Voices from the frontline – Managing

1 Jul, 2020

Voices from the frontline

Some of us you know well, some of us you see regularly, some of us you never see. We are the nurses, team leaders, care assistants, chefs, activity coordinators, receptionists, laundry assistants, cooks, cleaners, admins, those behind the scenes, the voices of the frontlines. These are our day to day and our extraordinary experiences. 

My name is Fiona Gilbert, I am the registered manager of Bridge, Burton and Trent Courts, and I took over managing these nursing homes in the middle of the Covid pandemic.

In the last couple of weeks in my previous role, I was working 5 days a week as a nurse as well as juggling managerial tasks. To say it was hectic and chaotic is an understatement!

Fiona Gilbert

I would generally start work at 7 am in my capacity as a nurse, complete my temperature check and health questionnaire in high spirits… Let’s get this shift on the road! Resident handover, nurse handover, start meds round on dementia and expressive behaviour floor. I’ve been spat at, sworn at, almost got a slap in the face, is that Weetabix on my tunic? I love my job!

Dear diary….

11 am – Finish morning meds. Quick check on emails and do an hour of managerial duties, back to meds by 12:30.

13:30 – Back to manager tasks until 17:00, audits, weekly timetable update, update Covid tracker, telephone call after telephone call, email after email, Rota check – do we have enough staff to cover, tanoy call, I’m needed on behaviour wing, this audit will have to wait.

15:30 – A phone call from a relative, spend 40 minutes chatting, reassuring and then offering to use my mobile to do a video call.

18:00 – Go home. quiet drive, roads are empty.

19:00 – Text message from nurses, respond.

20:45 – Email with a safeguarding referral – proofread, add additional comments – email back to nurses.

21:10 – A telephone call from nurses – someone hasn’t turned up for the night shift.

23:00 – Bed, shattered.

03:00 – Telephone call – Mr X has had a fall, ambulance called.

04:00 – Still awake, can’t get back to sleep.

04:45 – Alarm clock goes off; off we go again!

This has been my daily routine, pretty much since the start of Covid.

Fiona Gilbert wearing a mask

Dear diary…uh oh

On one of my nurse shifts, 2 weeks before starting my new job, I don’t feel well on waking that morning but have to go to work. Nurses are working all the hours and need a break; I can’t let the team down. Chest pains, struggling to breathe, halfway through the meds round, my colleagues are worried. It’s so hot. I can’t breathe with my mask on. I feel really nauseous, I can barely stand, one of the nurses does my observations – BP 147/135, I’m in stroke or heart attack territory.  I am never ill. 999 called. Someone rang my daughter, she arrived at work. Told she can’t come to the hospital with me.  Given morphine, paracetamol and anti-emetic, IV. Taken to hospital. Thankfully taken through ‘green’ door, after much discussion about ‘red’ and ‘green’ doors.

Triaged and taken to ‘majors’. The pain in my chest and shoulder is excruciating.  A nurse brings a nebulizer for me. A doctor says ‘no, if she needs to be nebulized, she will have to be moved to red zone’. Eventually diagnosed with left lung pneumonia, after taking blood, x-ray, more pain relief, being constantly told to keep my mask on, even though I can’t breathe under it. If my pain could not be controlled, I would have to be admitted, but the risks on a ward during this pandemic are far too high. After 6 hours, told I could go home and was advised to remain at home for 7 days, as I had been through A&E. Prescribed strong pain relief and anti-biotics.

Dear diary …. out the window!

My last day at work, stressful. Started as every other day for the last couple of months, but this one was different, I wouldn’t be coming back. Residents crying, telling me I can’t leave. Staff hugging me (social distancing went out the window today!). Relatives ringing to say they will miss me and wishing me well. Social workers, wishing me well. Very emotional day. Farewell ‘party’ in the sun lounge. I cried as I left, with my arms full of flowers, gifts and cards am saying farewell to a job, a home, a staff team and residents that I knew and loved.

Dear diary…..too much

Three days before my new job, get a phone call, my best friend of 32 years has passed away! Hit me like a train. What will I do without her? We have had so much fun over the years. Holiday together every year. My life has just changed course and I am starting a new job on Monday. This is all too much.

Dear diary …. new day, new job

Day 1 in a new job: Handed my laptop, shown to a desk, let’s go!

Everything is so different to what I know. Systems are different. A different way of managing. They are using different words than those I am used to, I know what the words mean, but they meant something different in my last job.  I will never get my head around this. Of course, I will, I’m a quick learner, always have been. Go to meet staff and residents. I am no good with names, takes me a while to remember them, I have to allocate a visual clue to remember them face + clue = name!  The staff are all wearing masks. Oh, my word, how will I remember who is who now!!  Meet the ladies and gents. Some names are familiar, they were referred to my last service, but no beds to accommodate. No meeting was arranged to introduce myself to the relatives – covid restrictions. No meeting GPs or other professionals. These are very strange times indeed. I am the new ‘girl’, even with 35+ years of nursing under my belt, 22 of those as a manager in various settings. It’s all-new, and I feel out of my ‘comfort zone’.

Dear diary….strange days

Week 2 in a new job: I’m on call. A new way of doing meetings – Microsoft teams. Almost a virtual senior management team. My previous role was a combination of the roles of 2 here, strange, hope I don’t ‘step on anyone’s toes’. Social workers ringing to discuss gents that I know nothing about, this is really uncomfortable for a manager. I knew everyone at my last place and could discuss them in-depth. I feel lost. I feel incompetent, but I know this will pass. Having questions fired at me, that I don’t feel able to answer, I don’t know the answers, I don’t know the service well enough to be able to answer. Thank goodness for the support of Carla, Karen and Shirley, as I am still feeling out of my depth, but they are helping me to find my way.

I am Managing!

The days roll by….

CQC/ESF call – completed by ‘teams’ call.

Registration certificate arrived, in under 3 weeks – no interview with CQC, not even by phone or ‘teams’ call.

Dear diary…I have been a little busy!!!

Roll forward to the end of week 8: I know staff names, mostly!! I can put names to faces of the ladies and gents, mostly. I can answer telephone calls with confidence and talk about the service. Give comprehensive Covid updates.  Chaired staff meetings. Chaired MDT. Feeling more like ‘home’ now. Chatting to relatives on the phone or by email.

Dear diary…I think I can say I now feel like the Manager.

But I would probably not recommend changing jobs in a pandemic. Everything is happening at a million miles an hour. I’ve tried to ‘play’ the graceful swan; calm and positive on the outside, whilst paddling like crazy under the surface, but probably looked more like a one-legged, one-winged duck!!

Swans and a duck for Fiona