Nursing the Nation - Laura’s personal perspective gives us a better view

Laura Giovanazzi (née Macaulay) is currently nursing on the mainland.

Laura was born and brought up in Stornoway, where she lived until she moved off island in 2009.

WORKING IN CHALLENGING AND UNPRECEDENTED WAYS

As a nurse caring for patients who have COVID-19 during the current pandemic, Laura is now having to work in new, challenging and unprecedented ways, that she never imagined would be the case during her nurse training.

Giving some background, Laura explained: “I got my Bachelor of Science in Nursing from the University of Stirling but studied at the Islands campus based in the Western Isles Hospital.

“I did go to Inverness to do a few placements in Raigmore Hospital including my final placement which was in the Intensive Care Unit (ICU) in Raigmore where I decided that Critical Care nursing was what I wanted to do.”

Laura, who currently lives with her husband, Matteo, described that her first job as a staff nurse was in Intensive Care and Coronary Care Units.

“When the hospital I was working in closed, I was transferred and I had to pick which ward I wanted to work in and I chose to work in the Coronary Care Unit,” she explained.

“During this pandemic I have been asked to work in the Intensive Care Unit due to my previous experience in the specialty.

“This has been challenging due to changes in ICU in the last five years since I worked there and the new challenges we are facing due to the pandemic.”

In terms of Personal Protective Equipment (PPE), Laura explained: “In ICU we wear full PPE at all times as everyone in these ICUs have been confirmed as having COVID-19 and ventilation is classed as an ‘aerosol generated procedure’.

WORKING 12-HOUR SHIFTS IN FULL PPE

“The PPE consists of a plastic apron under a full length surgical gown, two pairs of gloves, a surgical cap, a visor and a tight fitting mask for a full 12 hour shift, which obviously brings its own challenge.”

Laura also explained that a number of staff have been redeployed from other areas to work in ICU.

“Some of these nurses are not trained to give IV medications which means other nurses have to do it for them,” she explained.

“Also working with people who you don’t know can be a challenge and knowing who to ask for help if you need it.

“Everyone is dressed the same with just eyes showing so it can be difficult to identify people.

“We do have our names written on our surgical gowns, but until now, I had not realised how many people called ‘Laura’ worked in critical care. If you are not careful, this can cause some confusion.”

LONG SLOW PROCESS TO SEE IMPROVEMENTS IN PATIENTS

In terms of the patients she is caring for, Laura explained: “By the time the patients reach ICU they are really sick and can deteriorate very quickly, requiring not just breathing support, but medications to improve blood pressure and a lot of them need haemofiltration or dialysis to support the kidneys.

“This causes its own issues as, if you have not worked in ICU, it’s very unlikely that you will be trained in any of this.

“I was worried about doing it again, but thankfully it didn’t take long for it all to come back to me.

“It’s been a long slow process to see improvements in patients but we are starting to see people getting better and getting out.

“Long stays in ICU, however, bring their own challenges and people will need lots of rehabilitation after getting out.”

Laura is also conscious of how difficult the situation is for patients and their families in terms of the current hospital visiting restrictions in place.

She expanded: “No relatives being allowed in provides another set of issues: it’s very upsetting and distressing having a relative in ICU when you can go and visit them, but during this pandemic we have had to limit visitors to only being allowed in if we feel there is nothing else we can do for that person.

DIFFICULT TO SOCIALLY DISTANCE FROM RELATIVES

“I have found it very difficult having to socially distance from the relatives we do let in, as they are going through some of the worst times of their lives, in a horrible situation, and your instinct is to comfort them, but with social distancing it’s very difficult and they can’t even see our faces.

“We are having to update relatives over the phone. It is not common practice to give out so much information over the phone, but in this situation it is essential.

“Under normal circumstances we would sit down face to face and give people an update but we are having to have very difficult conversations by phone, which we are all finding very difficult, so it must be awful for the families.”

She continued: “I am lucky that despite the challenges we all face and that I am currently working in a different unit with a different team, everyone is very supportive, friendly and helpful, as we are all in this very strange and difficult situation together.

“I am lucky to have a very supportive husband at home who puts up with my emotional ups and downs through this trying time and always has a delicious meal ready or me when I get home from dayshift, I am very lucky to be married to a chef!

“I also have a very loving and supportive family who I speak to regularly and have sent me lovely wee gifts.”

On a personal note, Laura also described the difficulties of living in a flat in a city during lockdown, finding it particularly challenging not having a garden.

“We do have a park near us but have been trying not to go as it has been very busy during the nice weather,” she said.

“I have felt that during the first few weeks of lockdown the area around us was very quiet with very few cars on the road but as the weeks go on, I have noticed it is getting busier and busier every week.

“We are lucky to have a few friends who live nearby who could go shopping for us when we had to isolate for a week due to having symptoms of COVID-19, but living in a city, you don’t really know your neighbours or have the same community spirit that you have living on Lewis.”

Laura misses the Islands, where both her parents are still based (her mum, Moira Macaulay works in Patient Travel for NHS Western Isles, and her dad, Derek Mackenzie, owns Derek Mackenzie solicitors.

STICK TO GOVERNMENT GUIDELINES

She urged: “My advice to Islanders would be to stick to the government guidelines and remember that they are in place for everyone’s protection and to ease the strain on NHS and staff who are doing their best in this difficult time.

You are lucky enough to live on a beautiful island with lots of open space that you should take advantage of for your daily exercise and avoid places with lots of other people.

“Remember we are all at different stages of this pandemic and listen to local guidance as well as national.

“I would also like to say a big hello and I love and miss you to all my family and friends on the island, I can’t wait to come up after all this over.

“I would also like to say thank you to the whole of NHS Scotland and everyone who works so hard every day to allow us to have one of the best healthcare services in the world.”

NHS Western Isles would like to thank Laura, her colleagues and all the hard working health and social care staff across Scotland, for everything they do to care for us all during this challenging time.