Retired QARANC Nurse Volunteers at the Front-Line of the Covid- 19 Pandemic 2020-21- By Kay Foster

Experiences of Major (Retd) Kay Foster QARANC working in The Nightingale Hospital, Exeter as a volunteer.

In March 2020, I caught Covid -19 and was pretty ill at home in bed for ten days. Keen to know whether I had developed antibodies I had a blood serum test in July, which came back positive. With this knowledge I felt I wanted to make a positive contribution and as the pandemic was raging in the UK decided to apply to become a volunteer at the Nightingale Hospital Exeter (NHE). I was drawn to the Nightingale like a magnet and joined the team in August 2020.

The NHE was the seventh and last Nightingale to be built in England. It is 39,300 sq ft in floor space and built in the redundant Homebase warehouse on the Sowton Business Park site. It has five Wards, 116 beds in total with ITU capability. It has the highest specifications of all the Nightingales, one of the few to accommodate Covid -19 patients.

Chantal Baker, Assistant Director of Nursing NHE, was the senior nurse in charge of this project and when I joined her the only nurse involved. She took me on a tour of the building. As a former warehouse the building has no natural light and all the walls are painted white. Chantal wanted to brighten the walls with pictures, but was having difficulty getting the idea approved by the fire officer. I suggested murals. The comment flew out of my mouth, and before I knew it I had been tasked with organising this project. Where to start! On the way home, I popped in to visit a friend, and amazingly she was friendly with an artist who painted large canvas backdrops for local theatres. Having got funding approved, two artists where given the project of painting a wall outside each of the wards. Each ward has the name of an English flower and this flower was represented in every mural. I also contacted a local community group that used art work to assist the development of children of all ages. It was arranged that over a number of weekends children from the group would spend time painting some of the hospital walls under the supervision of their group leader. These sessions were great fun, I enjoyed being present and the results were amazing. The murals created much interest and the Medical Director commented that the Hospital could become an art gallery if it was not used for Covid patients!

Volunteers had not been used on hospital wards before and there were several meetings to discuss how to integrate the volunteers into the Hospital. Chantal wanted each volunteer to be part of the team and not just sitting on the sidelines. By the time the Hospital opened for the first admission of Covid-19 patients on the 26th November, I had fallen into the role of Volunteer Coordinator at NHE. Clover was a 24 bedded ward and was the first ward to open. It was not long before the ward was filled with patients. Initially we had 16 volunteers in total who were a variety of ages and from varied backgrounds. Several transferred across from the Royal Devon and Exeter Hospital, some were Exeter University students studying science, working toward becoming doctors, psychologists, sociologists etc., others in full-time employment or retired. They were to cover 3, 4 hour shifts from 07.00hrs to 20.00hrs. The volunteers chose their own shifts. We ran an introduction course covering PPE and welfare for staff and I was always available to offer support, answer questions etc.

It was daunting at first for the new volunteers. Clover was a Nightingale ward, and you could see from one end to the other, a very different appearance from the usual hospital experience today. Mostly ill, frail elderly patients occupied the beds, many on oxygen. The volunteers were in support of the staff. They would sit with disoriented patients, set up iPads for music and TV, help contact relatives or read to patients. One manicured and painted ladies nails to their great delight. Also volunteers were kept busy helping hand out meal trays, collecting visiting relatives from the main entrance and assisting them with their PPE etc. One of the volunteers wrote a Volunteers Handbook, which was most useful.

It was not long before the NHE was admitting more COVID patients. Then a second and third ward opened. In January 2021 patients were now coming from as far afield as Poole in Dorset and Somerset. We needed more volunteers to assist on Daisy Ward and an advertisement for new volunteers was published on the web. They needed to be fast tracked, interviewed on line via Microsoft Teams followed shortly after by induction and a tour of the Hospital. Once the volunteers Disclosure and Barring Service check was accepted, they were ready to go. We had a further 13 in total. The same message came back from the volunteers time and time again "we want to help, to give back to the NHS".

I personally aimed to do two shifts per week on Clover Ward plus cover the day to day running of the volunteers remotely from home. Chantal set up MST meetings for the volunteers, where we would meet online and were kept updated with events as they unfolded.

The volunteers became an accepted and integral part of the nursing team, where they could help staff who were working a gruelling 12hr shift. In January Navy Medics and Marine Bandsmen/women were drafted into the unit to help on the Wards. Their presence assisted greatly and they were valuable support.

I have been a nurse for most of my working life and spent most of my nursing career in the QARANC. With hand on heart, I have never experienced such a total feeling of care and compassion given to patients, and regard and respect for each other. Nursing care was heavy, many patients were not mobile, a number had other medical complications, compounded with Covid, many struggling to breathe. Some needed end of life care. Nurses/HCA's working at the NHE came from the three counties of Devon, Cornwall and Somerset.

To explore the previous paragraph further it would be good to consider the 6 C’s of Nursing, with an additional 7th C, described further below:

1. Care: The attention given to patients for their needs and all welfare. Dignity was a priority and Chantal encouraged local volunteer groups to collect bed jackets/shawls and clothes for the patients. The bed jackets/shawls were to keep patient shoulders covered as the air conditioning was cool for them at times. The clothes were to wear on discharge as having been in hospital for so long they often did not have any of their own. A local dentist also provided individual mouth wash as some patients found it hard cleaning their teeth. All these things went that extra mile to assist in the care.

2. Compassion: the sympathy and pity felt for those suffering, some patients were at the end of life or just missed their relatives. Provision was made for relatives to visit by appointment and to be supplied with PPE.

3. Courage: All that worked at the hospital volunteered to be there. Courage was in their DNA. They put their health and possibly the life of themselves and their families at risk to care for Covid-19 patients.

4. Communication: Staff and Volunteers helped set up mobile telephone links with patients friends and families. Gave them iPads to watch their favourite TV programmes, or listen to their music. Sat with  patients and held their hand whilst talking with them or reading a book or paper.

5. Commitment: The staff were always around when a bell rang to attend to the patients needs. The physio’s ran daily activity classes for more able patients and on an afternoon designated to reflect on Captain Sir Tom Moore who had recently died, the more mobile patients undertook several laps of the ward on Zimmer frames, seated on wheel chairs or pushed on their beds. On sunny days patients were taken outside in wheel chairs by a member of the team no matter who they were, doctor, physio, nurse, HCA, volunteer. The Royal Marines band played music and sang for the patients. A cinema was set up for able patients to attend a short show with ice cream provided.

6. Competency: This came from the leadership of the Director of Medicine and Nursing NHE. They gave the staff a role and totally trusted their ability to do it. They created an atmosphere where all staff were allowed to thrive, enjoy their profession, bond with each other and in turn happy staff equals excellent patient care.

7. Comradeship: This was so evident. The regard and respect that all staff had for each other. We all had a common goal and worked together for that. Saying good bye to each other was a very hard parting.

“We’ll meet again, Don’t know where, don’t know when, 

But I know we’ll meet again, some sunny day". 

Vera Lynn