Fiona Barton
Fiona Barton is a staff nurse in the cardiothoracic unit at the Royal Infirmary of Edinburgh.
Issues with the audio quality are due to problems at the time of recording.
Details
- Date of interview: 8 October 2020
- Archive reference: RCP/RES/2/12/6
- Interviewer: Daisy Cunynghame
Timestamps
00:00 Introduction
00:18 The effect of coronavirus pandemic on working hours and practices
02:50 Comments on availability of medical equipment and Personal Protective Equipment (PPE)
03:51 Complexities of treating patients during the coronavirus pandemic
07:00 Thoughts on the long-term impact of the coronavirus pandemic
08:57 Comments on the long-term effects of the coronavirus pandemic on the NHS
11:35 Comments on government responses to the pandemic
15:22 Thoughts on public responses to the pandemic including comments on how challenges brought on by the coronavirus have affected mental health
19:43 Recounting experiences of colleagues who contracted coronavirus
Transcription
Interviewer:
Can we just start off by you just saying your name and what you do and where you work?
Fiona Barton:
My name is Fiona Barton. I'm a staff nurse in Ward 102 in the Royal Infirmary of Edinburgh. Its cardiothoracic unit.
Interviewer:
Can you just briefly describe how the coronavirus pandemic has affected your working hours and the work that you do?
Fiona Barton:
So my working hours have not particularly changed. During the height of the pandemic, so at the start of lockdown, we changed the type of patients that we were looking after very quickly overnight and so the cardiac surgery side of things stopped working and patients were transferred through to the Golden Jubilee Hospital in Glasgow to keep them clean. And we had minimal thoracic patients, though we were still keeping going with the cancer patients. And then we had respiratory medical patients arrive. Initially we didn't realise they were actually going to be with us for quite some time, just thought that we were boarding because we had lots of beds because we weren't doing our usual number of operations. But then it rapidly transpired that these patients were going to be in our ward and we had effectively become a respiratory ward. And so for us it meant that we had to learn about a totally different speciality overnight and we had no warning and no training. So it was quite a baptism of fire. It was very interesting, but still very unexpected. Initially when lockdown first occurred right at the beginning of all that was happening we had very few patients and that was quite unnerving. I think it was just when things were happening and there was a rapid shutdown and everybody was wondering how it was all going to affect us and it was like what we experienced at Christmas time where elective admissions had stopped so we had lots of empty beds and although it was quite pleasant because we had time to do what we wanted to do, look after patients properly, at the same time it was really quite unnerving because we just didn't know what was going to happen, how it was all going to pan out. So I would say that that's really been major changes that happened. Obviously since then things have gone back to normal, shall we say. With the lifting of lockdown restrictions, our elective surgery returned, cardiac surgery returned and we were back up to do what we normally do. So respiratory patients eventually went back to their own area.
Interviewer:
Thank you very much. So did you experience any lack of equipment at all? Or if not, do you have any comments on the general discussions about lack of medical equipment at this time?
Fiona Barton:
I don't think we really had any lack of medical equipment. We were told that we couldn't use any of the aerosol generating procedures, so it was which patients are very often put onto, I can't remember what they are now, CPAP machines, and we were told that we wouldn't be allowed to use them because they would have to have gone to the COVID ward. But beyond that, we didn't really experience any lack of equipment per se. I was aware that certainly PPE, that was changing. The usual suppliers obviously changed because we were getting different styles of alcohol gel and the aprons and such like. But I wouldn't have said that we've had any problems with that.
Interviewer:
Thank you. So without naming specific individuals, can you think of any patients whose experiences of coronavirus you could kind of discuss as an example of what it was like to be treating and receiving treatment?
