This week I returned to my voluntary nursing position at a nursing and residential home.

I work a long day once a month for a few different reasons. The main one being that I love nursing, it is something I really enjoy and miss.

Secondly, working in a care home that uses AutumnCare gives me valuable hands on experience using our system.

This helps me understand the needs of the people using our product and gives me great ideas for improvements.

Finally, working in a front line nursing role helps to keep my clinical knowledge and skills up to date.

I decided to write this to give my non-clinical peers an insight into care during the COVID-19 pandemic. 

 

Returning to the care home

It was really nice to be back.

I was so interested to find out what it had been like for residents and staff living and working in a care home during these last few months. 

Before arriving for my shift, I was advised to get changed into uniform at the care home.

This is to avoid staff travelling around wearing their uniforms outside of the home.

I was also required to put my mask on before I entered the home.

 

Before I could be in contact with any residents, I was required to:

  • Log my temperature
  • Confirm that I did not have any COVID-19 symptoms
  • Confirm that I was not living with anyone with any COVID-19 symptoms

The new routine

Each morning the Registered Nurse completes a COVID-19 Observation Monitoring Chart for all of the residents. 

This meant that my first job was to speak to all of the residents, log any symptoms and take everyone's temperature.

A new 'no contact' thermometer makes this a speedier process and eliminates cross contamination. 

 

The staff 

One of the first things that struck me was that nobody was complaining about how hard it has been for them as staff.

People were just focused on how they can make things better for the residents. 

One staff member commented that he is trying to be extra jovial and have a joke with each resident to make them happier.

 

The residents and their families

The home was full of cards and letters of appreciation and thanks.

Staff confirmed that, although relatives have been upset they can't visit, they are supportive of the need to protect residents and minimise risk of infection.

 

The residents have been unable to see their loved ones since March, and this has been very difficult. 

I observed a couple of people who became tearful over the day.

They had dementia and were unable to fully understand what was going on, but are likely aware that things are rather strange and quiet. 

Staff are working hard to reassure people, spending lots of one on one time with them and attempting to bridge the gap currently left by their families. 

 

I found myself chatting to lots of people, trying to think of lighthearted stories and interesting things I have been doing.

A difficult thing to do when we have all been in lock down! 

One thing you usually notice is a relative sharing a story with their loved one will provoke conversations between lots of other residents in the day room.

They will then chat to their loved ones about it when they visit. This is something noticeably missing when there are no visitors in the home. 

 

Chatting to residents and communication itself can be quite challenging at present.

Staff are required to wear a mask at all times that they are in contact with residents. 

For residents who are hard of hearing or who have dementia it can be difficult for them to understand us.

Also, as I have not visited for a little while it was harder than usual for residents to recognise me and place my face. 

The challenges 

At present the GP is unable to conduct home visits and has been carrying out Zoom consultations. 

The GP was able to examine a resident's leg during the day, diagnose them and prescribe some antibiotics.

I was left thinking it must be incredibly hard to carry out consultations over the phone - making diagnosis' can be very difficult at the best of times!

 

A major difficulty for care homes is managing their staffing levels. 

Most homes have had staff isolating due to their own health concerns.

Some people have been taking time off, having had symptoms or indeed been infected with COVID-19 themselves.

 

I spoke to the manager about the use of agency staff and found out they had made the conscious decision not to utilise them.

While a care home may try and block book a member of staff just to come to their home and not to go anywhere else, this cannot be guaranteed.

Many staff are registered with multiple agencies. Not using agency cover helps to protect the residents further. 

Though this does require the goodwill of the team to work extra hours where required, to ensure that staffing levels are fulfilled. 

 

Reopening to visitors 

The home is currently making preparations to allow visitors back in a safe and controlled way. 

Care Managers face challenges in trying to get visitors back into the home, but to do it in a way that will not compromise the safety of residents. 

To do this they are looking to utilise a small, unused lounge at the end of the building. 

Families will be able to visit by appointments and will be able to access the room directly from outside.

This means they won't have contact with anyone else in the home. 

 

Reflecting upon a busy shift, I was able to see that working in a care home at the moment has many challenges. 

However, it was heartwarming to be a part of an extremely caring team that are doing absolutely everything they possibly can. 

They are being successful in protecting their residents from COVID-19, and also doing it with smiles on their faces (albeit hidden by a mask).