My experience as a nursing student undertaking a nursing degree during the COVID-19 pandemic cannot be explored without considering the health inequity prevalent within the UK and my particular interest in health and social care within the north east of England.
Working class and northern born, with strong familial links to our region's great mining history, I have long been acutely aware of the long-debated inequalities known as the north-south divide within the UK, and within England in particular.
The north-south divide has developed for many complex and historical reasons and has long been recognised. As many businesses have chosen to set up in the south of England, this has created a wealth divide. Those living in the north of the country experience lower incomes, higher unemployment, and a lower standard of living than those in the south.
Although always lingering in the background of day-to-day life, the economy, and politics, it is possible that regional health inequity within the country has been exacerbated by the COVID-19 pandemic. Before the pandemic, the health of the population in the north east of England was already poorer when compared to that of the rest of the country (Corris et al, 2020). Between 2017 and 2019 the region had the lowest life expectancy for both men and women, with London having the highest (Office for National Statistics (ONS), 2020). These conditions have long been attributed to unemployment levels in the region, alongside poverty and inferior social welfare and educational opportunities (The Lancet, 2017).
The fact that the north east of England is a hotbed of socio-economic inequality, and consequently health inequalities, makes the impact of COVID-19 on the region even more terrifying in terms of its effects and pressure on individuals and on healthcare services tackling the pandemic.
Although it seems like an eternity has been spent on combatting the COVID-19 pandemic, it was only in January last year that whispers about a novel coronavirus had begun to percolate around the globe. A Public Health England (2020a) report for the government stated that, from 31 January 2020 to 29 April 2020, the total number of COVID-19 cases had reached 115 859. Some 16 722 had happened within the final week of April. The north east had the highest incidence rate of 272 per 100 000. To date, more than 4 million people in the UK have tested positive for the virus, and, at the time of writing, more than 125 000 have sadly died (CovidLive UK, 2021). Although the number of cases recorded has been highest in London, it is important to consider the population of the capital city, which was 8.96 million in 2019, compared with that of the north east of England, which was 2.7 million in the same year (Clark, 2021a; 2021b).
With this in mind, it should be noted that by 13 May 2020, the north east and north west regions were shown to have the highest diagnosis rate per 100 000 population (Public Health England, 2020b). The health inequalities that the north east of England already suffers makes me genuinely afraid for both the short- and long-term impacts that the pandemic will have upon the region. Future analytical work will be able to shed light on this situation, and we will be able to see whether the continuing health inequalities have had a bearing on the way the pandemic has affected the region.
Reflections of a student nurse
Reflecting on my lived experiences as a student learning to become a nurse during the pandemic takes me back to last year as a first-year. At this time, the Nursing and Midwifery Council (NMC) made the decision to remove first-year students from clinical practice (NMC, 2021).
I was initially annoyed at the giant COVID-shaped spanner that had been wedged into the works of my training, but if I've learnt anything from my experience of nursing it is to make the best out of a bad situation. I took the opportunity to begin working as a support worker in the community for people with moderate to severe learning disabilities.
The impact of lockdown
The effects of the pandemic soon became clear. The negative impact that social distancing and staying at home were having on the mental wellbeing of the individuals I cared for became painfully clear—the effects of not being able to be visited by their family and loved ones was extremely frustrating and difficult to understand for some. There was a general sense of confusion and abandonment, and it was difficult for many of my clients to understand why their lives had changed so radically.
The government lockdown precautions, although beneficial and crucial in preserving people's physical health and protecting them from the virus, were visibly detrimental to their mental wellbeing.
Returning to placements
I returned to my nursing course and to a placement in October 2020. When I began my second year, I had a lot of anxieties. Was I adequately prepared to progress to the second year? Would the staff I worked alongside think I was incompetent due to missing 120 hours of my first-year placements, although I had taken the opportunity to work in the community? Would I be putting myself and my family at risk by working in health care during the pandemic? I realised that I could spend endless sleepless nights considering the ‘what ifs’ that my second year would bring or I could show up, give it my all, and contribute to the struggle against the pandemic in the region I love so much.
This unprecedented time in history has alerted many to the need for health and social care workers to provide treatment, care and compassion to those who are vulnerable and critically unwell. Instead of going back to the wards full of uncertainty, I had altered my mindset and considered the bigger picture in terms of care during the pandemic. I not only returned feeling needed and valued, but I felt proud of myself and my contribution to the NHS in the face of adversity.
Now I find myself halfway through my second placement of my second year, and I have had the confidence to fully immerse myself in every aspect of nursing within the new ward, and have found the resilience to continue to persevere and achieve excellence in my nursing practice.
To further encourage me on my journey of constantly bettering myself and my nursing abilities, one of the doctors I work alongside on the ward as part of the multidisciplinary team (MDT), recently submitted a Greatix about me (a scheme that recognises great practice that improves outcomes and should be shared (https://tinyurl.com/ajcsscm7)). I was commended on going ‘above and beyond’ in my nursing care, with specific reference to work concerning patients with a range of complex neurological conditions.
Not only was this Greatix great for my confidence, but it also made me want to strive towards continued excellence in my delivery of care to a region so close to my heart. Working alongside doctors, consultants, staff nurses, healthcare assistants, physiotherapists and other members of the MDT has offered me a plethora of learning experiences. Working alongside my student peers has provided me with a support network that is invaluable to my training. To know that there is this immense collaborative effort to deliver the highest level of health care, and to feel the collective passion of us all striving to become successful registered nurses, are aspects of my training that I couldn't be without.
The knowledge that there are so many motivated individuals willing to devote their lives to developing careers in caring for people within the north east of England, especially during such volatile times, is one of the biggest glimmers of hope that I have seen during the entire duration of this global pandemic.