Fiona Barton:
I can probably tell you in a general sense. So our patients that were respiratory patients were supposed to be clean. And we had patients that the doctors were convinced that they were actually COVID positive, but they had no evidence back in terms of their swabs. So we did have people in four bedders that they did think were positive and eventually the results came back as positive and I think as members of staff we found that very frightening because we felt initially at the beginning we weren't dealing with patients with any masks and no PPE at all because that's what we had been told was what we had to do. Then gradually as lockdown continued and the pandemic got worse as you know they changed what they wanted to do with masks and such like. So we did have them, but still we could be going in with patients who later tested positive and then were moved up to the COVID positive wards. But we were also getting patients who were going into our cubicles who had been exposed to COVID. Either they had been in four bedders - probably just because they’d been in four bedders - and they had were negative at that time again they would come back positive. So from that point of view it was quite frightening for the staff, the unpredictability, we felt a little bit unsupported because we were dealing with these patients and we were suspicious along with the medical staff things were not right but we didn't feel that the system with the support in place. I do remember one young woman who the doctors thought she had COVID and eventually her swab did come back positive but I remember going into her and she looked unwell, she had symptoms of COVID and some days later she then started to feel very short of breath, couldn't breathe had to come into hospital. She had young children so she had to leave them behind and then she was needing oxygen and she left our wards to go up to the COVID positive wards. I don't know how she got on but that kind of brought home just how deadly this disease can be in terms of that she was a very fit young woman and yet she had ended up in hospital. I don't think she smoked or anything like that. So that's probably about the extent of my dealings with COVID patients.
Interviewer:
Thank you. Do you have any thoughts on what the long-term health implications of coronavirus will be?
Fiona Barton:
That's a very difficult question. I think we'd all like to know that. We don't have crystal ball gazing. I think unless we get a vaccine, we're going to have COVID in the community. So I think we're going to have to learn to live with it. And as we're seeing even just in the last few days, that's not going to be easy. A lot of it, I think it's going to be a trade off between people's freedoms and people's safety. So I know that there has been a movement that started in the States and has now come over here where people are calling for greater freedoms so that people can carry on with their normal lives and perhaps just targeting more vulnerable individuals in society because we can't live like this in the long term with these continual restrictions because it's affecting the economy, it's also affecting people's mental health and there comes a point where you decide what's more important really. So it's a very difficult one but having not dealt with patients in the long term who have had COVID and have had what's called long COVID or continuing symptoms it's maybe very easy for me to say these things whereas if you’ve dealt with patients who previously were very well and have had COVID and then gone on to have had complications that have gone on for months then I might change my story. I don't know.
Interviewer:
Thank you. No, that is a tricky question. So, in a similar vein, do you have any thoughts on the long-term effects this will have potentially on the NHS, you know, in terms of how things are structured and funded and the way services are delivered?
Fiona Barton:
Well, I don't really have a sort of experts view on that can only give you my view as a person working within the NHS but I think that they're going to have to change major structures because if we are overwhelmed or potentially overwhelmed every few months every time that they lift restrictions - of kind of boom and bust culture at the moment - then the NHS can’t deal with this unknown and constantly sort of looking over their shoulders. So I think they're going to have to change some structures. For instance, where do patients go that come in that are positive for COVID? I know at the moment that they're being nursed in their own areas if they're going to be positive. But that's fine when you've got small numbers, but when you start to get larger numbers, which we are seeing in some parts of the country, then it means that you either stop the elective surgery and elective admissions again and we start moving people into green zones, blue zones, red zones or whatever you want to call them, or hot and cold zones. So I think that there will need to be a master plan or a bigger view of longer term. We shut down gaily fever hospitals 20 years ago, 30 years ago, because we thought we had got to grips with fevers and I actually I wonder whether we shouldn't have kept them open because these would have been the ideal places for looking after patients who have COVID. Yes, again, it's a kind of crystal ball scenario. I don't really have the expertise to be able to say exactly what could be done.
Interviewer:
Yeah, sorry, these are very unfair questions.
Fiona Barton:
No, it's fine. I can imagine that if you're working as a consultant somewhere, then you can probably say, well, I think for my specialty we need to do X, Y & Z. But because my area kind of continues on now and not really been affected much by COVID, I can't really think that we need to do anything differently.
Interviewer:
Thank you. Do you have any comments on the government's response to the pandemic, either the UK government or the Scottish government, how they dealt with it as the period has progressed?
