As a matron in a hectic ICU, Linda Gregson felt the coronavirus pandemic had stretched her idea of what was possible to its limits. Then came the video call.
It had been set up so one of her critically ill Covid-19 patients could see their loved ones. But instead of the usual smiling face, or couple of waving children at the other end of the line, this time there were 45 relatives, all crammed into one room.
“On several occasions we have had to stop Zoom calls because there have been numerous relatives in the room not social distancing,” said Gregson.
In the heavily-burdened ICU in Blackburn, northwestern England, where she works – and where eight patients died over the past weekend alone – abuse of the rules is not the only problem she and the other medical staff face.
“There are nurses withdrawing treatment from a patient and doing end of life [procedures] on a patient with a relative on a Zoom call – with a husband or a daughter at the end of the camera crying and saying ‘Please hold my dad’s hand.’ And the next phone call might be somebody hurling abuse at them.”
Last week, Blackburn had the highest rate of new infections in England. For the staff at the Royal Blackburn Teaching hospital, where 59 patients have died of Covid-19 so far in October, the abuse just adds to the litany of trauma and exhaustion they must – and do – overcome.
In an ICU where a third of patients have died since Friday, locals breaking the government rules designed to combat the disease are just another form of insult.
Earlier in the pandemic, relatives were banned from being with those dying of Covid-19 in many UK hospitals. Here, they are allowed to come and say goodbye – providing the same two people visit throughout. Yet even this rule is broken.
“Some relatives have come in and then sworn that just those two relatives will stay,” said Gregson. “And then people have swapped over during the night when the nurses haven’t been looking.”
Gregson said this upsets her nurses further, as they feel they should have enforced the rules. “They’re absolutely exhausted,” she explained. “And to then have to have something else to deal with, it’s really hard.”
As the second wave of coronavirus rises in the UK, the pace of events in the ICU is relentless, Gregson said. “You have a death and there is somebody [waiting] to go in that bed. So there’s absolutely no downtime. Change mattress. Next patient.”
Coronavirus rules ignored
Frustration is growing among the staff at how locals seem to think the disease can be dismissed, or the rules designed to slow its progress ignored.
Ian Stanley, a consultant, recalled hearing a local DJ on the radio that morning, “saying she’s going to have all of her family down for Christmas, and if that means breaking the rule of six - ‘so be it.’ Well, that’s fine. Have your Christmas because we won’t be having ours. It’s us that’s going to bear the brunt of it. And that is dispiriting.”
The UK’s so-called “rule of six” bans social gatherings of more than six people. Police have the power to break up larger groups, and those who disregard the rule can be fined.
The support and national unity medics say buoyed their work at the start of the pandemic has lapsed, staff here told CNN.
During the UK’s lockdown, at the height of Covid-19’s first wave, many people stood on their doorsteps each Thursday evening to applaud workers from the UK’s National Health Service (NHS). The weekly event became known as “Clap for Carers.”
“There’s a really good picture on Facebook that says ‘Thank you very much, you stood on your doorsteps and you clapped us and now it feels like you’re stabbing us in the back,’” said Gregson. “That’s exactly how we feel. We’ve given absolutely everything. And yet we’re being called liars and we’re being abused on the phone.”
The Royal Blackburn’s ICU – so often a place of calm and silence – is abnormally busy, and the staff fear it will only get worse in the days and weeks ahead.
Leaving the hospital for a break is tough for some nurses, Gregson says, because they feel guilty that they should be helping at work.
And then there is the persistent peril of overhearing Covid-19 “pub wisdom,” when they are trying to have a quiet night out.
“It really does wear you down when patients in work are dying in a very specific way and yet there are people who know nothing about the virus saying it is not real and does not exist,” said Dr. Bethan Gay.
The troubling denial of the disease’s severity is always dwarfed by the scale of the problem she works around daily, Gay said. When she started working on the ICU in August, the patient list covered two sheets of paper. Now it is five.
“Last weekend on my night [shift], as soon as I arrived here, a lady came to the ward and unfortunately passed away almost immediately,” Gay said, choking up at the memory.
She had not had time to meet the patient, yet was given the dead woman’s belongings by the hospital porter, just before her relatives arrived. “Giving some relatives a bag and a stick of a lady who has passed away in the bed in front of them is quite difficult. It’s difficult for them, and it’s difficult for us as well.”
