for better mental health

Life on the Covid wards

Friday, 24 April 2020 Andrea

Respiratory physiotherapist Andrea blogs about how she is trying to look after herself while looking after coronavirus patients.

I am a respiratory physiotherapist living and working in London, working directly with people who are being treated for Covid-19, both on wards and in intensive care. I have been working in the NHS for about 10 years.

One of the hardest things at the moment is the loss of any structure and routine. In the last eight days I have worked five 12+ hour shifts – two nights and three days. Trying to get enough sleep whenever I can is a challenge. I cannot imagine how people who have caring responsibilities for children or older parents (or both) are doing this. I live alone, which is good in that I only have to worry about myself, but I do also feel quite lonely at times when not at work. I'm trying my best to keep in contact with friends and family. I'm a natural introvert and do enjoy my own company, but I also find it hard to reach out to people. Even workplace support systems are difficult to maintain. I have been redeployed from my usual team and place of work into a hospital I've never worked in before (though it is part of the same Trust). Everything is unfamiliar, which would be daunting at any time.

Dealing with uncertainty is a fairly normal in healthcare, though obviously not on the current scale. I think it is something we are all taking in our stride, and in a way it's nice because everyone is in the same boat. I have to say the communication from my management has been fantastic – honest, direct, timely, not too much or too little. I have felt as well supported as I think is possible.

When I do have downtime I have to try to force myself away from the news.

Away from work, when I do have downtime I have to try to force myself away from the news and the constant stream of Covid-19 information. I have a separate Twitter account where I follow people who use Twitter for medical and educational purposes, and have to be disciplined with myself as to when I look at. There's so much fantastic work being done and learning being shared, but I have to have time away. As a slightly obsessive, knowledge-hungry person that can be a difficult balance to strike.

On the other side of that, when you are exhausted it's the easiest thing in the world to sit and scroll mindlessly through social media, looking at a million photos of cats and people getting into making bread, and then feel bad for wasting your precious time off. Higher quality entertainment takes so much more concentration and energy. The stack of books I hoarded remains largely untouched. I can't sit through a whole film, even breaking up the classics on Disney+.  Some of the things I normally enjoy feel like too much effort.

Having work be so dominant in my life right now feels helpful, but I am worried I will burn out.

I'm a slightly anxious person at the best of times, and it is tough to have lost so many of my normal ways of self-managing that. Having work be so dominant in my life right now in some ways feels helpful, but I am worried that I will burn out and be unable to sustain it. I feel like I know all the right things to do, but it's so much harder to implement them in practice. I did manage a walk and a home workout yesterday, which made me feel better at the time, but feel very tired today. I'm trying to be kind to myself and accept that sometimes I do just have to stop.

I have found some of the dialogue around the NHS a bit difficult to deal with. I don't feel like any kind of hero. It's nice that people are grateful, but that's enough for me. That said, I did find the clapping to be more affecting than I anticipated, and I know a lot of colleagues felt the same. Seeing people come together in such a simple way to show support can be a very powerful thing. The NHS, like any workplace, has its difficulties - there's bickering and politics and frustrations just like anywhere else. But right now there is a tremendous feeling of camaraderie and a willingness to pull together. I feel very lucky to be a part of it. I am thinking fondly of amazing people I have worked with in different parts of the country over the years, and hoping they are safe and well. It does feel like a big family in a lot of ways. I am also grateful to have job security in a time where friends are worried about their work, rent, bills and so on.

I don't have too much time to worry about the risks to myself from constant exposure. It's part of the job. If I get the virus then I will deal with that when it comes. Likewise I can't really let myself stress too much about PPE. It is frustrating as the advice has changed numerous times, and I have definitely been exposed to positive patients while wearing less than is recommended now. But I am putting that to one side, doing what I am told to do and concentrating on my job. It's too much of an unknown to do anything else.

Over the last few weeks I've thrown myself into work, turned my focus outward, and tried my best to be useful and helpful, which is my natural way of dealing with any crisis.

I have seen the avalanche of wellbeing advice and information, thought "that's nice" and moved on with my day. But sitting and writing all this down has made me check in with myself, and I feel much more vulnerable than I did. I think that's a good thing, because I am recognising that actually this is all a lot more difficult than I was letting myself acknowledge. Perhaps there's an element of self-preservation in that which I am now losing.  That's scary but in the long run it's probably healthier.

I am trying to stay positive and remember that this will end at some point.

I am trying to stay positive and remember that this will end at some point. Today I have started a list of things I will look forward to when this is over. A cold pint in a sunny beer garden. A good steak. Feeling my legs shake after a hard workout. A hug from my best friend. The smell of my cat's head. Football. And in the meantime I will just keep going as best I can, and focus on the simple things. Checking in with myself. Talking to people. Making space for things I enjoy. Washing, eating, sleeping. And reminding myself that this is unprecedented, and aside from looking after those basic things, there's no right or wrong way of getting through it.

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