The scandalous state of our care homes stripped bare in this nurse’s brave and utterly devastating diary
Clinical lead nurse, Newfield Nursing Home, Sheffield, as told to SIAN BOYLE
CORONAVIRUS has ravaged Newfield Nursing Home in Sheffield, where half of the residents have tested positive. Clinical lead nurse LAURA HIBBARD recounts a harrowing week on the front line . . .
FRIDAY: ‘He grasps my hand as he passes away’
LAST week, 16 of our 30 residents had tested positive for coronavirus, so I’m not sleeping well at the moment. Yesterday we lost Richard, a bright resident with a great sense of humour who deteriorated suddenly. He was our fourth coronavirus death since the outbreak began.
My alarm goes off at 5.45am and I arrive at Newfield at 6.50am. I’m told to keep a close eye on two residents, David and Edna, who are Covid-positive and have deteriorated.
I change into my uniform. The only PPE we wear full-time is gloves and a plastic apron — we only don mouth masks and visors to enter the room of a Covid-positive resident. We were told we wouldn’t get more masks until June, and a delivery from Sheffield City Council last week failed to materialise.
I’m covering for the manager, who is on week seven of a 12-week isolation, and I oversee around 60 staff. At 8.30am I start the medication rounds, while the care staff serve breakfast and help people with their hygiene.
‘Morning David!’ I say chirpily as I check on him. ‘Good morning,’ he replies.
David, who is 84, is a charming, wellmannered gentleman who is particular about having his hair neat, but today he is sedate.
This morning staff sit with him. If he takes a turn for the worse, we have a plan in place with the family for him to remain with us and not enter hospital.
I visit David at three o’clock. His breathing rate has changed, he looks ashen and his skin is mottled. From experience, I know the end is close, so we contact his family.
Usually relatives would come in. But at the moment, partners — and even children — of the residents are at an age where they’re at risk of coronavirus themselves.
We use David’s phone to set up a FaceTime video call with his daughter, and my colleague holds the phone up so they can say their goodbyes. His daughter tells him she loves him. It’s a distressing call and very brief.
After the call, I sit with David for a while and hold his hand. He suddenly grasps my hand, then shortly afterwards he passes away. It’s 4.30pm. Sitting with someone like this means we’re one staff member short on the main floor, but we would never want someone to be on their own at this time.
I’m trained to verify death, so after someone’s passing I complete the paperwork and inform the GP and the family. Then we freshen him up, change his clothes and call the funeral directors, who are very busy at the moment. They arrive at around 6pm.
Whenever the funeral directors come, we usher residents into their rooms and make sure all the doors are closed. We follow the trolley out of the building and stand by while the body is placed in a private ambulance, then watch it drive off.
Our team debrief usually starts at about 6.45pm, and we hand over to the night team at 6.55pm. Before leaving, I throw my PPE in a hazardous waste bin, shower on site and put my uniform in a carrier bag.
At 8pm I drive home and wash my uniform at 60c. It takes 40 minutes to wash, then another 45 minutes to dry, so sometimes I don’t relax until after 9.30pm.
To try to come down from the day, I have a glass of red wine and watch light television.
SATURDAY: ‘I’m sorry, you’ve tested positive’
DURING this morning’s handover, I am told that Edna passed away in the night. She was 88. The funeral directors are on call 24 hours a day, so she had already been taken away by the time I got to the home.
I’m told that one of our younger residents, Joseph, showed coronavirus symptoms overnight, so at 7.30am I visit him. He has a dry cough and a temperature of 38.2c.
We’re lucky in that, unlike most care homes, we have access to swab-testing kits because we’re an NHS overspill home. I wear a full-face visor and mask to swab Joseph’s nostrils and throat. The swab is then sealed to be taken to the labs.
The courier only works weekdays, so today we use a local cabbie to deliver the samples. The taxi firm knows its cargo’s contents and the driver wears a mask and gloves.
Joseph is 57 and here temporarily for health and social care reasons. He talks a lot about going home and likes to watch old game shows on TV in the communal room. I take my daily break at 3pm, and two hours later we get a phone call from the lab with Joseph’s results.
‘Joseph, unfortunately you’ve tested positive,’ I tell him. But because we had chatted it through earlier, he takes it well.
Tomorrow was supposed to be my day off but we’re short-staffed and can’t get cover, so I’m going back in. Last week, one colleague went into hospital with coronavirus and now he’s in intensive care.
SUNDAY: ‘Two residents are at end-of-life’
THIS morning I’m drafted into our sister care home, Westbourne House, and told immediately that there are two Covid-positive residents, Barbara and Edward, who are at end-of-life.
As soon as I check on Edward, at 8am, I can see he won’t be with us for much longer. I make sure he isn’t in any pain before asking a member of staff to sit with him. Edward’s wife and son had wanted to come and say goodbye but can’t because they’re self-isolating.
After a while, the staff member asks me to come into the room. There’s no breathing and I check his pulse. By 9am Edward has passed away, aged 82.
As it’s a Sunday, I need to call 111 and not the GP to proceed with the death verification process.
David is usually so charming but today he is sedate and by 3pm he has become ashen, his skin mottled. I know the end is close. We hold the phone up so his daughter can say goodbye. He suddenly grasps my hand, then passes away. There is so much death, it’s horrific. Care homes have been forgotten
I call the funeral directors and Edward’s son to break the news. He was expecting it but it’s still a shock and he is very distressed.
