A&E nurse reveals horrors of working on frontline including treating sexually assaulted OAPs & patients smuggling heroin

IT WAS at the height of the Covid national lockdown that a single dad was rushed into our A&E department, having tried to take his own life.

Newly jobless and with schools across the UK shut, the father had been struggling for months to care for his young daughter with cerebral palsy.

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Feeling like a failure, he'd finally reached the end of his tether.

"Because of lockdown I don’t have a break. She’s not at school and I’ve lost my job," he told me, adding that social services couldn't help them.

"‘There’d be a better parent out there for her."

His comments were heartbreaking to hear – yet they are among countless devastating remarks, and scenes, I've witnessed during the pandemic.

 

As an advanced clinical practitioner (ACP) in a major trauma centre's A&E, the past six months have been relentless, exhausting and, often, upsetting.

I've seen alert and talkative patients deteriorate in minutes from Covid, watched my hard-as-nails colleagues break down at work, and treated supermarket delivery drivers with stress-induced psychosis.

One had written the instruction, "wash hands", over and over on her phone.

Spike in suicide attempts

I've also seen a terrifying spike in domestic abuse and mental health cases: in one shift alone, I saw four patients who had tried to kill themselves.

Others – abuse victims, now trapped at home with their attackers – have come in with cigarette burns, cricket bat injuries and strangulation marks.


Of course, A&E has always been a place of unimaginable horrors – as well as a place of kindness, strong teamwork, and some incredible recoveries.

For many people, it's the sterile-looking place they went when they sprained their ankle or broke a bone as a kid. But there's actually so much more to it.

As a 32-year-old A&E nurse of eight years (until I started my new ACP role last year), I've dealt with cases so terribly sad they've stuck with me.

Harrowing self-harm & patients jumping out of windows

One Christmas Eve, a new father who had just returned from an Army tour in Afghanistan to meet his baby for the first time was brought in.

The man, his wife and their newborn had been in a head-on crash with a lorry on their way home from the airport. The wife had died instantly.

In these moments, when a patient arrives, everything is silent.

Unlike films would have you believe, there is no chaos – only the sound of machines bleeping, as various professionals swoop down on A&E.

While the tiny child was treated by my colleagues, I cut off the dad's clothes and started to work on him. But his heart soon stopped beating.

When efforts to revive him failed, I remember thinking: "This is s***".


 

Another time, I treated an elderly woman who had deliberately overdosed – then, when she woke up, repeatedly stabbed herself with a letter-opener.

"I don’t want to be here anymore. I can’t take it any longer," admitted the woman, who had no children and had lost her husband years before.

"My neighbour keeps sexually assaulting me," she revealed.

"I’m all alone with nobody to help me."

I treated an elderly woman who had deliberately overdosed then stabbed herself with a letter-opener. She said, 'I don’t want to be here anymore… my neighbour keeps sexually assaulting me'

As the porter wheeled the poor pensioner off to theatre, I called the hospital’s safeguarding team to alert them to her sickening abuse.

To date, it remains one of the worst cases of self-harm I've seen. 

On some awful occasions, patients have woken up in the hospital in delirious states and jumped out of windows to their death.

At other times, they've come in with as many as 17 stab wounds.

In our area, knife crime is a major problem. But unfortunately, gang crime victims often refuse to say how they got their deadly injuries.

Some almost see them as badges of honour.

Patients romping behind curtains

But for all of A&E's tragedies, there are the incredibly bizarre moments that leave younger nurses gobsmacked. I'm no longer fazed by anything.

One man, in his eighties, had a carving fork stuck up his bottom. He said he'd been experimenting with his wife, and I admired his honesty.

"Good on you," I thought.

In fact, the two biggest penises I’ve seen in the department belonged to men both aged a hundred. They were halfway down to their knees.

There are the teenage boys who claim: 'I fell on a deodorant can'

There are also the teenage boys who claim: "I fell on a deodorant can."

Deodorant cans are so often embedded in orifices that we once had a discussion trying to guess from the X-ray what brand it was.

