‘Nurses I’ve worked with for 20 years come out of intensive care sobbing’

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‘Nurses I’ve worked with for 20 years come out of intensive care sobbing’

Dr Michael Brunner, a consultant in ICU and anaesthetics, reveals the unprecedented stresses and strains he and his colleagues are under on the front line of the pandemic battle.

Dr Michael Brunner
Dr Michael Brunner

Having qualified in medicine in 1986, I have been a consultant in ICU and anaesthetics in a London Hospital since 1995. I have three children and one grandchild, who was born during the COVID crisis. My post virus goal is to hug my children and hold my grandchild for the first time. Of the many things that I have learned during this crisis is the that the devotion, resilience, bravery and compassion of my colleagues seems to have no limits.

When all this began, it felt like a lot of people had started shooting machine guns at us from out the blue. What was really hard was the fact that we could see this tsunami of people coming at us and yet nobody else outside could. I would drive to work and see people going into pubs and shops and cafés and then I would get into my ICU and it was a different world. I could not understand why no one else understood. It was a very lonely feeling. But then the nightmare was on us and we just had to get on with it.

The first few weeks we were really hit. There were just a huge number of people all showing the same symptoms and all needing to go on ventilators. We were not set up to be a COVID hospital and had to do a huge turnaround at a time when we were already extremely busy. People just kept on coming and we had to make space for them outside of our ICU.

So many things became even more difficult than we were used to. Communication was a huge problem – how do you communicate with someone in a different room when you don’t want to open a door to let the virus out? There were so many logistical problems to deal with and from that point of view it was extraordinarily exhausting. PPE is incredibly uncomfortable and we are all sweating buckets the whole time. Many nurses were coming out with pressure sores on their faces. Some will bear these scars long after this crisis is over. Because there are not enough ICU nurses we cannot have toilet breaks.

Amid all this we just didn’t know what we were dealing with as COVID is a very new disease. It has a huge mortality rate, much higher than our average patients. We are used to death on ICU but we are not used to this much death all at the same time. Meanwhile, we would be opening another theatre to put more people in and then another and then another to accommodate all the patients coming in.

 I burnt out ages ago but now I worry about my younger colleagues.

To do all of this we have brought a lot of new staff in, many of whom have never been into an ICU ward before. The people have been recruited from different wards and they have been pushed into the eye of a massive storm.

What is it like for them to go from being an orthopaedic theatre scrub nurse to going into ICU? I was with a nurse who had never seen a person die before and when she came out the room after being with the patient she looked really upset. So, I sat with her holding her hand while she held the patient’s hand and we sat there until they died. For someone who has never seen that is huge as there is no time to breathe and properly go and cry which is what you would usually do when you first see something like that.

People are scared for themselves also. We have had colleagues who have had it – some have recovered, some have not yet. You do worry, especially when you are looking after people who are your age. I didn’t think I worried until one morning I woke up and I just could not stop crying. My sister called and I just found myself telling her where my will was and then weirdly, I felt better. Never have I worried about contracting anything that my patients have had – aids, swine flu – it just hasn’t crossed my mind.

But now it is different.

Then of course it is the conversations with loved ones. We used to receive a lot of abuse from families – there was even a note outside our door saying do not abuse staff but that has completely eased now.

People are much kinder to us now. We have to talk to relatives over the phone as they aren’t allowed into the ICU any more. When I tell them that their relatives might die, I say “You can’t see how upset I am, but under this mask, my face is desperately sad”. We try to reassure them that while our patients are not members of our families, we treat them as if they are so that if the die, they don’t die alone. We can’t make up for the loneliness of our patients, but we try our best. I have to put a mask on my face and say ‘I am really sad but you cannot see it on my face.’

When lockdown ends there will still be more patients. We are overfull in the ICU hospital and now we are concerned about the next wave. There is an absolute breaking point and I’m not sure about when that will come.

Everyone is really exhausted. I’ve never been this tired. We have lost lots of sleep, when you leave work you feel filthy and when you go home you enter this other weird life. A lot of us have been having to isolate from family. I have not seen my kids or my dad for a long time. When you talk to your friends COVID is the only thing people talk about and you don’t want to scare people so you don’t want to say too much. It is extremely isolating.

A lot of us have been having to isolate from family. I have not seen my kids or my dad for a long time.

I think I burnt out ages ago but now I worry about my younger colleagues. I have juniors who are my children’s age who are phoning up relatives everyday telling them their loved ones will die. I worry about them and whether they will be able to continue doing this. We are beginning to realise that we are not bullet proof. There has been absolutely no downtime. I wake up dreaming of ICU. It never stops. I’ve never liked the word stress as I’ve always thought this is a job and needs to be done – but I think probably this is what stress is.

I’ve seen a lot over the years but this is like nothing I’ve experienced before. It is massive. We have had nurses who have worked for 20 years who have come out of ICU and just sobbed.

One of the benefits with PPE is you can hug people, which I’ve realised is a good thing. There is one nurse who has worked here for over 20 years and never have I seen her cry. A few days ago she came out of the ward and broke down into tears and I went over to hug her while we were both still in our PPE and we stayed like that for a few minutes. I’ll never forget that.

The Intensive Care Society has launched a crisis appeal to support the wellbeing and education of all staff on intensive care units across the country. For more information please visit www.ics.ac.uk and to donate see http://easydonate.org/now/ICUHELP.
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