There is no typical day at the hospital during these challenging times, but as a nurse there are certainly things we can expect to deal with regularly. I usually wake up at 6.a.m but nothing seems to be usual about these days. We are currently dealing with a pandemic and we need to be extra cautious. This disease has changed the way we deal with our patients and has made us extremely vigilant in order to minimize the risk of contracting the virus.
Before leaving my house I prepare breakfast and lunch for my four-year-old daughter and husband. I say my morning prayers, get ready and head out of the house. I live 12 kilometers away from the hospital, so it takes me around half an hour to commute. I ride a bike to work. As lock down rules apply – I’m allowed to pass only when I show my ID. My constant companions nowadays are a mask and an alcohol-based hand rub. One of the first things I do as I reach the hospital at 8.a.m is to change my mask as I enter the clinical area. I also remove my mask and wear a fresh mask while moving out.
Movement is mainly restricted for covid-19 patients and also the staff handling covid-19 patients. The doffing and donning areas are strictly monitored and staff movement to the patient care area too is based on the patients need. Unnecessary exposure is avoided. Also, while going to the patient area I wear complete PPE – gown, mask, gloves, goggles, face shield, shoe cover, and head cap.
8.30 a.m. to 8.45 a.m.
I head straight to the microbiology department to collect all the reports and inform the concerned departments about the same.
I wear a mask and gloves and go on my rounds which include monitoring and surveillance of all infection control practices in all wards. This goes on till nearly 12 p.m. during which time I complete my rounds. I check all the cleaning activities, monitor the dilutions of the cleaning chemicals, examine all the microbiological reports, check the cleaned equipment, check the cleaning protocols, monitor waste segregation practices and check the linen handling practices. I then report about the abnormal reports and communicating with the microbiology HOD and inform about the necessary measures that need to be taken up by the concerned departments.
12 p.m. to 1p.m.
We have our training classes for housekeeping, security and front office departments.
1 to 2 p.m.
Is reserved exclusively for nurses, because they need more details.
2:15 p.m. to 3:15 p.m.
I take training regarding covid-19 for the billing department, pharmacy department, intern doctors, all staff nurses, lab technicians, housekeeping, security and front office staff.
Mainly I train them regarding hand hygiene practices, doffing and donning of PPE, biomedical waste segregation practices, cough etiquette, safe handling of linen, safe handling of sharp equipment and environmental cleaning. Each training session is for one hour and I usually train 2-3 departments a day. I conduct training classes to all the health care personnel regularly and daily.
During these sessions we maintain social distance while communicating, always use a hand rub and face mask, and never touch the high-touch surface areas directly. We maintain at least three feet distance while communicating and during training classes at least 4 to 6 feet as there are many people.
An updated report is submitted to the Nursing Superintendent regarding all the reports, issues during the rounds, surveillance reports, cleaning activities monitoring reports etc.
As times we have meetings and attend these according to the schedule planned. Hand hygiene audit is done daily under silent survey. The critical care departments are thoroughly trained regarding bundle care practices. The hand hygiene survey is to check all the staff regarding how well they are practicing hand hygiene daily and routinely in the hospital. It is mainly to reduce the risk of transmission from the health care personnel to the patients and also the staff. I also ensure that all the protocols have been displayed in all the wards.
Conduct of nursing care in the isolation ward:
- Nursing assessment of admitted patients
- Minimizing the exposure to staff from patient
- Do’s and don’ts to the patient explained at the bedside with physical distance (3 feet) and the same in poster form displayed in the ward
- 3 layer surgical mask provided to every patient
- 7 a.m. the third shift nurse checks vitals, sp02, administers the prescribed drug, GRBS and food distribution (breakfast)
- 8 a.m. doffing of PPE and going directly to the staff isolation area (hostel)
- 8 a.m. first shift nurse comes for duty
- 12 p.m. first shift nurse follows the rounds, checks vitals, and administers medications and food distribution (lunch)
- 2 p.m. doffing of PPE and go directly to the staff isolation area (hostel)
- 2p.m. second shift nurse comes to duty
- 7 p.m. second shift nurse check vitals, administer medications and food distribution (dinner)
- 8 p.m. doffing of PPE and go directly to the staff isolation area
- 8 p.m. third shift nurse comes to duty