Covid-19 gave me the courage to quit my job as a palliative care nurse

2020 was always going to be a significant year. 

I was turning 50 and was going to celebrate my 25th wedding anniversary. The year also marked my 25th year working as a qualified nurse: I was working as a senior palliative care nurse in a busy London hospital. 

Working with a group of dedicated nursing and medical colleagues all committed to giving the best possible care to those coming towards the end of their lives, was extremely satisfying and a job I loved.

But by 23 March 2020, when the first national lockdown was announced, I was already experiencing the devastating effects of Covid-19 in my work. Patients were being admitted very unwell and with breathing difficulties

Just days later, I was called to review an elderly man with coronavirus in A&E. He was on oxygen, distressed and dying. He was anxious for his wife at home, who due to rigid restrictions, was unable to visit. 

‘What happens to people like me?’ he asked. The pandemic was changing everything.

I was desperate to assure him he would not be alone and I would do all I could to ensure he was as comfortable as possible.

For most of my formative years, I wanted to be a teacher, and went to university with that in mind. Nursing certainly wasn’t part of the plan. 

I left university with a degree in sociology, but no clear plan of what I wanted to do with it.

While deciding, I found a temporary job in a nursing home. A year later, I was training to be a nurse.

I wasn’t a natural. I was squeamish. I hated blood and most bodily fluids, and I didn’t much enjoy anything surgical.

Thankfully, I quickly found my niche in oncology and palliative care. Here, I met nurses who were infinitely compassionate and kind, but not afraid to have difficult conversations. This was the kind of nurse I wanted to be.

For most of my career, palliative care is where I worked. This brought, on occasion, tears and sadness, but fundamentally, joy. 

Giving good pain and symptom control to ensure patients are as physically comfortable as possible; empowering patients to take the lead and make choices; family discussions at the bedside.

Seeing the relief even a small change to a pain medication can make, or helping someone think about how to have a difficult conversation with a loved one. This is part and parcel of palliative care.

Though, as life changed for us all during the early days of the pandemic, so did the work of palliative care. It became mostly about medications to bring comfort in the last hours and days of life. The luxury of time to plan and discuss where someone might to die, or build meaningful relationships disappeared.

Intuitively touching patients during conversations, holding their hand, and even the occasional supportive hug from a colleague were no longer spontaneous.  

Assurances to families were given on the telephone rather than at the bedside. Video calls were facilitated. I held the telephone to the ear of a dying gentleman so his family in India could speak with him in his own language. He was too sick to respond, but I assured them of the comfort they were bringing.

There are images in my head of those I cared for that will stay with me for years to come. Memories of significant conversations had behind a mask and PPE with the dying linger. The feeling of helplessness as I repeatedly witnessed what I knew would inevitably end in death remain.  

Even after many years working in palliative care, I struggled with the volume and speed of death as the effects of Covid-19 took hold. Tears were often nearer the surface than ever before. I was thankful for the disguise of a mask to hide my emotion.

In a heartbeat, we can lose the people we love, the freedoms we enjoy, and the life we have 

I was fortunate that neither I nor any of my family became sick, and I went home each night to a supportive husband. However, sleep was tricky. Waking frequently became normal. The fear of passing on the virus was genuine.

Despite the horrors of the coronavirus, the spring of 2020 was spectacular in other senses. Endless sunshine, thick candy tufts of blossom and the fragrance of wisteria in the air. I left the hospital each day desperate to breathe in these signs of hope and new life. 

Support came from colleagues and in the form of clinical supervision. Palliative care is made up of the most altruistic, kind, supportive, people. There is a camaraderie, unique to those who work in areas where sadness has the potential to prevail. 

My work has repeatedly taught me how precious life is, but never more so than during the pandemic. In a heartbeat, we can lose the people we love, the freedoms we enjoy, and the life we have. 

The privilege of caring for a patient and their family when they are most vulnerable is one I never took lightly.

However, in December, when further restrictions struck and I was immersed in a hospital where Covid was taking hold once again, I knew it was time to make a change.  

Not because I no longer valued my role, or indeed in the pandemic, but because I had finally found the courage to move on.  

Nurses are loyal not just to their patients but to each other. Prior to 2020, I had been thinking about a career change. However when the pandemic struck initially, I know I could not leave. I needed to do what I had been trained to do; care for those in need. I was part of a team, and we needed to work together to meet the challenges we were facing.

Patients deserve the best. In early 2021, almost a year on, with the vaccine programme underway and with hope things would improve, I knew I had given my best. It was the right time to leave.

We all have dreams, and mine was of a more flexible working life, one where I could where I could write and create. 

I had written a blog for some years. During the pandemic I was also writing articles on end of life care for a social care journal which were being published. I realised I had something useful to say, and could still help people away from the front line.

On resigning I received nothing but good wishes and support from those I worked with, which is a mark of the kindness of those who give so much of themselves to care for others.

On the 27th March, just over a year after the first national lockdown and after 26 years of nursing, I returned my uniforms, and I walked out of the hospital for the final time.

I will always be thankful to the patients I cared for and the colleagues I shared so much with. Palliative care is a speciality I would recommend to all who want to ‘really care’.

Years of working in palliative and end of life care have taught me how stressful many health care staff find the work of caring, this was highlighted by the pandemic.

I am now writing and training other health and social care workers on how to manage stress and care for themselves while caring for others.

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