A senior charge nurse from Cork has spoken of the stress and tribulations he and his colleagues are currently facing in a busy UK trauma centre that has seen a huge surge in patients being admitted to ICU wards in recent weeks.
Alan Bohane from Ballincollig works in the Royal London Hospital, which is situated in the East End. Alan leads a team of 11 nurses and they are in charge of the day-to-day running of the shift in the busiest trauma centre in the UK.
The number of Covid-19 cases in London has already exceeded 1,000 per 100,000 people, putting immense pressure on an already stretched health service and the 7,034 people currently in London hospitals with the virus represents a 35% increase compared to the peak of the pandemic last April. These alarming numbers have led to the Mayor of London Sadiq Khan declaring a “major incident”.
Alan and his team are presently dealing with a situation of 125 patients in the ICU, which he admits is very tough.
“The variant is far more infectious, unfortunately. It is spreading a lot more rapidly. We have been crazy busy in recent weeks. It is very bad here at present, unfortunately. We usually have 44 beds in our ICU. At the moment we have got 125 patients inside and 108 of them have Covid. 95 of these patients are on a ventilator.
“We have more than trebled our numbers in ICU. We were supposed to be at the peak last March and April and the most we had back then was 84. We have already moved way ahead of that number. They are expecting our full peak to come in another week or two which is a frightening prospect,” he said.
The Cork man admitted he and his colleagues are finding it mentally and physically draining working in these very trying circumstances.
“I work in the biggest ICU in London. It is very draining. It is mentally and physically tough. We are in the eye of a storm at the moment. It is like a warzone. It is a huge emotional burden. It is being called disaster medicine because that is exactly what it is.
“In ICUs normally we would have one nurse for one patient. At the moment, we have to dilute our skills. We have one ICU nurse for three patients. We are calling on nurses from theatre, recovery, and other wards to help us out in any way they can. It is a huge challenge. People are exhausted. We have been dealing with this since last March. It is so tough. I am wrecked. It takes its toll,” he added.
Despite his sheer exhaustion at times Alan, who completed his nursing studies in UCC, before working in the ICU in CUH for three years, never felt any fear arriving into work post-Covid.
“This is my job and I just get on with it. That is the way I have always been. I was never afraid of going to work. It is our vocation. It can be tough and especially if you work in ICU. 12 months ago we were running a capacity of 44 in our ICU. We have now trebled that figure. In our hospital, there were two floors that were never developed so they put in €25 million to open up another 160 beds to deal with this crisis. They are planning to open another 30 beds again, but I don’t know where they will get the staff.
“They have currently stopped all elective surgery so they can reapply all the theatre staff to ICU wards. Anyone who previously worked as an ICU nurse has come back to us. We have junior doctors, medical students, and health care assistants all helping us out in the ICU ward. It is a herculean task at present.”
Mr Bohane has been monitoring all Covid-19 related events in Ireland very closely.
“We were too late to go into lockdown here in the UK. We were always behind the curve. The politicians need to accept some criticism for that. It is a far more urban population here so it is far easier to spread. In London, it is common to have three generations of families living together in a small apartment. There are lots of factors like that which haven’t helped. It is frightening.
People don’t realise how bad it is here. The UK is doing very badly. The more rural aspect of Ireland has helped while they went into lockdown earlier and in general the people were very obedient to the rules.
“Everyone at home deserves massive credit for the sacrifices they have made. The Irish politicians have taken it a lot more seriously than the politicians over here,” he said.
Mr Bohane, who has worked in London since 2012, received his first Covid-19 vaccine on December 24. He is hopeful the vaccines and the medical knowledge they have amassed in recent months will be a huge benefit to them going forward.
“Our average age of Covid patients is currently at 60 years. 70% of these patients are men. Our mortality rate from patients who were in the ICU during the first pandemic was around 40%. Hopefully, this will improve as we know more about the disease. We have treatments now that we didn’t necessarily know about when it started.
“There is light at the end of the tunnel. The vaccine gives us great hope. I got the Pfizer vaccine which I was delighted to take. None of my colleagues or I have experienced side effects. This new Oxford vaccine is very promising and could be the real game-changer. It will take all the vaccines together to defeat this awful virus.”
The senior charge nurse suffered his own personal trauma last year when his beloved grandfather Neilie passed away last June. Due to the restrictions in place, Alan was unable to travel home to bid farewell to his grandad which was very upsetting for him.
“I missed out on coming home for my poor grandad’s funeral. That affected me big time. It was very upsetting that I couldn’t come home to say goodbye as we are a very close-knit family. I had the consolation of watching it on Facebook, but it was tough watching it from afar.”
Mr Bohane said another distressing part of their job is witnessing the awful impact Covid-19 has had on families. Restrictions strictly enforced have vastly reduced the number of visitors who can visit their loved ones, which is truly heartbreaking he revealed.
“One family member is only allowed in for the end of life care. It is very tough as how do you pick one person? It is horrific for them. We try our best to let them do Zoom calls so they can see their relatives, but we don’t have the manpower to do this on a regular basis. Your heart would go out to them. It is very tough on their relatives as they are not getting to see them. It is so tough for them to comprehend and make sense of it when they die.”
The 33-year-old Cork man is hoping life will improve for all this year. Mr Bohane is due to get married in the Philippines this December. He is confident this year will get better as the year progresses.
“There will be another tough few months ahead but once the vaccine gets rolled out, hopefully, we will see a huge change by the summer. When I first moved over, I thought I would be only here for a few years, but I got great career opportunities. I have subsequently got engaged and bought a house so I’m not going anywhere in the short-term. My fiance is an accident and emergency nurse. I hope to eventually convince her to move home down the line.
“2021 will be a better year for all. We have to retain our hope,” he added.