The past two years highlighted the extraordinary care health services around the world provide, and the sacrifices those working on the frontline made to look after others during the pandemic. This week is National Intensive Care Week in the UK, and we share the story behind one of our recent Ardonagh Community Trust grants in which we have been able to support those working in healthcare.
Sarah Clarke is an Intensive Care Consultant at the Royal Blackburn Hospital in Lancashire in the UK and worked throughout the pandemic in the hospital, looking after patients with Covid. At the beginning of this year, Ian Barclay – Managing Director of Geo Agriculture and Sarah's brother-in-law – nominated Intensive Care Society for an ACT community grant of £5,000 to fund the society's activities to mark Intensive Care Week in hospitals around the UK.
Here, Sarah tells us about her experience of working in Intensive Care during the pandemic, and how both she and Ian have taken on fundraising challenges this year to give back to those who continue to work on the healthcare frontline.
At the very beginning of the pandemic, it was like we were waiting for a tsunami to hit. We could see it coming, and we were all very anxious.
It was a frightening time, but as consultants we were the leaders, and we had to instil a sense of calm and confidence. In reality though, we didn’t know what we were going into or how bad it would get. We were trying to prepare for what was essentially unknowable.
Royal Blackburn Hospital, had a 24 bed intensive care unit. We had our first Covid patient on the Saturday and by the Monday we had four patients - the figure just kept rising. At our very worst we hit 62 patients requiring intensive care.
We needed to rapidly expand our capacity, so we worked to upskill staff, bringing them in from theatres and other wards. We had to teach them about the equipment we used and our practices. We were constantly assessing our resources - we nearly ran out of oxygen, as did many hospitals in the UK and indeed globally, and nationally we ran out of dialysis equipment. We had a lot of help from the community, schools, businesses and colleges, who all worked very hard to supply us with PPE, which was humbling and we were just so very grateful.
It felt like I was on a hamster wheel, just going, going, going. I had to focus on what was necessary, to do the best for patients and to do the best for staff, and I just couldn’t think about anything else. I saw a surgical colleague recently, and she told me that our team looked like ghosts during the pandemic – we were all so preoccupied.
On our very worst day we lost nine patients and at the end of that shift we were completely spent. Not being able to speak to families face-to-face was probably the most difficult part. Having to phone and tell them that their loved one was going to die, and doing that over and over again. We couldn’t comfort them and there was a sense of helplessness that these people with families and lives and so much to live for were going to die prematurely and there was very little we could do to change that.
It placed a higher emotional burden on nurses, as visitors were not allowed into the hospital and our nurses were often the last human contact a dying patient would have. A lot of families were very angry and they could on occasion direct their anger at us. They couldn’t understand why they couldn’t come in to see their loved one, to be with them and comfort them as they died. Again, we felt helpless.
I’m very proud of my team and am incredibly humbled by the way they all pulled together. Everybody stepped up. People stayed on longer shifts, if somebody was dying, nurses wouldn’t leave their patient and would stay with them, often until way after the end of their shift. They wanted to be with them to the end. They would lay them out, taking every possible care they could, saying a prayer, finally escorting them to the mortuary.
I was very concerned about the impact of the pandemic on my team. It was the little things though, that we did personally that made a huge difference. Asking people how they were, making those personal approaches. In our Covid zone we were able to hug because we were all in full PPE, and that physical contact, a hand on a shoulder, just to check that members of the team were ok, it was something people really remembered.
We had wellbeing boxes - a hygiene box, because once you left Covid zone, the first thing you wanted to do was take a shower; and there was goody box with sweets and treats and a food box. The local restaurants in Blackburn brought in crates and crates of curry, pizzas, coffees, cakes, and that really lifted morale, to know that people were thinking of us.
At the end of a shift, I always tried to make sure I was the last member of the team to leave the Covid zone. It was just my way of trying to reach out to my team. Nobody was allowed to spend too long in the Covid zone because it was not only physically unpleasant but also mentally very distressing. We made sure that we had an open culture where anyone could say they were not happy and be able to get some time away.
Looking back now it’s hard to believe that any of it happened and I still sometimes fight with my emotions. I don’t feel the fear any more I just feel a terrible sadness and that feeling of helpless still endures because there were so many people we just couldn’t save.
Working through the pandemic was an exceptional experience and although it’s not something anyone would ever want to repeat, we did learn a lot of valuable lessons. Camaraderie and teamwork were just phenomenal. We got to know each other and bonded in ways that would not have been possible in ordinary times. Communication skills were really honed and we have adopted a new hands-free walkie-talkie system that allows us to communicate across the team.
We have flattened the hierarchy considerably, which has led to a more streamlined and efficient way of communicating. Working in PPE nobody knew who anybody was because we all looked the same. We had stickers, but they peeled off as it got so hot and humid in Covid zone, so we wrote our first names in black marker across the front of our gowns.
Thanks to this, we’ve pretty much abolished surnames and titles. Now there’s no more, doctor this or nurse that, everyone is just called by their first name. At that time, in that situation, it no longer mattered what your training position was, it was about your skillset, and what you were able to do and bring to the team. It was an opportunity for a lot of people to extend their skills and push their limits because they were enabled to.
Covid has also led to a more open culture in terms of addressing the mental wellbeing of our staff. Recognising workplace related stress has definitely been accelerated across the healthcare sector. It’s great news for the staff and patients, because if you have happy staff, the patient care will be better.
