Nurse Rosenberg

Here we are at the end of February, and I feel pretty good about how the month has gone, despite the physiotherapy exercises having done very little to improve the knee situation. Other things have been very helpful in lifting my mood, including Zooming with at least four different groups of friends, walking with another friend and his dog, and some pretty inspirational online talks.

I have completed my first shift as a Covid-19 vaccinator. It started with me going to the location on the first floor of the hospital where the e-roster system indicated I would be working, to find the door locked and everything inside looking dark. So I returned to the Portakabin in the car park, only to find that locked too, but with someone waiting outside who let me into the secret of access to the first floor ward (knock hard on the door). So I went up there again and managed to get in, only to be told that I was actually going to be working in the Portakabin. A good start.

There were about ten of us working there as vaccinators plus about four doing reception and admin on my shift, which ran from 7.30am to 2pm. Reception and admin are about checking that people are who they say they are and are entitled to receive the vaccine, answering basic questions about the process, enabling them to avoid being charged for parking, supervising them for the 15 minutes they must wait afterwards in case of adverse reaction, and setting a date for the second dose.

There are three different roles for which I needed to be supervised and signed off. One is going through the protocol and ticking the boxes on the paperwork to establish entitlement to the vaccine and any contra-indications to be taken into account - for example, people with clotting and bleeding disorders are not necessarily disqualified but vaccinators need to be aware. The second is the process of diluting the vaccine and drawing it up into syringes for administration, and the third is checking paperwork before sticking the needle in. 

The paperwork role is pretty straightforward, the main skill being remembering to ask all the questions and providing the necessary information - it takes two weeks for the first dose to reach full effect, you can still catch Covid, you need to carry on taking all precautions. Reconstituting the vaccine is fiddly. There are many, many steps - drawing up saline, mixing with the vaccine in a particular way, then getting six doses out of one vial, and timing everything to make sure no doses are wasted. When I did the first part of my training a month ago we were only being asked to get five doses out of a vial, which is obviously much easier. I got the hang of it with a bit of practice.

Sticking needles into arms was obviously the most nerve racking for someone who has always been pleased that being a Dietitian does not require you to touch people at all, and certainly never expected to be performing this role! The supervisor was really good and took things just at the right rate, and my first victim was very calm - in fact, they all were, even the one who said she sometimes went a bit funny with needles. I did get some strange flashbacks later in the evening of needles going into arms, but nothing traumatic.

The most interesting experience came when one of my victims was sitting ready to be injected, and I was running through the information he'd provided on the form. In the place where you state your role in order to ensure that you qualify for our clinic (which is for health service and associated roles only) he had written 'Transport'. When I asked what sort of transport, he said 'Uber'. So I went off to fetch the supervising nurse.

I'd been warned that the taxi drivers of the area had found out how to play the system and were presenting themselves at the clinic despite not being entitled to a vaccine. This chap had got through the reception and the paperwork stage, where I would have thought his entitlement would have been challenged, and nearly got his jab. He was turned away unvaccinated. But it does expose the weakness of a fairly loosely defined protocol operated by well-meaning health workers who are reluctant to deal with conflict. Much easier just to let people get away with it than challenge their entitlement.

This decision was made more difficult because it was not very busy in the clinic that day. We are reaching the end of the wave of first doses, and second doses are about to become available at which point it will turn busy again. We only have a certain allocation of vaccines, so it's important not to give too many first doses otherwise we will run out of second doses - hence the criteria for entitlement. I was lucky to do my first shift when I did, because it would have been much more stressful if lines of people were forming outside and there was pressure to operate quickly. As it was I had time to practise and get things right in my own way. I've now booked a day a week for the next six weeks and two days on the weeks when I'm on leave from my main job.

The latest 'road map' out of lockdown has made me feel slightly better because of having an idea of how long things will take to change, and at the same time makes me feel slightly worse because of having an idea of how long things will take to change. There is a risk of raising hopes and expectations only to be disappointed. So I'm still trying hard to take it a day at a time, finding ways to tame my increasingly wild hair, and taking pleasure in music, in visiting mum and dad, in walking, in Zooming with friends, and in films. It's hard to remember what it was like to play badminton.