Anxiety, exhaustion and six deaths a shift: Fighting coronavirus at Russells Hall Hospital
It was a deadly virus that caught doctors and nurses by surprise.
On March 9, the first case of coronavirus was confirmed in Dudley, one of England’s early hotspots outside London.
Two days later, Covid-19 was declared a pandemic by the World Health Organisation.
Staff at the borough’s Russells Hall Hospital were braced for a rise in patients. But nothing could have prepared them for what was about to come. In the C5 respiratory ward, which became known as the “coronavirus ward”, nurses were seeing six patients die each shift. As the pandemic got worse, the ward – which was at the epicentre at Russells Hall – went into isolation over a 24-hour period.
All 48 of its beds were filled with Covid-19 patients, while frontline staff feared for their own safety and taking the virus home to their families.
Today, three months down the line, the picture is a lot better. And staff have time to look back at the challenges they faced, the lessons learned – and how they can prepare for a possible second wave.
There are only two coronavirus cases in the ward, although even that number remains a concern.
The hospital has played an active role in trialling a successful treatment for coronavirus, leading to hopes of a better response against a new larger outbreak.
But staff at Russells Hall hope the worst is over for good. Dr Lauren Jones, who has worked on C5 for six months, said she was exhausted from the huge pressure in battling the pandemic. But she added: “Everyone came together and we got through. I’m a bit happy now.”
Asia Ahmed, an occupational therapist on C5, said she and her colleagues “soldiered on” through the worst. She hopes they can look back and say they did their best.
The number of cases maybe falling but the hospital is still very much on lockdown.
A bright red and yellow sign greets people entering C5 warning of “restricted access” and urges staff and patients to help “stop the spread”. Strict measures are in place asking people to replace their face masks and scrub their hands upon exit. The ward is split up into different areas with different levels of security, due to ongoing threat of coronavirus. The highest security is where the current Covid-19 patients are based.
The Express & Star was not allowed in that area, only in the ward’s reception. Team leaders were there to greet us on arrival. And they did not hold back in describing the impact of Covid-19.
“What was different with Covid-19 was the speed of deterioration of patients,” said Marie Banner, the ward’s matron.
“We had patients who were talking to us one moment who passed away, sadly, very quickly. Young patients who were relatively stable and within seconds, minutes, their condition changed rapidly.”
Susanne Jay, the ward’s manager, said: “It was very intense. I couldn’t put a number on the patients that were passing away. I mean the whole ward was positive at one stage.
"We have got 48 beds. I think on my worst day, I would say there was about five or six deaths per shift. At the very beginning, it was quite intense.”
She added: “But now, it seems to have settled down a lot. We have only got two positives at the moment.”
The strains of the intense work amid the pandemic has affected staff in different ways. Ms Banner says some hospital workers have sought help through a telephone service.
“A lot of staff won’t even recognise they were under pressure until much later. It is like post traumatic stress disorder.”
What has lifted their spirits is the “extremely generous donations” made by the general public such as food, water and toiletries, she said. “We were very supported.” Water was particularly appreciated due to the sweltering long hours wearing personal protective equipment.
Another positive aspect is the hospital’s participation in trialling a steroid, called dexamethasone, to treat coronavirus.
It is an anti-inflammatory drug which is already used to treat severe asthmas and arthritis. The trial began in March as part of a national scheme organised by the University of Oxford. After several months of collecting data, including from patients at Russells Hall, university statisticians this month announced the drug cut a third of deaths in seriously ill Covid-19 patients.
To date, a total of 81 patients at Russells Hall have taken part in the study – but recruitment is still going on.
Diane Wake, chief executive of Dudley NHS Trust, which runs Russells Hall, added: “It is difficult to know if a second wave is a real threat or not.
“I think every health economy, every part of the country, at some point is going to see some outbreaks.
“For me, it is about being prepared and being vigilant.”
‘We have soldiered on but it’s been scary’
Asia Ahmed is an occupational therapist on the hospital’s respiratory ward.
This has been her first job since leaving university.
She began the role in December – four months before coronavirus was declared a pandemic.
The 22-year-old said: “I wouldn’t say I was ‘thrown into the deep end’ because no one predicted that this would happen.
