Alcura nurse Kathie Roberts, wearing her full personal protective equipment, gives an injection to patient Alyssa Jacobs during a recent home visit in the UK. As part of its wide-ranging work with health care companies and professionals in seven European countries, Alcura provides home medical services.
By Pip Reid
Driving to work at the beginning of the coronavirus pandemic, I couldn’t help the feeling that my team of nurses and I were suddenly exposed, both in terms of safety and the extra pressures this situation brings. But I have been truly amazed by their spirit and ‘We’ve got this’ attitude. We have faced the virus head-on.
I head up a fantastic team of 33 Alcura nurses through Alliance Healthcare, part of the Pharmaceutical Wholesale division of Walgreens Boots Alliance. We provide clinical home-care services for NHS – the United Kingdom’s National Health Service – to private patients no matter where they are in the UK, including highlands and islands. As head nurse, it’s my responsibility not only to look after my own patients and help keep them safe, but to look after my nurses’ well-being, too, as they continue their complex work during the pandemic.
My team are all doing a fabulous job to maintain patient visits. Every one of them has high standards of essential clinical skills that enable us to provide complex and often high-tech treatments right there in patients’ homes. We’re supporting patients with critical conditions like cancer, haematology, rheumatology and growth hormone deficiency, among many others, and it’s our duty to continue to give them this vital home service.
Comfort in our voices
One of the scariest things for an in-home patient can be being treated by a nurse who’s now wearing full PPE – personal protective equipment. Many of our patients’ feelings of vulnerability are heightened at the moment, and while the coronavirus is invisible, wearing this equipment makes it very real to them. The PPE makes it harder for them to see our reassuring expressions while we listen to them telling us their fears and how they’ve been, so it’s vitally important that we talk to them to reassure them. Luckily, we’re all great at talking to people. Personally, I stand two meters away from the front door when I first greet my patients so they can see me smile. Then I don the protective mask and visor.
My patients include small children. The mask was daunting for one of them recently, so, being creative, we struck a deal. To distract from the mask on the next visit, I turned up with a surprise: pink hair. The mask was no longer an issue. However, I now have the challenge of rainbow hair next time.
Protecting nurses and patients
We’re doing all we can to keep nurses and patients safe, meeting or exceeding recommended guidelines. We give every nurse a gown, surgical mask and gloves. Full visors, overshoes and respirators are also available as extra protection when we treat a patient with coronavirus. For added assurance, every one of my nurses has a lone worker device, too, so they’re able to discreetly communicate in an emergency while working alone. To make things easier for our teams making house calls, we’ve also started video-calling dermatology and rheumatology patients, when appropriate. They are shown how to self-administer medication instead of us doing it in person – a way to keep everyone a bit safer.
Managing the pressure
Unexpectedly, I feel like the situation has made me and the team stronger mentally. I try to check up on all of the nurses daily, and I’m so proud of how they’re coping. All of the team looks out for each other. Resilience is definitely a strong team trait, and we’re all jelling closer than ever before. If a nurse is self-isolating because of possible exposure to the virus outside of a patient visit, then we will step in as a team, work longer hours and travel farther to make sure our patients continue to receive the vital care they need. When it’s been needed, we’ve also` manned the COVID-19 help line and even covered night shifts at NHS service centres.
We’ll be setting up debriefing sessions for after this is all over. In the meantime, what helps keep me and my team strong is the support and appreciation we get from our patients and the public. The weekly “Clap For Our Carers” gesture across the UK gives us all a huge boost.
By Kathie Roberts
I’ve been part of the Alcura team since last November. The first time I visited a patient at home with suspected symptoms of COVID-19, I felt very emotional, as in my 19 years of being a nurse, it was the first time I wore full PPE. The severity of this virus hit me then – it suddenly became very real.
Now it feels like COVID-19 has been here forever. I remember initially thinking this will be here for about four weeks, and then we’ll be back to normal – or what was normal. It does feel a little scary at the moment, but my patients need me. I’m lucky I work with such an amazing team, as we’re all supporting each other through this incredibly challenging time.
I remember feeling angry as to why this is happening. Am I going to take this virus home, spread it to other patients? I’m visiting patients in their own homes – am I taking it elsewhere? Why have I got to change the way I nurse my patients? But all of a sudden, while driving to see a patient at home, I started to think it's not all about me. It’s about my family, work colleagues, nursing, and I realized this virus is here and that we will have to live with it and beside it and have faith in science to get us through this crisis. Yes, I have had to change the way I nurse, but that's nursing – it changes all the time, and I have to adapt to this.
I know each day I have to be careful and ensure that I and my patients and family are protected and follow strict guidelines. Yes, it feels a challenge, and I am scared, worried and feel like I just want to hide away sometimes – but I don't and can't give in to this.
‘They need normal right now’
I now go out with a different mindset that I will continue to nurse, because that's my role. I offer comfort, support, reassurance, even as I see the fear in a patient’s face. I laugh with them because they need normal right now, not a nurse who’s a quivering wreck. I know that, as a team, we will come out of this together even stronger, because that's what we do. Nursing will change from this – how, I don't know – but I know we are up to the challenge.