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27 Sept 2022

The reality of five minutes as a general practice nurse in Ireland

GP nurses: We answered the call during the pandemic, why aren't we considered frontline workers?

The reality of five minutes as a general practice nurse in Ireland

I sit with John and hold his hand through double gloves that slip from my sweat. He weeps as he tells me how lonely it is without Mary. She died alone in hospital. No visitors allowed.
“Do you think she was scared nurse?” he agonises. My glasses steam silently with shared sadness. The phone rings, interrupting the only face-to-face interaction John has had with another human in nearly a year. I ignore it.
I try to connect with this 85-year-old widower through my mask, visor and glasses. He cannot see the sadness I feel for him. The phone rings again. John holds my gloved hand tighter.
It’s reception- “Your next two patients are getting agitated, they’re waiting for you nurse”.
I ignore them. My door bangs. Let’s go, you have people waiting. I give John a gentle nod - go on, it’s ok to talk.
My phone rings, it’s the trainee GP- “Nurse, can you come and look at this wound with me, I’m not sure what dressing to use”.
My breath draws short, my chest tight. Is this stress or could this finally be a visit from the virus? Maybe it’s this mask - it’s so tight. My face is cut. I wipe John’s tears and tell him to continue. He tells me how his wife of 70 years was zipped up and taken away to eternity. My hands are now working while my heart is listening. They draw vaccines into syringes, an action my hands do themselves by now. They buzz like bees beneath me. Working away. There are Covid vaccines to give.
I can tell John is comfortable with me as he begins to weep harder. Someone walks into the room and interrupts again. “The other nurse is sick, she’s been sent home with Covid symptoms so you’ll have to double up appointments”.
I take a breath and bring my gaze back to the crying man who sits before me. He apologises for keeping me. I can feel his grief magnify as he feels like a burden in my room.
“No John, it’s fine. Tell me more”. I try to speak in soft tones, but the layers of protective wear drown out my condolences.
I hear the hungry cries of the new born baby girl waiting outside my door. She waits for her first ever vaccinations. She needs to be protected too. I take silent note of mum’s worried tone as she tries to sooth her. I need to make sure she is coping. There’s a lot of baby blues in this isolation.
John starts to tell me about their first born and how naturally his Mary took to motherhood. An earth mother he calls her. His sobs are halted by another phone call.
“Nurse, we have an elderly woman on the phone, she’s scalded herself with the kettle. Her carer has Covid so she is home alone. Can you see her on your lunch break, the burns are awful.”.
No problem. I will make sure her wounds heal.
John squeezes my hand and tells me it’s nice to talk. It feels good. Well, better. I check his blood pressure and do some bloods, even though that was not the point of this visit today. I want to make sure his diabetes is under control. I don’t want him to end up in hospital. He might catch the virus there. There are no beds. Best to prevent rather than cure.
The door jolts open again. This time with force. It’s a patient. They are angry. They have been waiting for 20 minutes on their Covid vaccine. There is shouting and abuse.
“It’s not like you’re doing much anyways”.
John quickly wipes away his grief. He sheepishly mutters “thank you nurse” as he shuffles his frail feet through the doorway. I blink away my tears.
No time.
I bring mum in next. She is carrying a tiny bundle of pink hope. She goo’s at me, a new face is a rare sight for these children. Mum already has tears in her eyes. It is so hard. She hasn’t slept. I tell her she is strong. She is a woman. The phone rings. The newborn baby is startled and shrieks ensue. The world has stopped for a short time but I think about the future. The phone rings again.
My name is Clare. I’m a General Practice Nurse. Like all nurses, I am well used to the oppressive gaslighting of our profession. Unequal pay and unsafe staffing is the baseline for nurses in Ireland. But we answered “Ireland’s call” when the time came.
There are many misconceptions about general practice nursing. For insight - We are the chief vaccinators in the country and the backbone of health screening and health promotion in Ireland.
We spend our days doing immunisations, cervical screening, chronic disease management; asthma, COPD, diabetes and cardiovascular disease, nurse prescribing, medication administration, phlebotomy, weight management, smoking cessation services, women’s health, men’s health, dermatology, wound management, travel vaccinations, cryotherapy, aural care and ear irrigation, triage, health promotion, counselling, as well as follow up, referrals and liaising with other healthcare professionals, conducting clinical audits, developing practice protocols, coding of health conditions, maintenance of emergency equipment and are involved in practice staff education.
When Covid hit, GP's switched to mostly phone consultations, but us Practice Nurses never culled our clinics. We continued to see all our patients, run GP clinics and put ourselves at risk. Our workload increased and we stood with our other nursing colleagues on the frontline just as much as anyone else. Although we did not zip up body bags on the wards, we did make sure that we kept the rest of the country well in an effort to avoid this fate, whilst also trying to treat sick patients to keep them away from the doors of acute hospitals.
Then the primary Covid vaccination programme was rolled out and I can assure you each and every single General Practice Nurse was at the forefront of this nationwide.
The first day those patients walked through our doors, aged 85 and up, we soothed their fears and reassured them that everything was going to be ok.
We spoke softly. We were gentle and tactile through suffocating layers of PPE. We wiped the tears of our elderly patients as they told us just how lonely it had been in their "cocoons". And then we carried on and vaccinated half of the population.
We stayed into the night at the end of each clinic when we had extra vaccines to be used up, we called every patient we knew and we walked the streets to find arms to vaccinate when everybody else was done.
We answered "Ireland's Call" and gave up our holidays and festive celebrations and came to work to give the population hope of new beginnings.
I am aware the GP's (doctors) were paid for each vaccine given in their clinics but we weren't. For us, this is not about the money.
Practice nurses nationwide are shocked and perplexed as to how they've been excluded in this "recognition" when they have been integral in leading this country through this pandemic.
Babies were still vaccinated, new mums were soothed, the elderly were cared for, the dying comforted, wounds were healed and the country was given protection against Covid 19. But because we are "privately employed" we were not frontline workers?
Did we not put ourselves at enough risk? Did we not work hard enough? Did we not do a good enough job?
How is it that we are now excluded, but 6 weeks ago we were told we were "healthcare heroes" when we were yet again asked to disrupt our annual leave to come in and vaccinate you and your colleagues and their families and the rest of the country?
Why is it that Minister Paschal Donohoe tells Ireland that we are not frontline workers?

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