Covid Family Liaison Team
In response to Covid-19, we set up a dedicated Covid Family Liaison Team to maintain regular communication between patients in intensive care, and their loved ones at home, who are unable to come to our hospitals at present due to visiting restrictions.
Claire Bailey, Jennifer Ross and Abi Simpson are all key members of the team – and they agreed to share their experiences of Covid-19 so far.
Claire Bailey is the lead Clinical Nurse Specialist for breast screening at St George’s.
“I’ve worked at St George’s since 2007, and love my job, but as soon as the seriousness of Covid-19 became clear, I wanted to see how I could help, particularly as the national breast screening service had been temporarily suspended, says Claire.
“So I spoke to Dr Ros Given Wilson, Consultant Radiologist, who said she would talk to some people – and very, very quickly, I was up on ITU discussing with senior staff on the unit ways in which we could help.”
Claire is now a central figure in the Covid Family Liaison team for ITU. Claire and her team contact relatives by phone every day to tell them how their loved one is doing; and to answer any questions or concerns relatives have.
“None of us are experts in intensive care, but we do have advanced communication skills, and that is where we can add value. I’ve worked in breast screening for many years, and had to have difficult conversations with many women during that time. Covid-19 is very different, but the principles of good, open communication are universal, whichever service you work in.”
Claire can make as many as 15 calls a day, and no conversation is the same. “It’s an exhausting job, but the ITU team really appreciate what we are doing, and so do the relatives.
“Some calls last just a few minutes, whilst others take longer. Many relatives are very upset, and still processing what is happening to their loved one; whilst others have more practical concerns about the things we all worry about; paying the bills, sorting out life admin and so on. As much as anything, we provide relatives with a familiar voice, and someone they can ask or say anything to.”
Patients with Covid-19 on ITU do recover and return to the wards, and then go home – but others will sadly die in hospital, and that is a sad reality of working on ITU at present. Given their roles, Claire and her team support each other to deal with the emotional impact of the job they are doing – and also have access to clinical supervision.
She adds: “In a short space of time, and despite my long career in the NHS, I have learned a lot about people in recent weeks – and the power of making connections. We are all doing our best to manage an incredibly difficult situation. I have been involved in training to staff in delivering bad news to patients and relatives for many years, and what I say regularly is that it doesn’t matter if you don’t use exactly the right words, in the right order. However, patients and relatives will remember how you made them feel, that you were kind, and gave them your time – and that is what drives what we are trying to do in the current situation.”
Jennifer Ross is a Macmillan Lung Cancer Specialist Nurse at St George’s, but is currently based on neuro-intensive care, where some of the most seriously unwell patients are treated, including those with Covid-19 nearing the end of their lives. Jen and her colleagues use ipads to facilitate contact between patients in ITU, and their relatives at home.
She said: “We are here to support the intensive care team, who know they can call on us to help facilitate contact between patients and relatives. Visiting is no longer allowed, so it is difficult and challenging for everyone involved – but we have found new and creative ways of maintaining contact between patients and relatives, which is so, so important.”
“Our role is important; both in terms of making and facilitating contact, be it a phone-call or via video, but also in terms of talking to relatives, and preparing them for the emotional impact of seeing their loved ones.”
She continues: “We always talk to relatives before setting up a call – many patients in ITU are ventilated, so look very different to how they do outside of hospital – so it can be distressing for people to see. However, when we do make contact, the vast majority of calls have been a really positive experience for relatives, although also very emotional of course; and we feel it to.”
“Our role is to facilitate contact, and it is a real privelige seeing families connect in this way. The whole team have seen families share some really difficult and emotional moments – but also some incredibly uplifting ones. Hearing is one of the last sensations to cease functioning properly – so we tell relatives that talking is important.”
She adds: “It is really difficult, and mentally and physically demanding. We work in pairs, as sometimes one of us will just need to step out – there are a lot of emotions for people to manage. We also have access to staff support, which is really important – as is taking time away. However, overall, it has been an incredible experience, and one patients and in particular families really appreciate.”
Abi Simpson is a Speech and Language Therapist, and one of five in her speciality to have been redeployed to support staff on ITU.
Like Claire and Jen, Abi helps facilitate contact between relatives and patients, but often works with those patients who are either coming off ventilation, and/or recovering from Covid-19.
‘’As speech therapists, it felt appropriate that we were the professionals who undertook this project and we all wanted to play our part in supporting the organisation’s response to Covid-19. We come from a variety of speech therapy teams and we are used to helping patients optimise their communication skills as well as preparing families for how best to support loved ones.”
Many of the patients she sees are recovering and, unlike those patients with Covid-19 who are ventilated, are able to communicate with their relatives, again using ipads.
“It has been an incredible experience and a real privilege. We have seen patients connect with their families for the first time in weeks as well as families wanting to spur their loved ones on when they are unconscious. We have had many heart-warming moments, plus a few funny ones. The first thing one of our patients asked her husband for on a video-call was how the cat was keeping, he hadn’t seen her in weeks but he had to hunt the cat down for the call! We’ve also had families celebrating birthdays and anniversaries together – all the calls are different, and each one is special.”
As well as preparing families for the emotional impact of seeing their loved ones in hospital, Abi also helps ensure patients are contacted at the right time of day and are facilitated as best as possible, as many will be more tired than others, depending on the medical interventions they are still undergoing. “We think carefully about the calls, because we know how important they are. We don’t want people to get upset unnecessarily, but equally, it is important that we are honest with relatives about what to expect, so we have felt a strong sense of responsibility and duty of care to the families.”
She adds: “The feedback from staff has been really great. The teams on ITU are doing such an incredible job in extremely challenging conditions, so we feel really honoured to be doing our part as well. At times it can be difficult , the PPE takes a lot of getting used to, and it is really hot – but we know the value of what we are doing, and the experience has been a really positive one, and a real privilege to be part of. We all feel very passionate about making sure this service can be maintained when we return to our typical roles”.