Fiona Barton:
I can tell you how we dealt with it at the beginning. I think the way that particularly Westminster dealt with the coronavirus pandemic wasn't good because they didn't really want to have to deal with all that was happening. They didn't, well in fact I think they just disbelieved that this was such a, virus that was so infectious and they kind of put their heads in the sand and hoped it would all go away. Or they had gone down the immunity, the herd immunity, line where they thought that more and more people were getting it, then that would help others. But then they rapidly realised if they continued to do that, there would be a massive death toll. So I think there was a huge amount of chaos and confusion. Also, I think the Westminster government hadn't learned from previous mistakes because I understand that there was a scenario run in 2017 about how the NHS would cope with PPE, with ventilators and so on and so forth. And it was clearly stated afterwards that we didn't have enough ventilators, we didn't have enough intensive care beds and we didn't have enough PPE. And the Westminster government decided that the money that would have been allocated to that would be better spent on Brexit. So it was very much a short term view of the pandemic, even though there had been a lot of people saying that there was likely to be a pandemic to sort of end all pandemics almost, particularly as we had seen quite a few pandemic type diseases in the past 20 years. I think the Scottish government, particularly Nicola Sturgeon, have been much better. They've had a much more pragmatic, measured view. I think she's more precise, she's calm, she tells you exactly what's to be expected. She doesn't try and pull the wool over your eyes. She's less political than the likes of Boris Johnson. I think it is maybe down to personalities that Boris is somebody who likes to have lots of options, doesn't ever like to close anything down. There's always another day, unless you're thinking about that. And so therefore you tend to get a sense that while there are difficult decisions to be made, we don't really want to make them today. So everybody's kind of left hanging, not really sure. what should be happening whereas with Nicola she does at least tell you how it is. I think that the best place was New Zealand because they were able to learn from previous mistakes where they were able to see it all playing out across Europe and they immediately put things into play and weren't afraid to make tough decisions. I think because we have a Westminster government isn't very keen on making difficult decisions, we in Scotland are not so easily able to put things into practice. But I think Nicola is learning. I think from this week she's showing that she's not going to wait for Boris to possibly make a decision. Yeah.
Interviewer:
Thank you. Do you have any comments on how the public has responded? In terms of following the regulations and any of the challenges that people have faced.
Fiona Barton:
I think the public have been remarkably good. I think that whenever a policy has come in, people have followed it. There's always a spectrum where you have those that will do exactly what they're supposed to do and there are those at the other end who are not going to be told what to do. And I think probably the vast majority of the population fall in between. But having been out and about in shops and pubs and restaurants and just in the streets, people tend to do what they're supposed to do. I think the ones that don't, perhaps so much, are youngsters, because for them it's not really that important because it's older people. It's affecting all of you, although possibly now they might be thinking that it could be affecting the universities and so on and so forth. I think initially at the beginning of lockdown people were very afraid. I mean certainly I was because I thought well are we going to have any elderly people left? Are they all going to catch it? Are they all going to die? Are we all going to get it and then just be unwell and then get better or what? But I think as the pandemic has moved on, particularly having worked with COVID patients, we did have an outbreak in our ward, quite a small one, and I didn't get it. So perhaps I've become a bit more brave, shall we say, that this thing is not just going to all of a sudden appear regardless of whether you wash your hands or wear a mask, whatever. But it is kind of logical that if you mix with people and you don't wash your hands then you're more likely to get it. So yeah, I think overall it's had a massive impact on people, particularly people's mental health. I was talking to somebody last week who is normally quite a happy-go-lucky go-getting lady and she was saying that she's having dreams at night - quite horrifying dreams and I think we're all kind of the same. It's the unpredictability of it all, don't really know how it's going to pan out, how it's going to end, is it going to end? But I also think it's shown a good side to everybody or to a lot of people because people have become much more aware of other folk. I think before the pandemic we were all very very busy and you could just sort of, you're carrying on months ago by and you hadn’t seen friends or hadn't spoken to people or hadn't looked out for people in the same way whereas like people are more aware of people and those that are vulnerable and it's actually okay to say that you're not okay. Like before perhaps you just got on with it and thought “well I'm the only person feeling like this” but now there's the recognition that actually that's not the case. There are many many people who aren't coping. I was listening to Jeremy Vine today just at lunchtime talking to people who are being affected with the close down in Scotland - or in the central belt rather - of the hospitality industry and people there that are struggling with mental health because they're wondering how they're going to cope with keeping their businesses going. Six months, eight months ago, we would never have dreamt that anybody would have that kind of problem. So it's, yeah, it's very challenging in these strange times.