When I go into Covid-positive residents’ rooms, some of them are confused about why we have so much PPE on. They don’t see a smile; only our eyes. It’s difficult communicating with people who are hard of hearing, who usually rely on our facial expressions and lip movements.
Throughout the day I’ve done checks on Barbara and made sure she is comfortable. Unfortunately, she too reaches the end of her life, and a staff member is with her when she passes away at 4.45pm.
When someone resides here, a conversation has been had with the family and GP about whether they should be resuscitated. Would they like to die in a hospital or in their own room here, with staff they’ve known for weeks, months or sometimes years? Here, it’s more of a family environment.
Barbara was 92 and her next of kin was her neighbour. I go through the routine: verify the death, call the next of kin, the doctor and the funeral directors, do the paperwork. At 8.30pm I’m still here, waiting for the funeral directors to arrive.
We’re not used to dealing with so much death. It’s horrific. I now recognise a typical ‘coronavirus death’: coughing, breathlessness and they really do seem to fight for their lives. I’m concerned about the spread of the virus and how many more lives we’ll lose.
MONDAY: ‘What would I have done without you?’
WE’RE preparing to reopen the care home to hospital discharges — people who are medically well enough to leave hospital but need care before they can return home.
We’re apprehensive because we believe the home was infected in the first place by people returning from hospital. We had to halt discharges because our staffing levels fell to such a degree that at one point nearly 40 per cent of our staff were off sick.
It’s scary, but we know the acute sector is struggling. To protect against the virus, we have a floor to quarantine hospital discharges while the other residents are on a separate floor. This also helps us ration the PPE.
We’ve been told that everyone will be swabbed before they leave the hospital. But will we know the result of the swab before they come to us? A swab is only accurate at the time it’s done. People could pick up coronavirus in the ambulance on the way here.
This afternoon we have the good news of our own discharges — two residents who are well enough to go home. One is a 92-year-old who survived coronavirus and is going back to be with his family.
We are especially pleased to be able to wave goodbye to Alice, who is in her 80s and has been with us for three months. During that time she caught the virus and was very ill for 17 days.
To nurse someone back to health, we encourage fluids and rest. But we also jolly on the residents with success stories — the people who survived. Alice became one of those success stories. As she leaves, she tells us: ‘I don’t know what I would have done without you these past few weeks.’
TUESDAY: Red nail polish and Nat King Cole
TODAY is one of those days — a rarity now — when everything is calm. At 6.50am, before my shift begins, I have time for a cup of tea with some of the girls.
At the briefing, I’m told everyone slept well and is settled.
We have a decent number of staff on today, and at around 3pm two of our girls who are former hairdressers decide to have a pamper session with some of the ladies.
They set their hair in rollers and paint their nails. We have a box of colours but the ladies always go for pink and red. The residents are delighted with the makeover and have pictures taken to send to their families.
Another lady loves to sing and wants music, so we put on CDs — old crooners like Nat King Cole and Frank Sinatra. The staff have a singalong with her in her room. It’s a morale boost when we can have a bit of fun like this. After work, I have a video call and some drinks with two close friends.
WEDNESDAY: ‘In a face visor, I meet two Covid patients’
AT 10.30am we welcome the first of three hospital discharges from the Northern General Hospital, two of whom are Covid-positive.
They were in hospital for other reasons and contracted the virus there, but as their symptoms are mild they’re deemed medically fit to be discharged. Likewise, residents may come down with it here but either aren’t poorly enough to go to the hospital, or they and their family have decided they won’t be admitted. We keep a close eye on people to monitor them.
I’ve heard some hospitals have been discharging patients to care homes without telling them they are Covid-positive.
Early in the pandemic, people weren’t tested before they were sent to us, so who knows? But in the past week people have been tested before they come to us.
When I welcome someone to the care home, I like to make them feel comfortable. But now there’s an added barrier because I’m wearing full PPE and a face visor throughout the conversation.
My parents, who I live with, are scared for me. I’m worried about my own health but I try not to think about it. I stay in one room in the house — it’s isolating but no different from what everyone else is experiencing. My parents understand I’m needed in my job. I haven’t hugged them in weeks.
Some people ask why I want to be a care home nurse, but I’ve wanted to be a nurse since I was at school. I love working with the elderly — I have a lot of respect for that generation. They’ve done so much for us and sometimes they get a rough deal at the end. Anything we can do to make their lives better is hugely important to me.
Care providers are the forgotten sector. Reflecting on the beginning of the pandemic, we were definitely forgotten about –— especially how the people dying of Covid weren’t counted. In the past couple of weeks I think people are realising the work care homes do.
THURSDAY: ‘Thank you for getting her home’
FROM 10am I’m preparing for Julia, who is 86, to be discharged from the care home.
She has been with us for two months, having first been discharged from hospital, and every day her husband Reginald calls her on her mobile phone. They’ve been married for almost 60 years and before she went into hospital they’d never spent a night apart.
This month she had a temperature and a dry cough, and swabs came back positive. Two days later she couldn’t eat, drink or talk. We didn’t think she was going to make it. Reginald tried to call Julia multiple times a day and I spoke to him every time he rang.
Julia was ill for a week, then suddenly rallied overnight. By the morning she was almost her usual self. That was six days ago and now she’s ready to leave.
We have a false start at lunchtime when the wrong type of ambulance arrives to collect her, but by four o’clock she is leaving.
I speak to Reginald on the phone one more time. ‘She’s on her way,’ I tell him. ‘Thank you so much for getting her better and getting her home,’ he replies.
I can tell he is over the moon.
All names have been changed.