NHS heroes reveal what
WITH nearly 50 years of experience between them, Ceri Lynch and Penny Beckett thought they had encountered the most extreme pressures intensive care had to offer.
But the pair admit they have never witnessed anything quite as physically demanding, energy sapping or emotionally draining as the current Covid19 outbreak.
The medics, who work at the Royal Glamorgan Hospital, near Llantrisant, are at the coalface of the crisis which has already claimed more than 750 lives in Wales alone.
Not only have they seen patients dying from the virus without loved ones by their bedside to hold their hand in their final moments, they also live with the very real fear of becoming unwell themselves and passing it onto their families.
“I’m banned from hugging the children, who are nine and 11, and my husband has been sleeping in the spare room,” said intensive care consultant and mum-of-two Ceri.
“They are understandably worried about me at the moment, but at a time where there is unprecedented demand on intensive care, you have a duty to help those who are critically ill.”
Since the very start of the outbreak in early March, staff at the Royal Glamorgan have been busy preparing for an anticipated surge in the number of Covid-19 patients.
The intensive care unit, which normally consists of six beds and an additional four in high dependency, has now doubled, with a further 10 beds available should the outbreak worsen further.
Field hospitals have also been created by the Cwm Taf Morgannwg University Health Board, including one at the Welsh Rugby Union’s training facility at the Vale Resort, Hensol, which will further boost bed capacity should it be needed. Ceri, 43, said the intensive care unit at the Royal Glamorgan has “expanded sideways” to increase capacity, taking over the coronary care unit and elective orthopaedic wards.
“Very early on the decision was made to stop non-essential surgery and clear areas of the hospital,” she said.
“That meant we were able to carry out extensive training of staff, run through the protocols with PPE and how to get them on and off safely without contamination. It’s a twoperson job.
“We ran drills and even had simulation dummies brought in from A&E so staff could learn how to carry out emergency intubation.”
Intensive care unit manager Penny, a senior nurse who lives in nearby Llanharan, said the collaborative working between medics, electricians and NHS estates staff to expand the unit within days was quite remarkable.
“If we needed an extra wall here or another door there, they just got those jobs done,” said the 57-year-old.
Before long, they said a “trickle” of suspected Covid-19 cases in early March soon turned into a “torrent” by the start of April.
As a consequence, staff were redeployed onto the unit from a variety of departments around the hospital, many of who had never dealt with severely ill patients before.
“In intensive care we’re sadly used to people dying. Probably about a quarter of intensive care patients don’t survive,” admitted Ceri.
“We are trying to shield the [redeployed] staff from seeing a lot of that.
“Unlike most illness and injury, with Covid-19 we are learning as we go along.
“At first we were intubating [inserting breathing tubes] patients early, but as more information came in from places like Italy it proved more beneficial to use CPAP machines to give them that extra oxygen.
“That was a big change just a few weeks in. We had to learn to be flexible.”
Penny added that due to the very nature of intensive care, there is no way of knowing what will come through the doors, day or night.
“We have a core group of staff who are experienced in intensive care,” she said.
“But as the demand has gone up so much, there are now a lot of nurses, healthcare support workers and physiotherapists in the department to support us.
“We are trying to balance the skill mix between ITU nurses and those who have come to help from elsewhere.
“It has been a challenge. People come in – who are understandably feeling nervous and apprehensive – at very short notice and we are not able to give them weeks to prepare, but they have been absolutely amazing and the feedback from them so far has been so pleasing.”
Both Ceri and Penny admitted one of the hardest elements of care during the pandemic has been trying to ease the fears of patients while treating them in full personal protective equipment (PPE).
“It is extremely hot and it can be very uncomfortable,” said Penny.
“To try and communicate through all of the hoods, masks and visors, you often find yourself shouting to get your voice heard.
“Normally you attempt to reassure them with a smile or holding their hand, but that’s missing.
“Staff have had their photographs laminated and put on their fronts so the patients can identify them, which is a great idea. It also helps staff as we all look so alike in our equipment.”
Due to the strict rules around the spread of infection, families have been unable to visit Covid-19 patients on the wards.
However, these are now being relaxed for those who are reaching the end of their lives.
“We have iPads where patients can FaceTime their loved ones, but often they are unconscious,” said Ceri.
“We now say that visitors of patients who are coming to the end of their lives can come in but have to wear PPE and cannot be ill themselves. We tell them to isolate afterwards for 14 days.
“However, most haven’t taken up that offer and do it via video link instead. Feedback has shown that families are reassured that someone is with them and holding their hand when they say their goodbyes. It’s very upsetting for everyone involved.”
Penny added: “It’s a privilege to be there with somebody holding their hand in their final moments. It’s a deeply personal thing to do.”
Ceri said while she feels protected in work due to the amount of equipment staff are given, she does not know how much longer the supplies of gloves, visors, masks and aprons can be maintained.
“We always feel like it’s about to run out, but it never has,” she said.
“We’ve always had another delivery in time. I have never felt unsafe.”
Penny, who is the youngest of nine children and is originally from Porthcawl, said being away from her family for weeks on end has been a struggle.
“It’s been very difficult not being able to go and see my family, but maintaining contact through video chat has been a godsend,” she added.
“I normally do the run at least once a week to see my four sisters in Porthcawl and we go for a coffee.
“Yes, it is a constant concern [that I might get coronavirus], but I feel we have sufficient PPE to go into these areas and we do feel protected.
“Unfortunately we do know colleagues who have