Interviewer:
Thank you very much. So the next questions I'm going to ask you are more about the personal impact of COVID on you. If there are any questions that you don't feel comfortable answering, then please just say and don't feel obliged. So have you had, or do you know of any colleagues, friends or family members, without naming specific people, who have had any personal experiences of contracting coronavirus? And if you're comfortable doing so, could you just talk about that a little bit?
Fiona Barton:
I haven't had any close contact with people. I mean, there was a small outbreak at work and so speaking to my colleagues at work, they said that they became very unwell - it was like a really bad flu, that it was, they just felt really unwell for a few days and then some of them came back about two weeks after and thought that they ought to be fit enough to come back to work and then they found that when they got back to work actually they were just exhausted and had to go home and they found that hard because as nurses we tend to just keep going regardless. And there is a sense of, yes, you're allowed to be off for one week, two weeks max if it's really bad. So actually after the two weeks and still not be well, I think that shocked them. So it's a disease that is pretty devastating in terms of what it does to your health in the short term. There was another girl at work who has asthma and she found that she was affected with breathlessness for a much longer period. In fact, I think she was off for about 6 weeks and she's a young girl. So that I think was quite scary because at one point we thought, well, gosh, is she ever going to get better? She was backwards and forwards to the doctor, but she's now thankfully back at work and doesn't seem to have had any lasting symptoms. But beyond that, I've not really had doings with other people and had tremendous problems.
Interviewer:
Thank you. So could you describe how your home life routines have been affected by lockdown?
Fiona Barton:
During lockdown, not a huge amount changed because I was still having to go out to work. And in some ways, things improved because we didn't have to use - after a while we didn't have to use public transport - initially we were still going on the buses but then we were allowed to park at the Royal so that was great but then the other thing is that on our days off the only place we could go was to the shops, as usual, so it meant that we had to look around for places for exercise and that actually has been great because my husband and I have lived here for 11 years and we had discovered one walk I think so we went back on that walk and then I thought “well this is a bit boring keep going on the same walk” did some further investigations and discovered that there were paths on the council website so we explored those paths and it kind of opened up a whole new area around about the house which was really interesting and in fact there are still some areas that we've yet to explore. So that was a bonus because it meant that we discovered places which were not particularly busy and we could still get out and get some exercise. Other impact of course is that all my hobbies and pastimes were affected because I am a singer, I love singing in my choir, and we couldn’t go to church which I normally do every Sunday. So all that shut down and just meeting up with friends and family, so we weren't able to do that either. So suddenly the only way that you could see people was by using the computer this thing called Zoom. I'd never done it before. So I had to learn how to navigate the computer. I had to buy a camera and microphone and get that to work. Now I feel like it's been around for all my life. It's very strange how you quickly adopt this new technology. So I suppose actually when I think about it, quite a lot has changed with lockdown. Some of it good, but mostly it's been sort of sensory deprivation I think. Sometimes I felt quite trapped because if work's hard normally then you can think “oh good on my next days off I'm going to be doing something nice” and that was taken away because you couldn't meet up with friends, there was no music, no live music, I couldn't go to church, and so that that was hard but I found if I went out for a walk then that rapidly brought me back down to sort of feeling things were okay, copable with and I found that being at work was a great benefit because my colleagues kind of became a surrogate family. We could sit around the coffee table and chat and just talk about what we were going through, and you know just having the physical presence of people just helped to make it feel okay and a bit more normal. And there were a lot of things that we could have tapped into at work if we really needed the support, phone lines and things like that, and helplines. And there was also a coffee room that you could go to, although I never went to, but other folk would go off to in the afternoon just to have that space to get away from work. So yeah, so I think that's about it.
Interviewer:
So considering everything that you said in terms of your professional work and obviously the changes to your personal life, do you think the support for medical professionals was as much as it needed to be, particularly thinking of mental health and the challenges that nurses and doctors have faced in that way?