I love working in intensive care and I honestly wouldn’t work anywhere else. The teamwork, camaraderie, and the systems and processes that are in place make it a very unique and rewarding place to work. ICU is highly specialist and the care we provide is critical by its nature, but it’s a very supported environment. The decisions we make and the care that we give mean that we are able to help people when they are at their most unwell and vulnerable. We are also the people who get to return loved ones to their families, and in terms of job satisfaction, it doesn’t get better than that. It’s a privilege.
I saw the advert for the charity challenge during a lull in the pandemic and I felt I needed something to focus on to take me out of what I’d been living through. I applied on impulse, because it looked like an opportunity for me to move on and take care of my own emotional wellbeing but also because I wanted to do something to constructively support the workforce, by raising funds for the Intensive Care Society and Doctors in Distress. I got a lot of closure by doing the expedition.
That first day was great - the sun was out, everyone was happy and there was a sense of excitement. But on the second day of the challenge, I hit a wall. It was a very cold morning which started with a steep, icy, descent. If anybody had slipped, there would have been serious injuries and the pressure was on from the get-go.
We came across the end of a glacier, and it didn’t just peter out, it was like a sudden tower block, it’s called a Serac. In the previous 24 hours one of the seracs had fallen - it was like an ice avalanche and it would have killed anyone in its path. Our guide was really worried and stopped us all. He told us that we had to cross as fast as we could, but he would only take us one at a time, because if another Serac fell he only wanted one of us to be killed.
You could hear the ice creaking above our heads and I remember thinking, this could be it. I slipped and fell and the guide was telling me to go faster. I got to the side and I was spent. I was just exhausted and in pieces. But there was a lot of encouragement from the group – who until three days before had been strangers with a common cause, and it was very much about teamwork. There were lots of hugs when we made it through and I feel as though I made friends for life on the challenge.
I want to thank my brother-in-law Ian, for supporting me in my fundraising. I had a conversation with him last year before I started the challenge. He said that I needed to get news of what I was doing out to businesses. I told him, I’m a clinician, I’m not a salesperson, and he just said: “Just leave it with me!” Words can’t describe how humbled I am by all the support we’ve had. My daughter plays rugby, and her team raised £75 through a fitness session, and little by little the amount just kept growing. I can’t believe we’ve now raised over £75,000 - it’s just amazing.
Being able to contribute towards supporting the profession and to receive funds from Ardonagh has felt wonderful. When I heard the company was awarding a community grant to the charity, it was days before we started the challenge, and it was an enormous boost to feel that someone was taking us seriously. It was not just lip service, but actual help that would make a real difference to the ICU community, and I honestly could not be more grateful.
I feel that as a business, there’s a lot we could learn from healthcare and in particular, the way they responded to crisis during the pandemic. I think people who go into the medical profession tend to do so because they have a vocational mindset and I have a huge amount of respect for them. Throughout the pandemic they were very committed to the cause and they really were prepared to do whatever it took to achieve the best outcome, but for many health professionals that commitment came at a cost to their mental wellbeing.
I really wanted to help support intensive care professionals who had been on the frontline during the pandemic. I’d been hearing about some of those challenges from Sarah, and I wanted to help them, particularly in terms of supporting their mental health.
The pandemic was difficult at time, because there really was nothing we could do as a family to relieve that pressure or burden from them. The ACT community grant has meant that I could at least contribute to a cause which offers Intensive Care professionals practical and worthwhile support.
Sarah’s expedition has inspired me to undertake my own challenge for the Intensive Care society so I’m nervously excited to be undertaking the Quebrantahuesos challenge in June. It’s the largest cycling sportif in Spain, I’ll be covering 205km and climbing around 3,500 meters (the height of three Mount Snowden’s stacked on top of each other) through the Spanish and French Pyrenees. I’m hoping to complete the course in 9.5 hours. Quebrantahuesos translates roughly as ‘bone crusher’ which is probably a fairly accurate description of what I can expect!
I feel very lucky to work for an organisation that gives me the opportunity to raise funds for a cause I care about. The culture of charitable giving at Ardonagh is hugely important. There will be many reasons why we do the jobs we do, but that ability to be able to help society, that spirit of altruism we have across Ardonagh’s businesses, is of immense value, and something that I know is treasured by many of my colleagues.
The Intensive Care Society is incredibly grateful for the support from The Ardonagh Group, and it is because of the generosity from supporters like them that we are able to provide the UK intensive care community with all tools they need to care for the nation. These past few years have created a stark window into our specialty and has highlighted the vital care our professionals provide to the sickest of patients in hospitals.
We are blown away by the support Ardonagh Group have given us to help run Intensive Care Week. We established this national week in 2020 to not only raise further awareness of intensive care, but also to promote the incredible ICU workforce and the care they deliver every single day.
Each and every member of the ICU team plays a critical role. Whether it is the Dr making sure you have the right care, or the nurse that stands by the bedside 24hrs a day or the allied health professional team that enable patients to walk, talk, breathe and eat again.
Your donation is helping us celebrate the whole ICU community and encourage more people to consider work in intensive care as a career path. We’re very excited about what we have planned and grateful for your support.
Read stories about the people and projects we have supported so far on the ACT website.
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If you have any questions, reach out to the ACT team using info@ardonaghtrust.org.