“But it was a shock to see everything happening.
“I never thought I would live through a pandemic.
“When this whole thing started, the main goal was to get everyone – who didn’t have coronavirus – back home safely.
“Then, obviously, when we got hit with the big rush, it was about managing them with their ongoing rehabilitation.
“A lot of the patients, their main goals were getting back to normal.
“This meant like walking, washing, dressing independently.
“That is where me and the physios got involved.
“My role has been to help people get back to being independent, like they were beforehand.
“Just getting them back to normal life, with rehabilitation and tasks that we can give them on the ward, before helping them to discharge appropriately.
“We have all just soldiered on. We have got to the other side now, so I hope and we can look back and be like ‘we did everything we could’.
“It is definitely scary and it has been a weird environment.”
‘We hadn’t seen anything like it before’
Dr Lauren Jones is a senior health officer on the respiratory ward.
She has worked on the ward for the past six months and at the Dudley NHS Trust for the past three years.
Dr Jones, 30, said: “We usually deal with all sorts of respiratory issues so it is quite a busy ward anyway.
“However, when Covid-19 hit, we had never seen anything like it before.
“Initially, the first few weeks were very difficult and we were under an awful lot of pressure.
“Our uniforms changed. There are different bays now for different patients. There are different masks and different levels of PPE.
“It has been difficult. I think all of us have been very anxious throughout it all.
“I’m tired. We have got there now. Things are much better now. Everyone just sort of came together and we got through it.
“Now we are over it – so I am feeling a bit happy.
“I think, initially, when it first started, it was obviously very upsetting regarding the number of Covid-19 deaths.
“But it also makes you nervous. A lot of the staff were nervous because we weren’t entirely sure what we were dealing with, how it spreads, whether we were protected, whether our families were protected and how to manage our patients as well.
“It was both a difficult and challenging time.”
‘Patient numbers were unprecedented’
Marie Banner is a long serving member of staff at the hospital. But even she said the pandemic was unprecedented.
Ms Banner is a matron on the respiratory ward which manages the medical arrangements.
She said: “Since the start of Covid-19, my responsibility has been ensuring the quality aspects of care for our patients, their relatives and our staff.
“It has been extremely challenging – something none of us had been prepared for.
“Even though we were aware, and tried to put plans in place, the volume of patients was quite unprecedented. The staff were just fantastic, they just rose to the challenge. We went into isolation on here, C5, extremely quickly.
“We started with one bay and really, within 24 hours, we were in full isolation with 48 beds.
“Taking some of the sickest patients, we had a direct access from the emergency department. The team of nurses, doctors and therapists had to really adapt with the way they normally work.
“And they did that tremendously quickly, with great grace. But actually, it was very frightening for them because there was a lot of media attention, obviously, in regards to the virus. We also had patients being sick without being able to have their relatives close.
“A lot of their relatives were very poorly, we had multiple family members in at the same time so that was quite difficult.
‘It was hard for people to communicate’
Stacey Pinches is a specialist nurse who volunteers in the hospital’s research department alongside her colleague Ellie Forsey.
The hospital has run a trial of a successful Covid-19 treatment called dexamethasone, the steroid which could save as many as one in three deaths of Covid-19 patients on ventilators.
Stacey described how the trial worked at the height of the pandemic, with restrictions on taking the drug relaxed due to the unprecedented circumstances hospitals were facing.
She said: “We wanted to our bit but we were scared. We were on the front line on wards with a lot of positive Covid-19 patients.
“We wanted to take the pressure off the doctors and nurses because they were so busy.
“Ellie and I would go and speak to a whole bay of patients about the study and give them patient information leaflets.
“A lot of the time, we would read the patient information leaflet because the patients were on some sort of ventilator or breathing apparatus.
“It was hard for them to communicate.
“Usually, it is 24 hours that patients are given to think about it [taking a trial treatment]. But there was no logistical way of being able to do that. So we were giving them half an hour, 45 minutes to read the study. They said you don’t really need to give patients time. We would then go back and if the patients were happy, we would get them to sign a form.”
“I have worked for the trust for a long time but I was really proud of how everyone rallied together.”
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