Diary of an A&E Nurse - Entry One
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Hey everyone 👋, I’m an A&E nurse and have been working in the NHS for 6 years now as a registered nurse. As you all know we’re facing unprecedented pressures within the NHS at the moment and many of you may think it’s due to the strikes, well it’s not. It’s because it’s massively underfunded. There’s minimal staff and minimal resources. For years, the NHS has been struggling but this year we’re facing a “tridemic” due to RSV, Covid & Influenza alongside all the other health demands.
I’m hoping that sharing this diary entry can provide a little insight into what we’re facing in my department at the moment:
I was working in a 12 bedded resuscitation unit (resus) where we primarily treat cardiac/respiratory arrests, diabetic ketoacidosis and traumas to name a few. On this particular shift I clocked on to find 24 patients in resus as there was no beds available in the trust which meant there were 2 patients in each bay and we didn’t have an airway bay available. We then got a pre alert stating there’s a patient in cardiac arrest coming in 7 minutes. There was no room for this patient which is a situation we shouldn’t be in, we made an airway bay free but we shouldn’t have to do this.
Despite our best efforts and well led arrest, the patient unfortunately died after an hour of CPR and adrenaline but his heart remained in PEA (Pulseless Electrical Activity), which is an un-shockable rhythm, so we had to stop. We then had to break the news to a family that were understandably devastated and were screaming, there was nothing we could do to console them, that was someone’s husband, dad and brother. After this, we all had to fake a smile and went to see the next patient acting like it never happened.
“I don’t know how much longer I can do this, I’m tired, drained and this is the 6th child I’ve lost this week”
An hour later we then received another pre alert for a very recently born baby in cardiac arrest, baby had arrived in the paramedics arms receiving chest compressions. We then took over the resuscitation. Anaesthetics, ODPs, paediatric registrar and our ED resus team were all present. Mum and dad was watching from the side. We again gave our best efforts to try and resuscitate this baby. After 2 hours, mum and dad asked us to stop. The heart break was unreal, no amount of training prepares us for this moment. We then gave mum and dad as much time as they wanted to spend with their baby before she was taken to the mortuary. As we all came out following the arrest the paediatric registrar burst into tears, I took them aside and they looked at me and said “I don’t know how much longer I can do this, I’m tired, drained and this is the 6th child I’ve lost this week”. They were on hour 23 of their shift that they were supposed to finish 11 hours ago but due to the demand and no staff, they had to work the night shift too.
I then had a patients relative verbally abuse me because her mum hadn’t had a drink or sandwich since lunch time despite her seeing the poorly child come in and hearing the emergency. Funny thing was the relative that was complaining was sat with food and a coffee from costa. The question I asked was if your that concerned then why didn’t you get your mum something from costa too. I don’t think that went down very well… Along with the 2 arrests we still had to care for the other 24 poorly patients in resus with only 4 nurses. Some of these required hourly blood gases, ketones, intravenous medications/fluids, serial ECGs and repeat bloods but that’s not all…there was numerous outstanding tasks following doctor reviews that needed to be completed alongside us providing basic nursing care.
Our staff are feeling burnt out, deflated and feel like we can’t give the care we would like to give due to the amount of pressure we’re facing. We are all SICK of the abuse, we get called all sorts from useless to the ‘c’ word, and I’m sure you can imagine the rest. We get hit, spat at and there’s even been a situation where there’s been a member of the public running round the department with a knife threatening to stab nurses when we’re just trying our best! There’s days where patients and/or relatives make nurses cry, what people forget is that we are only human too, not ‘super heroes’. We don’t always have chance to eat, drink or go to the toilet but god forbid we get a break then that’s frowned upon.
I’m not asking people to praise us for doing our job, all we’re asking for is to be treated with respect and for people to realise what it’s like working in the NHS. The current situation is making nurses leave the profession for good which is only going to put the NHS further into crisis. The government needs to pull their finger out and treat the NHS and NHS staff with more respect. On the subject of striking, my colleagues are striking across the health service for valid reason, we want our patients to be safe in our hands, and we want to make sure we are doing the best possible - not the best that we can with limited resources and overwhelmed corridors filled with trollies. If you think not, please talk to one of my NHS colleagues or follow this diary. Todays entry is from just one shift - I do 6 a week, and there are hundreds of thousands of us. Imagine if we all kept a diary, then would you hear us? Then would you support our strikes?
I’ve asked for these diaries to be kept anonymous, for obvious reasons. It’s necessary though. I don’t think the media show the true scale of the problems happening and I don’t think the general population understand them until they speak to us in person or hear our accounts. I hope that this place can be a safe haven for me and other nurses or NHS workers to share what we are thinking and going through.
Please support the strikes and your nurses.
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