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a nurse in blue scrubs talking on the phone
Nurses are an essential part of the health system. (Photo: Getty)

SocietyMarch 31, 2020

You’re scared, I’m scared too: A nurse on life on the Covid-19 frontline

a nurse in blue scrubs talking on the phone
Nurses are an essential part of the health system. (Photo: Getty)

Nurses are the first people you’ll meet if you think you have Covid-19. Here, one of our frontline workers describes the rapid changes both healthcare workers and the public are facing. As told to Josie Adams.

I was working at an urgent care clinic in East Auckland when the first reports of Covid-19 came out of Wuhan. A couple of coworkers and I did some basic calculations based on the reports, and we came up with a mortality rate of around 2%. We thought it would all be OK.

We were wrong.

Within a week, we were testing possible cases in the car park. Everyone was on alert, and there were patients who already thought they might have it. One man who worked for border control presented three times. We assessed his symptoms, took his recordings, a history, and provided advice and reassurance each time. He was not sick.

I had one guy ring me up yesterday and say, “I need to come in and get swabbed – now!” I ran him through the checklist and he was negative for everything. He had a headache and had vomited. Once. You get a lot of people who have one symptom and think they’ve got it.

That in no way means we don’t have compassion for the worried. People like to maintain any control they have, real or imagined, over their lives. They think if they stock up on toilet paper they’ve got it sussed, and they’re in control. The reality is: absolutely not. People will do a lot of things to make themselves feel better. That’s why some turn to homeopathy, or similar practices. They want to believe it offers assurance. Some others think that if they eat broccoli every day they’ll never get breast cancer. The likelihood might be reduced, but it’s never eliminated. You don’t have absolute control over what happens to you.

As an essential worker, I control what I can, but at the end of the day I’m at risk. I come home and take my shoes off outside the door, I put all my clothes in the laundry, and I get in the shower. I don’t touch anything else until this is done.

When the government announced we were moving to level three and then four, I was in a break room with four other nurses. Most of them paused, and then wept, quietly. There was a stunned silence and fear, which I imagine was pretty much the universal reaction.

There’s something called the R0 number, and that basically tells you how contagious an infectious disease is. If you’ve seen the movie Contagion you might be familiar with it. We don’t know exactly what Covid-19’s R0 number is, but it’s obviously really high. If this weren’t so contagious, we wouldn’t be so worried.

If you get a small group of people who are infected with the disease, and they’re locked down, you won’t get so much sickness and death. That’s what we’re trying to achieve with alert level four. But if you cast that net wide and get a whole lot of people infected, then you’re going to see what happened in Italy. A lot of infection, and a lot of death.

Italy has an excellent healthcare system. They have 12.5 intensive care beds per 100,000 people. That’s great. In New Zealand, there are about 4.7. That’s what scares me. If things get bad, and lots of people get sick, you’re going to see a bottleneck.

I’m also losing work. I was scheduled to do flu vaccination work at educational institutions and offices over the next couple of weeks, but that’s out. I’ve heard people compare Covid-19 to the flu. In some ways it’s a poor comparison, but they do both kill people. At the GP clinic I worked in last week we were doing drive-by flu shots, which is novel. I’m thinking of offering fries with the jab next time.

Vaccines are still on. Please call ahead. (Photo: Getty Images)

I’m an agency nurse, which means I go where I’m needed. Every day my income changes. I’m worried I won’t have one at all. At this point, I don’t even know where I’m working in two days’ time, let alone next week. Clinics all over the country are condensing their services. Many are no longer doing vaccinations, booked, or routine procedures. Hours are reducing for doctors, nurses, and lab techs, many of whom are contractors like myself and not salaried.

There was a woman who called asking if she could still get an ultrasound of her shoulder — no. Not now. It’s not essential. There was a baby due for its six-week vaccinations, and we told the parents not to come in that morning. There was a cluster of sick people outside, and you don’t want that baby caught in that. On that day, in that clinic, with that crowd – that was a bad idea. The Ministry of Health is encouraging people to stick to their vaccination schedules. You’ll get your shot, in the safest way we can manage.

People need to hold off, which scares them, but they need to know that’s not forever. The point is that they need to hold off for now. We’re just getting new processes and protocols in place.

Everyone is doing their best. I have seen so much compassion from doctors and nurses. The prime minister and her government are putting emphasis on the need for kindness and compassion at the moment – shit yeah. When could that be wrong?

People expect us to be on their side, and we are. We do get tiresome questions, but you know what? No-one’s asking them to be a pain in the neck. They’re asking it because they’re scared, and you have to bear that in mind.

These people ringing Healthline and their GP, asking “stupid questions” – they’re not stupid, they just want to feel like they have a handle on things. When patients tell me they rang Healthline and they were “bloody useless”, I tell them exactly what Healthline said with a little extra kindness and give them a bit more time to talk (I can afford to – Healthline can’t). You have to make people feel they’re on the right track if you want them to have any hope.

Doctors are, sometimes, available for a face-to-face. There are illnesses that still require seeing a doctor, things like strep throat; you need to be seen, you need to be swabbed, and you need antibiotics. There’s no way around that.

