Daniella Mazurkiewicz reflects on how she adapted to working solo as a preceptorship homecare nurse during the COVID-19 pandemic to help patients continue with essential therapies.
Four months ago, I’d just started my induction week with LloydsPharmacy Clinical Homecare and was feeling excited about starting the preceptorship programme. My hospital placements had never really afforded me the time to properly care for my patients, so I was looking forward to learning new therapies, getting to know my patients and helping care for them in the comfort of their own homes.
Then just weeks later, COVID-19 struck. Being newly qualified was daunting enough and having only worked in hospitals during my placements I knew I’d have a lot to learn. What I didn’t realise is that I’d also have a pandemic to contend with at the very start of my nursing career.
Unlike a lot of my colleagues, I’m not able to compare what a day before the crisis looks like to one in the very midst of it – I’ve only really known lockdown nursing. In the 3 weeks prior to the country being told to stay at home, my typical day would involve either going into the office for group training sessions or shadowing other nurses on patient visits. There was no need to wear PPE and the patients didn’t object to there being two nurses in their homes.
Fast-forward three short weeks and everything changed. Like most other healthcare professionals, we had to adapt to new restrictions and policies, and it’s been difficult at times. There’s been weeks where the workload has increased because there’s been nurses self-isolating. Wearing PPE in 20-degree heat has been uncomfortable although I’m grateful I can take it off in my car, unlike a lot of the nurses working in hospitals.
As the number of cases rose, patients became increasingly apprehensive. Some of them only wanted you to spend a short time with them and others wanted to cancel their visits altogether. A lot of patients also wanted to restrict the number of nurses entering their homes which meant I couldn’t shadow my buddy. I understood and accepted this – I’d be the same if I was living with an underlying health condition, but it was frustrating. All I wanted to do was to learn and progress, but more importantly, get to know my patients – I couldn’t really do any of these things.
The preceptorship programme was originally supposed to last for six months but will now be extended. I’m not overly worried about this and I know that our practice educators, clinical trainers and nurse buddies will do everything they can to support us over the coming months, as they have done throughout all of this. I’ve really missed seeing all of them as well as the other newly qualified nurses, but it’s been a huge comfort knowing they’re all only a call or message away.
Despite all the deviated changes to the programme and fewer opportunities to shadow patient visits, I’m proud to have been signed off to work solo in home parenteral nutrition (HPN) and subcutaneous immunoglobulin therapy (SCIG). I’ve got so much still to learn but it’s great to be working independently in these two therapies and responsible for my own patients.
The patients I have been able to see, and treat, have still been very anxious about having someone in their home, despite the full PPE. These patients are considered high risk and are naturally worried about catching the virus. They’ve often had lots of questions and I’ve done my best to answers these which has helped to put their mind at ease.
My favourite therapy to administer so far is SCIG. The infusions take at least an hour which gives me more time to spend getting to know the patient and understanding why they need these medicines. But not everything we talk about relates to their condition or is clinical, and that reminds you that they’re not just a patient, they’re a person. I feel very fortunate to do a job that gives me the opportunity to build trusting relationships and play a part in giving someone a better quality of life whilst maintaining their independence – that’s a really special feeling.
My patients have been at the forefront of my mind throughout this pandemic. My main concern has not been infecting them or my family if I were to catch the virus, but I have taken every precaution necessary to minimise the risk of contracting it and will continue to do so until things return to some kind of normally, whenever that might be.
I really hope the Government will recognise the fundamental part nurses have played in the COVID-19 pandemic and the sacrifices they’ve made to look after their patients. I think that nursing tuition fees should be scrapped to help solve some of the understaffing issues in the NHS and salaries should be increased to reflect the vital role they play in caring for those that need it most.
The last 4 months have been a bit of a rollercoaster ride, with highs and lows, but all that’s mattered is that my patients have stayed safe and well at home and out of hospital.
I might be newly qualified, but I already know that there’s no other profession I’d rather be a part of.