Within minutes of arriving at work this evening, I am warned that one of our residents had died the previous morning. Joseph was 82 and had been suffering from pneumonia caused by a chest infection for several days. When I last saw him on my shift two days earlier, he wasn’t eating or drinking, so I knew he’d probably not survive the week.
Yet still it hurts. He’d also developed a moisture lesion, the start of a pressure sore, on his lower back — a consequence of not being repositioned regularly. Joseph’s death wasn’t caused by anything we did, but what we were unable to do. Had we had our full team of staff, I’m sure that we could have moved him more regularly and perhaps have prevented the lesion, which no doubt hastened his decline.
One of us could have sat with him and fed him, listened to him and held his hand. But we simply don’t have the time. The loss of one permanent member of staff a few weeks ago because she refused to be vaccinated, and the resulting reliance on agency staff, has had a devastating impact on the standard of care in our home. When it becomes compulsory next April for staff to be jabbed unless they have a medical exemption — at the moment care homes can decide their own policy — the situation will only deteriorate. Some estimates suggest more than 100,000 unvaccinated care home workers could be forced to quit.
Tonight’s shift is intensely busy, as always. We have 30 residents in our private care home in Sheffield. They all need feeding, washing and changing — and I don’t stop for a moment. It’s six hours into my shift when I’m stopped by my colleague Lisa. Grabbing my arm, she practically throws me into the room and onto the sofa and tells me to sit down for five minutes.
“You’ve not stopped,” she says. “Eat something!” I check the clock. She is right. It is almost 1.30am and I haven’t eaten a thing since I clocked on at 7pm. The only time I’ve stopped is to pop to the toilet and take a few sips of cold coffee. It is time for a quick break.
I sit down to eat a sandwich, but a pile of paperwork sits on my desk and I can’t ignore it. As the senior member of staff on duty that night, it’s my responsibility to be in charge of the medications, so I might as well audit the drugs paperwork while I eat my dinner. It will save time later.
Barely five minutes have passed when another colleague, Sheila, asks for some help moving one of our residents, Anne, who has soiled herself. Many of our residents are incontinent and accidents are common, but it’s often impossible for care workers to move residents on their own, particularly when they’re only 5ft 2ins like Sheila. If we don’t clean and move them swiftly, bed sores can develop and that’s when residents are at risk of infections which can be fatal.
We find Anne in some discomfort and distress. Who knows how long she’s been lying in her mess? The staff tonight are spread even more thinly than usual: Clare, one of the younger members of the team, called in sick and no agency nurse has turned up. We clean Anne up and make her comfortable and she sleeps.
It’s a small consolation. I have worked in the care sector for ten years and while we’ve always been busy, it’s becoming clear that things are dangerously close to breaking point now. The pandemic was stressful but now we have the added burden of being short-staffed. Carly, the unvaccinated nurse, left a fortnight ago and we are unable to find a permanent replacement.
Carly is one of many careworkers who refuses to have the Covid vaccination. She’s not what you’d call an ‘anti-vaxxer’ because she’s had other vaccinations such as flu; she simply didn’t trust this one. She felt it hadn’t been tested rigorously enough and could harm her health in the future. I’ve no idea why. The rest of us tried to persuade her that it was safer — for the residents, herself and us. It felt like another level of protection.
But for whatever reason, Carly was adamant she didn’t want it. She initially thought the Government might perform a U-turn but when it became clear they wouldn’t, she looked for a new job. She’s working in a school now.
Of course, it’s a shame. She loved her job and she was good at it. But if she’s going to put others at risk, I can’t blame the Government for wanting her out.
Yet her departure leaves us in the lurch and it makes me nervous about what lies ahead. Although I have a 36-hour-a-week contract, I’m regularly working up to 60 hours — all for £9.60 per hour and I’m exhausted. There’s no bonus for overtime. I suppose I should count my blessings. I know of another home that has lost four members of staff who refused to have the vaccine.
Once Anne is cleaned, I return to the staffroom to finish the drugs paperwork. I’m always terrified of making a mistake when I’m tired. Only two weeks ago I’d been so busy rushing from room to room that I’d forgotten to give someone his epilepsy drug. He ended up having a seizure and although we found him in time and he was fine, I felt dreadful. I held my hands up. I knew it was my fault. But with so few staff, mistakes are going to happen. Not long ago a lady fell in our lounge area and broke her hip. I watched it happen, almost in slow motion but I couldn’t get to her in time. Would that have happened if we’d had enough staff members? Possibly. But I couldn’t help but feel she might have been saved if someone had been able to keep a closer eye on her that day.
I thought things might improve when the pandemic started to subside this spring. Like many frontline workers, we had little in the way of PPE at first and had no idea what we were dealing with. Watching people deteriorate when they got the virus was horrific. I’ll never forget them desperately gasping for breath, as if they were drowning. We couldn’t do anything except prop them up on their side or turn them over onto their fronts. That seemed to help. But we lost seven of our residents and there would be many nights where I’d go home in tears.
The terror and paranoia of bringing the virus home has never really left me, even now. After my shift ended, I would undress at work and put my uniform in a tightly sealed bag to take home and boil wash. But when I got home, I was fearful that I still had the virus on me, so I’d strip off in the hallway and rush up to the shower to scrub myself clean before I went anywhere near my daughters. My husband would grab the bag, put the uniform in the washing machine and then thoroughly scrub his hands.
When the vaccine arrived, it felt like we’d been saved. I managed to have mine early in the year and I’ve now had all three. I don’t think anyone should be forced to have the vaccine, but I still can’t understand how people in our sector are reluctant to get jabbed. We have people in our homes in their 90s who are completely bedridden with dementia. Even though they’ve been vaccinated, they will be among the most vulnerable if this new Omicron variant takes hold, as it looks like it will.
For the moment we’re relying on agency staff to plug the gaps but this is never ideal. Although they’re competent enough, the people who need the care can become upset if they see a face they don’t recognise. There’s no continuity of care. Last week, one of our more vocal residents got spooked. She doesn’t speak much English and was screaming and crying about the new staff member.
And so I feel pessimistic about the next few months. We are currently Covid-free in the home but I don’t expect that to last. Our residents have all been vaccinated so we know they have some level of protection and that’s reassuring. But it’s the ‘stepdown beds’ — people who arrive in the home for temporary care straight from the local hospital — who we constantly worry about. Although they are tested before they arrive and they’re put in isolation and tested again on Day 5 of their stay, we’re all worried that one of them will bring in the new variant.
Then what do we do? Will it mean another lockdown? Families unable to visit their loved ones again? Although I hope it doesn’t come to that, we are all expecting it.
Don’t get me wrong: I love this job and I don’t want to leave. But there have been many nights where I’ve come home — sometimes after 16 hours on my feet — and I wonder if it’s worth it. We are all scrambling. And things are only going to get worse.