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New Year, new job, new challenge: from fertility to frontline

22 June 2020
By Courtney Carr
Fertility Nurse at Gateshead Fertility Unit
Appeared in BioNews 1052

17 February was the first day of my new job as a fertility nurse at Gateshead Fertility Unit. I had just left a job in the critical care department (CCD) where I had worked for five years as a staff nurse.

Prior to starting my new job, I enjoyed a holiday to Tenerife for my little boy's third birthday, where I fell ill on our last day. Fever, sweats, muscle aches, headaches, sore throat, cough, shortness of breath you name it I had it. A novel coronavirus was beginning to be reported in the news, and a few days later news broke that an Italian in a hotel in Tenerife had tested positive for the virus and that the hotel was on lockdown. I was shocked, but it wasn't my hotel, I couldn't have caught coronavirus, could I? I was swigging Covonia from the bottle, I couldn't sleep for all the coughing and the shortness of breath and I was having to sleep sitting upright. At the time I just brushed it off that I'd obviously just picked up another virus; and although I'm only 28 and in good health I still didn't question why this lasted ten days.

Finally, I was ready to start my new job in fertility. I was so nervous, though was thrown right in and on my first day witnessed my first vaginal egg collection and embryo transfer. I also observed the embryologists in the lab and I was in complete awe! I still am. I couldn't believe I was finally going to be a part of something I found so amazing and rewarding, having struggled to conceive myself I understand the desperation people can have in starting a family. I continued to work observing staff, taking notes, reading notes and talking to the patients about their treatments.

The patients were all saying how they love the unit and the staff and how very happy they are with the care and support they receive. I remember feeling so lucky. I have always been interested in becoming a fertility nurse, but it's not a job that comes up very often so when it did I grabbed it with both hands and here I am. My husband is also an IVF baby, a triplet from treatment 29 years ago. So to be able to be a part of something that gave me my husband and to help others achieve the same is so rewarding and I truly feel blessed to be a part of the process.

The news had become all about COVID-19 and the severity was growing. As weeks went by I knew that it was only a matter of time before I was called back to CCD, after all I'm highly skilled with five years' experience. How could I not go back and help? It's not that I didn't want to, but I was scared, the uncertainty of it all was just too much to take in; the anxiety about the virus and the risk for not only me, but also my family. It was my sixth week in the job and I was just starting to find my feet and feel comfortable in my new role when I received that dreaded phone call from my manager telling me I was being redeployed back to CCD. It was also decided by the trust that the fertility clinic and all other non-emergency treatments and appointments must stop. There was the potential for other members of staff to also be redeployed to areas of need during the pandemic.

My final week was spent helping the other nurses make heartbreaking phone calls to our patients pausing/postponing their treatments. Although they were obviously very upset about the situation they were also very anxious themselves and understood the reasoning. They were also very concerned for our health and would give us their well wishes and tell us to 'stay safe'.

It was 30 March and my first day back on critical care in the new COVID-19 unit. I sat anxiously waiting in the staff room for the handover. Once completed, I made way to the airlock where we would 'don' in our personal protective equipment (PPE). Whilst being shown how to put on our PPE by a colleague, I remember feeling so overwhelmed by it all. I also remember feeling instantly hot, as though I was profusely sweating already. Once I put the mask on I felt even worse, I could hardly breathe, as though I was suffocating. How was I going to do a 12 hour shift like this? As I made my way out to my first patient I started work as though I had never been away. I had to keep pausing, taking deep breaths and talking to my inner self to try and stay calm.

I was really struggling wearing the PPE and because I was so hot the goggles were steaming up from the heat coming off my forehead, making it difficult to see, it made me panic. Finally, it was my turn for a break and I was so relieved. A colleague showed me how to 'doff' my PPE and I made my way into the female changing room. I was soaking wet. I had to change into new scrubs, freshen myself up and when I looked into the mirror I noticed the bright red marks on my nose and cheekbones. I was shocked, this was only the beginning and I wondered how I was going to look after 12 weeks of this, as that was how long I was told I would be needed for.

Later on during my first day back I had a second admission from A and E, which meant I had two level three patients. The legal requirement is 1:1 for level three patients (patients on ventilators/dialysis) and 1:2 for level two patients (patients requiring more detailed observation or intervention and those 'stepping down' from higher levels of care), but due to the pandemic we were told to prepare ourselves to each take multiple patients (up to three) with the help of redeployed staff.

Days went by, patients so sick, no relatives or loved ones by their side and multiple deaths daily. The environment was just chaotic, there were hundreds of staff who had been sent from many areas of the trust, redeployed to help fight this pandemic, including my lovely team from fertility. We had to multitask and care for patients with COVID-19 but also quickly teach/train the support staff on how to perform the tasks in order for us to care for multiple patients. I'll be forever grateful for all the help and support they gave us. It was scary enough for me going back to a place I had worked for five years, never mind being someone completely new to the environment/job during a pandemic.

Communicating with patients' loved ones over the telephone was hard. We used passwords as a way to safely communicate or iPads to facetime for patients who were awake. It was heart-breaking hearing their anxious tone of voice or listening to them cry. It was a completely different side of nursing and I knew I wasn't being my normal self either. I wasn't the nurse I know I am and I really struggled with that, but reflecting back I think I was naturally protecting myself from the whole experience, from grieving for the patients, their loved ones and their outcome.

After a few weeks the whole situation really started getting to me and I began questioning myself. Was I doing a good job? Was I being a good wife, mam, daughter, sister, granddaughter and friend? I was exhausted, not only physically but mentally too. I was sick of wearing PPE, feeling trapped/claustrophobic and being surrounded by death. I had to keep telling myself to think myself lucky because it wasn't me or a loved one in one of the COVID-19 beds. Yet, it was just so hard and all too much to take in. I was sick of being stroppy, snappy and constantly complaining that I was tired. I felt as though I had completely lost myself. I had to completely avoid the news and social media as I found it so overwhelming and it really didn't help with my anxiety at all.

However, the support the NHS and keyworkers has received from the general public has been absolutely amazing; the donations, the letters, the pictures, the Thursday evening clapping, the list is endless. It certainly helped us during a very dark and uncertain time and I can definitely say it was exactly what I needed over the past 11 weeks to keep me going.

As the weeks have passed the number of cases has dropped and as a trust we now have an empty COVID-19 unit, there have been no new admissions for a couple of weeks. I asked when I would be able to return to the fertility unit as the Human Fertilisation and Embryology Authority and the trust had recently authorised us to re-start treatments.

So here I am about to start my first day back at Gateshead Fertility Unit and I'm really excited to be back with the team, and to be a part of something positive again. I still have a lot to learn and there has to be big changes to maintain safety to both the staff and the patients. It is going to be a learning curve for all the staff here but I'm looking forward to getting stuck back in and helping people on their fertility journey. Here's to hoping we don't have a second wave of COVID-19 and we can all return to some sort of normality very soon.

Stay Safe!

SOURCES & REFERENCES
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