You will need to call ahead, be met at the door, and given a mask. Every patient needs to be asked the Covid-19 screening questions. This is, as they say, the new normal. 

I understand you’re scared. I’m scared too. I can’t control much; but I can control how I make you feel when you visit me.

Keep going!
A doctor examines a patient. Photo: Getty.
A doctor examines a patient. Photo: Getty.

OPINIONSocietyMarch 30, 2020

Disabled people can’t be allowed to fall through the cracks of the Covid-19 crisis

A doctor examines a patient. Photo: Getty.
A doctor examines a patient. Photo: Getty.

Robyn Hunt writes on the challenges facing disabled people and what needs to be done to support them in lockdown and beyond.

Disabled people at higher risk need more help. Many of the almost one quarter of New Zealanders who are disabled are doing it hard as the country goes into lockdown. If the levels of anxiety are high in the general population, they are even higher among disabled people who are more at risk on a number of counts. It’s also a deeply anxious time for families with disabled children.

Under Article 11 of the Disability Rights Convention (CRPD), the New Zealand government has an obligation to “take… all necessary measures to ensure the protection and safety of persons with disabilities in situations of risk, including situations of armed conflict, humanitarian emergencies and the occurrence of natural disasters.”

But that’s at odds with the hurtful ageism and ableism of the flippant, faintly eugenicist line that we hear so often – that only the old, the ill and people with compromised immune systems will die. It’s an idea which has caused distress and even fear among the disabled community, which of course also includes many older people. There is a feeling among disabled people that they are being pushed aside by public bodies and public panic in this crisis.

One example of this is a recent announcement from Metlink in Wellington that it would no longer board buses from the front door, because of Covid-19 concerns. “Metlink apologises to customers who rely on the accessibility options provided at the front door and encourages customers to find out more about Total Mobility services during this time by calling 0800 801 700,” the announcement read.

A message like this completely negates the accessibility features for people who need the ramp. The instruction to explore Total Mobility is pointless, since it’s likely that no new users can join during lockdown, and it’s not an option anyway because Total Mobility vans are like hen’s teeth even at the best of times. Pushing disabled people away from public transport also adds extra cost to travel for some of the poorest New Zealanders. While Metlink says it is working on alternatives – and during lockdown buses cannot be used by much of the population – it’s causing stress to disabled people who rely on buses.

Panic buying in supermarkets has been dog-eat-dog, and shopping for food is now difficult for disabled people without transport. A friend who uses a stick said she had experienced hostile glares as she shopped. People who are blind, have vision impairments or who are slower for any reason are missing out. Even if you could get your groceries delivered it comes at a cost which may be a deal breaker for some, since disabled people are among the poorest of us. They are having to rely on the kindness of friends and others, especially those who are physically isolated or on their own. Happily there is kindness in the community.

A woman uses a motorized wheelchair in the supermarket.

A disabled person facing the next four weeks alone apart from support workers posted updates on Facebook about their position in the Countdown phone queue. At the time of posting they were 123rd. The person was posting on social media to draw attention to non-disabled people first taking the available supermarket delivery slots and then clogging the phone lines.

It is encouraging to see that Countdown is now providing a priority delivery service for older and disabled customers. This service comes as a relief to many disabled people, including myself.

I’m also pleased that the Deaf community will continue to have access to Sign Language interpreting for essential services such as government updates. And video services like Zoom can be a godsend for accessing non-essential services.

Still, the mental health of people in the disability community is of concern. They are experiencing high levels of anxiety, stress and depression because of all the extra difficulties they are encountering. Some disabled people have already chosen to be in self-isolation for a week or more. Others have found that more difficult. The Ministry of Health has a page of fairly high-level advice for disabled people here and specific advice on personal care and support services for disabled people are included in essential services here. You can also find information for the Deaf community here.

But the disability community has not been idle either. Two groups have been set up by the Ministry of Health Disability Directorate to focus on the unique issues that disabled people and their families are facing. These groups include representatives from disability service providers, Needs Assessment Service Co-ordination, the Ministry of Social Development, the Hutt Valley, Wairarapa and Capital Coast DHBs, the Office for Disability Issues, the Disability Rights Commission and the coalition of Disabled People’s Organisations (DPOs).

The first group – the solutions group – is identifying issues specific to the disabled community and finding practical solutions to them.

The second – the communications group – focuses on communications within the disability community. This group is communicating accessibly with the disabled community. This means making sure information is available in accessible documents, including large print, Easy Read, braille and audio. Information in New Zealand Sign Language and online accessibility are necessary too. The communications group is also gathering concerns of disabled people and their DPOs, making sure they are heard and addressed. This group directly links into the solutions group, and will provide feedback to them.

Disabled and older people should be able to ask others in their communities for help, especially with things like shopping and collecting prescriptions. But it’s up to everyone to be neighbourly and make sure others are OK, especially if they are alone in their bubble, or simply to keep in touch with a friendly phone call, email or chat over the fence at a two metre social distance. After all, we’re all in this together and we all need to support each other.

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