Bernie Waterhouse

The images of Bernie Waterhouse receiving her COVID-19 vaccine on December 29th 2020 was a welcome boost at the close of a horrific year for everyone.

Bernie, a Clinical Nurse Manager (CNM) in St James’ Hospital, became the first healthcare worker in the country to get a dose of the long-awaited vaccine. More than two years later, she has reflected on the many changes that COVID-19 brought about in her work life, completely revolutionising the delivery of healthcare in Ireland.

“I got so much from our time dealing with COVID-19. It learned more than I did in any other stage of my career and I was so proud of all that we did. It has instilled in us such high-quality standards and patient-centred care,” she said.

“We did what we could to keep patients alive and get them back to their families. And we got great feedback from families who were so grateful to us so we knew we were doing the right things.”

As COVID-19 hit the country in March 2020, Bernie, who was a CNM on a surgical ward, volunteered to work on a COVID-19 medical ward. For her, the first wave of COVID-19 was the most traumatic as staff on the frontline battled an unknown beast.

“It was really tough. The lack of PPE was the worst part at the start. By the second week, staff were dropping like flies and the anxiety around was huge. It was a very tough on everyone psychologically because of the very high death rates that we were experiencing on the ward,” she explained.

“The number of deaths we would see in a year on the surgical ward, we were getting in just one or two weeks. On one day, we sent five people to the ICU and had two deaths. It was quite overwhelming. Patients were deteriorating so quickly. One lady was eating her lunch at 12pm and was dead by 2pm, completely without warning. And we were seeing that with both young and old people.”

Bernie, like every healthcare worker, was impacted greatly by the lack of touch and physical contact with her patients, particularly as they were dying.

“Patients weren’t able to see our faces and they weren’t able to hold our hands. It was just torture not being able to comfort them as they were so scared and anxious. Facial expressions and physical contact are so important in patient care and that was all taken away from us,” she said.

“We ended up getting lanyards made with photos of ourselves on it so that our patients would know what we looked like underneath all that PPE.”

She said lots of things changed by the time the following waves hit and, despite the volume of COVID-19 patients, the staff were much better equipped to handle it.

“It was all so scary at the beginning. Patients were dying alone because we were afraid to let family in. We just didn’t know if the PPE was going to be enough to protect them. But we have all learned so much about the virus and how to treat our patients. It has made life much simpler,” said Bernie.

The isolation was also a tough side effect of being on the COVID-19 frontline.

“I had one of my staff who was living with her parents and she isolated by herself for four months. The only social integration people were getting was at work.”

She credits her colleagues with helping to get her through the toughest of times during the pandemic, as well as a ‘phenomenal’ multidisciplinary team.

“Everyone showed so much kindness to each other. We were a strong, united team that proved very resilient throughout. The multidisciplinary team were phenomenal. They were so nice and so respectful of nursing. There was no hierarchy at all.”

Bernie said that there are many innovations in patient care that the entire team will be carrying forward.

“Our end-of-life care has been transformed for the better. We now have a Spotify account approved by the Foundation here and we can play a patient’s favourite music to them. One patient recently loved Andre Rieu and he actually passed away listening to him. We also have students in holding their hands while they are dying to help reassure them and keep them comforted,” she explained.

She said that the Hearts for Heroes initiative is another that the staff in St James’ are only too delighted to continue.

Early into the pandemic, the hospital was sent a box of knitted hearts by Angie Fennell, an outpatient of the hospital. Each heart had an identical match. When a patient was dying, a heart would be placed in their hand and a matching heart was given to their family. This gesture brought families closer to their loved ones when they were dying and could not be physically by their side.

“I had families on to me crying, they were just so touched by the gesture. And it helped them to feel closer to their loved one even though they couldn’t be with them as they passed.”

She said she is happy to continue wearing masks on the wards and out and about in crowded settings.

“Staff definitely feel more protected wearing them and are more than happy to keep wearing them. We’ve seen fewer absences through other illnesses on the wards too.”

With restrictions lifted, Bernie noted that it was “great to be able to finally meet people again. There are some that I haven’t seen since the beginning of COVID-19. Seeing people without their masks is also a lovely thing. I have worked with some people that I hadn’t seen out of their full PPE so being able to see their face was wonderful. I have a lot of babies in the family that I haven’t met yet because they were born during the pandemic so I can’t wait for that,” she said.

“It’s just great to be able to meet in bigger groups, go to restaurants and not have to plan everything that you do. I am also a big swimmer and used to go four times a week. I’m only back to it in the last month and it was brilliant. And, of course, holidays are back on the cards. It’s all feeling very hopeful.”

Bernie’s reflections are published in the latest edition of Health Matters.