NHS Dumfries & Galloway

The Critical Care team tackling COVID-19

COVID-19 has impacted on every aspect of health and social care across Dumfries and Galloway.

Those who have seen the most direct and devastating effects of the coronavirus are the staff who have been working in the ‘red zones’ of the region’s hospital. These are the people who have been helping those have contracted the virus, and who have been working amid the constant danger posed by the virus.

Anne-Marie Cossar is a deputy charge nurse in the Critical Care Unit at Dumfries and Galloway Royal Infirmary (DGRI), and is just one member of a small army of staff assembled to take on this role.

Asked to provide an insight into the response to COVID-19, the 33-year-old said: “To be honest, when the coronavirus began to emerge as a danger it was pretty terrifying.

“For me, it was the most stressed I’ve ever been in my career. I think that was partly because I was new into the role of deputy charge nurse, and because of the thought that we might, potentially, be overrun with patients needing ventilated.

“When we started to talk about what might be required, I wondered, ‘How are we going to do this?’”

However, Anne-Marie notes extensive forward-planning which took place to prepare for coronavirus, based around a phased escalation plan. She also notes the number of additional staff brought in to support the existing critical care team.

Anne-Marie said: “It was mostly the theatre and nursing staff who joined the team, but we had medical doctors as well. We have a paediatric specialist who has been with us all the way through, and we’ve got nurses returning who had left critical care in the past to go and work in specialities.”

Estimating that up to an additional 50 nurses have joined the team, she added: “They were all pulled back in with the skills that are obviously going to be valuable, and they were helping to train up other people as well.”

Despite the extensive planning and additional staffing, Anne-Marie says responding to the first wave of patients admitted to DGRI was ‘intense’.

Anne-Marie said: “Everybody felt nervous. Everybody felt the pressure. And on each day that went by, there would probably be one or two people in tears in the run-up to the peak that we had.

“But after things started to settle down, and the number of cases fell, we started to relax again. Right now, following this first wave, we’re thinking, ‘It could have been so much worse. We’re lucky’.

“However, we’ve trained everyone up, so if we were to have another peak we’d deal with it in a completely different way next time. We wouldn’t have that same fear because we know what we’re dealing with now.”

Nevertheless, Anne-Marie speaks for many when she reflects with honesty on the anxiety of dealing with the virus.

She said: “Everyone was very apprehensive, especially with the first few people with COVID who came in. For the first people who were asked to go in and look after the patients, the first nurses, it was a big deal. We did get used to it after a while, but we were very particular about our infection control.”

Noting staff’s concern for their own families, and her concern for a husband with a lung condition, Anne-Marie added: “I worried that I would bring COVID back to him, and I worried that he would be one of these young men that it took hold of. I’ve had that worry in the back of my head, and I’ve always been so careful.”

Personal Protective Equipment is a major part of life when working in a ‘red zone’, and Anne-Marie reveals the demands of wearing PPE for the duration of an entire shift in CAU when providing one-to-one care to a COVID patient.

She said: “You’ve got that exposure for your whole 12-hour shift. You do feel isolated. The risk is always there, and the PPE itself is horrible; it affects your vision and hearing, depending on what you’re wearing.”

However, asked if she ever had doubts about being in that role, Anne-Marie said: “No, I’ve just rolled up my sleeves and thought, ‘This is what I was made to do; I’m a critical care nurse, and I’m needed’.

“There was no doubt about it. I’ve felt very useful and needed by the public.”

Anne-Marie says the impact on families unable to visit a sick relative is ‘absolutely awful’. Having witnessed the effects of the virus, she urges people to do everything that they can to help limit its spread, saying, ‘It’s not over yet’.

Nevertheless, if a second wave hits, she says that staff are ready.

Anne-Marie believes one of the major positives to come out of the crisis is staff working together in different ways which has an increased appreciation for each other’s roles, and seeing staff rising to meet the challenge as a solid team.

“It’s been amazing,” she said. “Everyone has been amazing.

“Everyone just pulled up their sleeves. They were like, ‘Right – where do you want me?’

“We’ve created this team which is strong and I think we could cope with it if it came back. It’s been quite incredible what we’ve achieved, and what we’re capable of. Well be able to cope with it on a completely different level to where we might have been before this started.”