Sometimes, people put animals up there, which is cruel – they usually die.

During my career, I’ve also caught people having sex behind hospital curtains. I always tell them to stop, and stand there until they do.

In A&E, we treat everyone – from celebrities and sports stars to rough sleepers. It’s a constant sprint, and a marathon at the same time.

It's also like a relay: there's brilliant teamwork. You can be at the bottom of the food chain – or at the top – and you’re still respected and listened to. 

But despite our work ethic – and our experiences in A&E – nothing could have prepared us for Covid, which has killed more than 42,000 in the UK.

We saw patients rapidly go from 'fine' to dying. Their chest X-rays came back showing their lungs were infiltrated with Covid

Before we knew it, A&E had taken over nearly an entire floor of the hospital to boost capacity, as Covid patients trickled, then poured, in.

The unit was split into hot (Covid) and cold (everything else) areas, while we were given sweltering PPE to wear to protect us from the virus.

Before our eyes, we saw patients rapidly go from 'fine' to dying. Their chest X-rays came back showing their lungs were infiltrated with Covid.

Some victims were younger than me, aged only in their late 20s and 30s.

From an A&E point of view, if anyone was imminently close to death we would allow a loved one to visit as an exceptional circumstance.

We'd encourage it so the patient wasn't alone.

Heartbreaking last moments

I know this wasn’t the case everywhere, though, and there is no doubt some patients died without their family around them. Many nurses will have taken that place, comforting the patient in their last few hours. I married my engineer husband Ed in 2018, and I can't imagine being in that situation.

Patient deaths were marked by a pink hash mark over their names on our computer system: a softer shade than red, but still arresting to look at.

Yet while the isolation units were filling up, the cold areas became very quiet: our typical 600 to 700 patients a day in A&E suddenly halved.

There were nationwide fears that people with serious health conditions were suffering in silence – leading Dr Katherine Henderson, President of the Royal College of Emergency Medicine, to warn in April: “Do seek medical help if you need it – don't stay at home with a heart attack out of fear.”

Heroin smuggling & violence

However, other people wouldn't stay away from hospital.

In the midst of the pandemic, we saw people from every walk of life, and of all ages, come through the doors. One day, a heroin-addicted patient's girlfriend sneaked in to give him his daily hit of the drug.

We've seen violence, too (which is, sadly, not unusual in A&E). One patient came in yelling, "I've got the coronavirus," while another tried to bite me.

Luckily, the police have our back. They've been working tirelessly during this pandemic, too – in hospitals, on the streets and everywhere in between.

On a positive note, Covid has strengthened the feeling of camaraderie within A&E: everyone has pulled together to offer help and support.

It was also amazing to witness the nation Clap for our Carers every Thursday night. I actually welled up the first two times it happened.


We are so incredibly lucky to have the NHS.

But I fear, as a second wave of Covid infects thousands, that healthcare workers are exhausted.

So many devoted nurses across the UK are leaving the profession. Others are going off sick and reducing their hours. They're simply burnt out.

With winter approaching, those of us in the NHS are now getting anxious… we feel a sense of impending doom

With winter approaching, those of us in the NHS are now getting anxious: we know the seasonal pressures, the overcrowding, the exhausting shifts.

We also know that there will be a lot of loneliness and isolation among the elderly – while abuse victims will continue to suffer behind closed doors.

Because of this, I – and my colleagues – feel a sense of impending doom.

Yet amid the worry, there's also hope. We’ve been through previous winters and come out the other end.

We've also come through the first wave of Covid – albeit, with countless pink hash marks, including hundreds of health and social care workers.

And with further teamwork, positivity, and the public's help in following government rules, I believe we'll get through the second wave too.

  • A Nurse’s Story by Louise Curtis with Sarah Johnson is published by Pan Macmillan (£8.99) and available now
  • Louise Curtis is a pseudonym. Other names and some details have been changed to protect identities

If you are affected by any of the issues raised in this article, you can call the Samaritans for free at any time on 116123

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