telling them that we don't know when we may be able to offer them treatment in the future. The majority of our patients walk through our doors with a long history of infertility – we are their hope at the end of a long road and even with the chances of success not always being the best, that is the hope that drives them. 

I've heard my patients plead, 'Please don't do this', 'This is our last attempt', 'I'm running out of time'. As a nurse, to crush my patients in this way went against everything I stand for. But this is a pandemic of devastating consequence and I had to take responsibility for my patients and my staff. My training that has stood me in good stead throughout my career has been tested to its limits – to care for and nurture my patients and my staff, to support them and advise them in a world that had changed beyond my control. 

I had to listen to our regulatory and medical advisors and abide by my clinical, ethical, regulatory and social duty. The Nursing and Midwifery Council code of practice tells me that I need to always prioritise people, practise effectively, preserve safety and promote professionalism and trust: I truly felt that suspending cycles, while seemingly so unfair and unjust, was in accordance with these values. My patients could not make this decision for themselves as of course they would always choose 'hope' first, so I became their advocate.

Asking our dedicated staff, who love and cherish the jobs they do, to stop coming into work was also gut-wrenching. They may have been scared of the potential of what this virus could do but, overwhelmingly, they wanted to stay and help, so again I had to make a difficult decision on behalf of others in what I believe to be their best interest.  

We have so very quickly learnt to adapt in this strange COVID-world – our clinics may be deprived of the usual flow of patients and staff, but our heartfelt support and understanding is still so very strong. As a nurse, I still need to care for my patients. I do this now, by reaching out to them and talking to them in all the new ways we have learnt. Thank goodness for the digital world, at times so alien to us as medical practitioners, as it has become such an amazing tool allowing us to adapt and to communicate with each other. Three months ago, who would have predicted that we would be holding video consultations from our living rooms, and ringing patients from our kitchens? 

Our patients have become so adaptable in working with us; they know we want the best outcome for them and that we will strive to make treatment as safe and welcoming as possible when we are ready to start again. I am committed to remaining professional and my patients trust me to do the right thing for them when the country is ready. We communicate through social media channels to keep our patients upbeat and to look after their total wellbeing; we let them know how they can keep focused and ensure that they are 'fit for fertility' when we get that green light to reopen our doors. We are learning so much about ourselves and others, by channelling how we are feeling into finding solutions and by getting the best out of each day.

We are now starting to put in place measures for when we reopen, but of course we need the appropriate guidance to do this in a safe and effective way. We will need to learn to work differently, wearing personal protective equipment (PPE) and asking our patients to do the same; learning to smile through a mask and learning to let our patients know how much we care whilst comforting them with a gloved hand. All of these measures are alien to me as a nurse who wants to hug my crying patient or congratulate them on their good news, but we have to adapt. We have shown and proven to ourselves that we can work differently so that we can keep each other safe. 

I chose nursing as a profession because I wanted to care for others. Just because I face challenges that really do test my ability to do best by my patients by no means compromises that 35-year commitment to them. This pandemic has challenged me in so many ways, but I have learnt so much about myself and my patients. Mahatma Ghandi said: 'The best way to find yourself is to lose yourself in the service of others.' I have tried to be true to this ideal and hope my patients feel nurtured and cared-for in these craziest of times.  

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