6 April 2020
We need to talk about COVID…
We’ve got something a little different to share with you today. Meet Naomi Berry, one of our tutors with a long history at the Primary Care Training Centre! Naomi graduated from the Cert HE course and went on to do her nurse training whilst working part-time as Healthcare Assistant in general practice. She qualified in November 2019 and now works full-time in a GP practice in Bradford. Naomi has been a tutor on our HCA courses since March 2019.
Our Director of Education, Rebecca Owen talked to Naomi about her experience as a recently qualified nurse working during the Covid-19 pandemic, and asked for any advice to colleagues in a similar position.
Interview with Naomi Berry, Practice Nurse & Tutor
By Rebecca Owen, Director of Education
Rebecca: Thanks for talking to me today Naomi. This is an extremely challenging time for any nurse, but I imagine it’s particularly challenging if you’ve fairly recently qualified?
Naomi: I never thought I would be entering a pandemic any time soon! It’s been an experience to say the least. I had just started getting used to my role as a practice nurse.
Rebecca: What have you found the most difficult to deal with?
Naomi: The not knowing how the next few weeks are going to pan out and whether we will be redeployed into community/secondary care or the primary care hubs.
Rebecca: What support have you received?
Naomi: My practice and nurse manager have been really supportive. We are currently working one day per week to cut down contact timings with patients. We are taking it day by day to ensure we don’t risk our own health. We have all the PPE available and no patient is allowed into the practice until we have donned all our PPE and feel comfortable.
Rebecca: We hear about ‘frontline’ NHS staff and often the story is about hospital-based staff. How do Practice Nurses and primary care teams contribute to managing the pandemic?
Naomi: At the moment we are not being classed as being front line as hospitals are dealing with all COVID positive patients. This is about to change with the red hubs that have been set up in Bradford, and we are also going to see more palliative care patients. We will now be providing care for COVID positive patients and their families to try and reduce the amount of hospital admissions. We will become very important in the fight against COVID, and in providing dignified and painless deaths which will be the hardest time in my career.
Rebecca: Can you describe a typical work day now, and how does this compare to before the pandemic?
Naomi: When I arrive, I clean all my clinical room including surfaces, chairs and computer to reduce the risk of contamination. When a patient arrives, they wait outside until I have donned all my PPE and I then go and get them and lead them into the clinical room. Once the appointment is done, I escort them back out of the surgery, and then deep clean my room to ensure now contamination from patient to patient and also to protect myself. I used to be able to spend time with my patients, as I often worry that I may be the only person they see, but now we are like a conveyor belt. We are not seeing elderly patients unless absolutely necessary. I worry about how they are coping and whether they have enough support.
Rebecca: How have patients reacted to changes in their care?
Naomi: They have been brilliant during this time. Some have not been able to understand why they cannot come into the surgery especially during baby immunisation clinic as we are only allowing one parent in the room which can be difficult for them. Some have been abusive and maybe this is down to frustration, but we are trying our hardest at the moment.
Rebecca: Do you expect any further changes in how you deliver patient care?
Naomi: I do wonder whether we will be deployed into the community setting to help the district nurses and work more within the red hubs. We have started seeing patients in the community to provide urgent bloods or injections as they are self-isolating for the 12 weeks. I also wonder whether they will deploy us into secondary care. These are very uncertain times.
Rebecca: Are there any resources you’ve found particularly useful?
Naomi: Nursing in Practice is providing regular updates. Also, Skills platform, E-LfH and the Primary Care Training Centre. There is a Facebook group for Practice Nurses and it has been good to see what other practices are doing and whether we need to update our current practice. We have communications regularly from the CCG on what will be happening and what we need to update our practice on.
Rebecca: How do you think your professional practice might develop as a result of this experience?
Naomi: This is going to be something that I am going to remember for years to come. Being able to provide care during a pandemic is overwhelming and emotionally draining, but also still a rewarding process. Staying calm and collected, especially in front of patients is a new skill I have gained. Working as a multidisciplinary team will be the biggest development as it will allow me to swap from a different skill set from day to day.
Rebecca: Do you think the pandemic will lead to any permanent changes in how primary care delivers care?
Naomi: There will be a lot more telephone consultations, I think. GPs were always unsure whether it was seen as good care but patients have been really receptive. I think as nurses we may be expected to provide a different range of skills and support community teams, or work across different sites. We will need to be more flexible in our skills range.
Rebecca: You started the GPN Ready Scheme in November, what happens to this now?
Naomi: I’m not sure about this. I am presuming that the funding will be postponed and we will be allowed a further 3-6 months to use our funding as it will be needed further down the line.
Rebecca: What clinical knowledge and skills are you planning to develop when things get back to normal in practice?
Naomi: Respiratory is on my top 5 of skills and knowledge that I really need to increase. I also want to do more training around palliative care as this is one of my interests in primary care. I think this is an area that we often forget about.
Rebecca: Do you have any advice for colleagues in a similar position?
- Stay calm
- Keep safe, your family need you
- Talk to your colleagues. Touch base every day and don’t filter feelings
- It’s ok to be scared or nervous
- Keep up to date with all the new guidance that gets released
- If you don’t feel comfortable then don’t do it, take a step back, breathe and go back
- Reflective diaries – I have always found them useful as allows me to understand if there was something I could have done differently
- Document everything on the patient’s notes, no matter how minor their symptoms may have been
Rebecca: Thank you Naomi
Feel free to share any of your own advice or tips. You can email us on email@example.com, or just post on our Facebook page.