Fiona Barton:
I would say so. I mean, as I say, there were every day they were sending out the COVID speed read. And at the bottom of that, it was by e-mail, at the bottom of that, there were phone lines and e-mail addresses that you could use to contact places, sort of staff counselling or people that you could talk to if you felt that you were unravelling a bit. And also there were these spaces that you could go to just for time out. And as managers were being made aware of how to support their staff. There were also resources where you think about bad things and good things. And there was also the rationale of before you leave the ward to think about something that's been hard and to let it go and so on and so forth. So there were sort of resources there to try and help you deal with it if it was particularly difficult. Certainly much more than what was there before the pandemic.
Interviewer:
So this is my final question. I'm just interested about where you look to for accurate information about the pandemic. And do you have any thoughts on what are the best ways to share information, both within the profession and publicly? Do you think apps or social media or the web are useful ways of disseminating information?
Fiona Barton:
Well, for me, I look at the BBC News website. Because that's always up to date and they tend to be quite impartial in the way they report, and also looking at the news on the television. I don't think I go anywhere else. My husband follows people on Twitter and he can sometimes feed back information. I think there was enough information about the pandemic on the news and in fact there's almost a bit too much because it can be a bit frightening if you keep reading all the time. I was interested with my work colleagues - because I'm somebody that likes to know so I'm a bit of a news addict now. I never listened to the news before the pandemic but now I tend to keep an eye on things because for me information helps to keep me prepared and able to cope with what's going on. Whereas my colleagues, some of them are like they don't want to know. For them the ignorance is their coping mechanism. I find that really interesting, being at the opposite end of the spectrum from them. I think one criticism I would have with the hospital was that there wasn't enough information out there. I had no idea that there was any kind of protocol or policy for dealing with a pandemic and that there would be the different zones, that operations would stop, and I think there's five different stages and then those different stages are different ways of working. It would have been really, really useful for all of us as members of staff to have been given that information so that at the start of the pandemic we would have known what was going to happen in the hospital, outpatient departments would close, all staff would be moved elsewhere and to expect to be doing jobs that they've not done before, that there were all sorts of procedures that could be put in place. I suppose the fact that GPs now do everything remotely that might have just been a new thing but whether they would have thought about that beforehand I don't know. And also when we were actually working within the height of the pandemic we had no idea what was happening in the rest of the hospital, the nurses on the ward. It was all kind of filtered through that you would hear that another ward had shut, it had become the COVID testing ward or the number of patients with COVID had moved along the top corridor and so on and so forth and for some reason those statistics were not given out. All the statistics that we had on a daily basis were what you could get from the BBC news website i.e. the number of cases that were in Scotland and the number of people that were positive COVID in the intensive care, but nothing about actually what was happening in the Royal and I don't really know why they decided not to give that information out. I'm sure they must have a good reason but I just felt for us working within the midst of it that we were kind of working blind and not really given that information and it kind of makes you feel that you're not worthwhile in some ways that you're just there to work but not be a part of the decision making processes. So it would have been good if we had more information.
Interviewer:
OK, thank you. So before we finish up, just Is there anything else that you would like to bring up that we haven't covered already? Is there anything that we've sort of missed out?
Fiona Barton:
I don't think so. I think we've kind of covered most things. I suppose what possibly might add is that really just how frightening it was during the sort of March, April in terms of that we didn't know what was happening and we didn't know how COVID would hit and I think also the speed with which it could spread made it quite terrifying and it just was trying to take that on board. Because I've worked in intensive care in the past, I was told that I needed to be aware that I might be drafted into working in intensive care if the number of COVID patients increased. So one of the things that I found really valuable was I that did a course that - this is how I knew about the Royal College of Physicians of Edinburgh - the critical care course, along with the University of Edinburgh, and I found that really helpful because again it gave me lots of information about how to look after COVID patients and I felt like I was sort of tapping into resources near. We also had resources on mental health and things like that so that was really useful. So I would say that was a great benefit to me and to say thank you very much for Mr Nimmo, Dr Nimmo for organising that, and yourselves for allowing us to take part in that. But yeah I think that's probably all I've got to say actually.