From the frontline: Beccy Lytton, paediatric intensive care matron, redeployed to adult intensive care

From the front line: Beccy Lytton, paediatric intensive care matron, redeployed to adult intensive care

Beccy Lytton, Royal Brompton deputy matron on the paediatric intensive care unit (PICU), was redeployed to the adult intensive care unit (AICU) during the pandemic. She shares what it was like treating adults after 23 years of being a paediatric nurse.

“I’ve worn personal protective equipment (PPE) before, but there was definitely a heightened sense of anxiety about putting on PPE for COVID-19. The first time I put it on for a shift I was terrified. I could hear every breath I took, as the masks originally had a valve that would click as air went in and out. This was equally reassuring and terrifying – to know that it was working, but whenever you couldn’t hear it you’d worry it was broken. The weight, both literally and metaphorically, of the PPE was overwhelming. It felt like a costume, I had to put my face mask on as well as my metaphorical nurse mask and act brave while I treated patients as best I could.

“Opening the doors to the Covid ward was like walking through the doors to another world, it was so surreal to see an entire ward dressed in PPE. Not that you could see much, the masks and hoods muffle all your senses – your vision becomes blurred and your hearing is distorted. You feel entirely disconnected from reality, like you’re in a bubble.

“Once the novelty wore off, I came to hate it. The donning stations (where you were helped to put the PPE on) felt like a production line. It almost felt de-humanising, I’d lose all identity and just be given a role, such as runner or staff nurse.

“During shifts I’d be sweating and stressing that I couldn’t get out or even take a breath of fresh air. But I knew that I couldn’t show any weakness as I was in a position of responsibility, so I felt a huge sense of pressure to be a role model to the rest of my team. I wanted to do whatever I could to make it easier for them; to make them feel safe. But the whole time I feared that I didn’t have the answers, none of us did.

“When you eventually take PPE off after a shift, no matter how hot the weather is, you feel freezing. I really appreciated the staff who helped take off our PPE (doffing) though, they would give us such a morale boost, I hope they know how much they helped build people up after difficult shifts. But immediately after you were out of ICU, the anxiety would start back up, knowing you had to go back eventually. I have scars on my face from the PPE that won’t heal.

“When we were first told that we might be redeployed my initial reaction was ‘I don’t want to do it’. I just couldn’t imagine how to do that job, treating adults is much more physical than caring for children and babies. But I knew I had to step up. Once I came to terms with it a sense of peace settled. The first shift in full PPE almost felt like a rite of passage, I was proud to be helping my AICU colleagues. I learned a lot from them, they are so slick and professional. It was inspiring.

“But it was intimidating going to other departments where at first you didn’t know anyone or any of the processes in place. I was totally out of my comfort zone.

“There was joy to be found though, such as meeting new colleagues. Sometimes I pass them now in a corridor and I can tell they recognise me but without the PPE they aren’t quite sure who I am!

“Communicating with the few patients who were well enough to be awake was also frustrating in PPE. One patient spent an entire shift trying to tell me something, but with a tracheostomy (a tube inserted into the windpipe to help patients breathe), even understanding one of his sentences was hard. When I did finally understand what he was trying to tell me, I was overcome with emotion. He gave me a smile and a thumbs-up. It just felt so great to finally have a positive interaction with a patient.

“Looking back, I am so proud – both personally and for the whole of my team who were exhausted but got through it. Everyone was amazing.”

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