Staff inside the ICU at the Royal Liverpool University Hospital
8 min read
BLOG: My experience filming inside Intensive Care
Earlier this month, I was given access to doctors, nurses and a Covid patient at a time when few hospital staff have the capacity to stop and talk. They gave me their time anyway. They were generous and patient while I asked them to describe what was happening. I watched some of them hold back tears as they described being on the frontline of the fight against Covid-19. This is the story of how it came about and what I witnessed.
Wednesday 14 October: I was stood in the Royal Liverpool University Hospital’s reception waiting for one of their team to take me to their ICU. I felt the familiar mix of excitement and practicality, mentally checking off my camera gear alongside the facts of the story I was here to cover.
There is so much about this story that is truly gut wrenching. I’m no stranger to high pressure, or volatile situations. I’ve documented the anger of a nation in violent protests across South Africa; I witnessed desperate rescue efforts first hand following Japan’s tsunami and earthquake; I experienced the palpable terror and anguish inside the women and children refugee camps that followed the xenophobic violence in Johannesburg. My gut is not easily wrenched.
The difference between those stories and the Covid-19 pandemic is in the virus’ passive aggressive nature. The formula is different. There’s no big boom moment followed by the aftermath and then the recovery.
All the visual elements indicating this is a crisis are hidden away. The tense frowns behind the face coverings. Worried families in homes across the country. Isolated patients behind the doors of one of the city’s ICUs. It’s important we open those doors and take people into the very heart of this crisis. People need to know why they must to keep their distance, wash their hands and continue to wear their face coverings. People need to know what to do to keep themselves and their families safe.
There’s something about the people who have experienced the virus. A 76-year-old Covid survivor said: “I know I’ll never be the man I once was..” He stuck his chin out in defiance of the tears collecting in his eyes. Or the way an ICU medic gently brushes the hair of a patient while five of her colleagues tend to the tubes and machines keeping the patient alive. We can’t show you these details unless we open those doors, step inside and document what’s really going on.
We planned and negotiated behind the scenes for the access we required. I collected and edited hospital footage as the familiar wait for access went on for 48 hours. The hospital had the final word. Aside from the PPE needed for me to get inside the ICU safely, our access hinged on the 20 minutes it took to fit and test the heavy duty face mask. If I failed the fitting that was it. Game over.
All the visual elements indicating this is a crisis are hidden away. The tense frowns behind the face coverings. Worried families in homes across the country. Isolated patients behind the doors of one of the city’s ICUs. It’s important we open those doors and take people into the very heart of this crisis.
Thursday 15 October, 10.30am: Royal Liverpool University Hospital. I was taken to a small room where a friendly nurse explained the process. I had to complete no less than seven tasks to ensure the mask fitted properly. I kept thinking: “Don’t screw this up. Pay attention. Do what you’re told.”
Truth was, it was out of my control and depended entirely on the shape of my face and whether the mask could do its job properly. I was shown how to tighten the red straps properly, one by one, really tight.
“Don’t try and tighten them both at the same time or it won’t work properly. One by one, really tight.”
“Ok….one by one…. really tight….”
Mask on. The test began.
“Step forward and then backwards, while breathing normally for 60 seconds, I’ll count you down. Ready? 3…2…1…”
I focused on a mental health poster on the wall behind the nurse and began. At each stage I was told I had passed, until we got to task number six. After 60 seconds of the two step I had now become accustomed to performing while breathing deeply and nodding up and down like a toy dog in the back of a car, a frown appeared on the nurse’s face:
“Hmm…it says you failed that one.”
I stood dead still. Held my breath. Didn’t say a word. Waited.
“Let‘s see if we can tighten your straps, they might feel tight, but they probably need to be tighter, see if you can adjust them.”
“One by one”, I said.
“Yes”, the nurse said, her eyes smiled above her face mask.
It worked. I completed the test. A huge wave of relief crashed over me. I was shown how to remove the mask safely, one strap at a time, allowing it to fall from my face into the bin.
I made my way back down to the first floor where Trish Rowan, the Critical Care Ward Manager was waiting to help me with the rest of my PPE. Two people are required to get into the PPE. The gown is first, followed by the surgical gloves while the gown is being tied at the back, followed by the all-important mask with the tight, red straps.
“Ready? Let’s go.”
Trish pushed open the door of the Covid ICU ward. It was strangely quiet. We turned left. There were medics and machines and tubes everywhere. In-between the medics, machines and tubes were patients in varying stages of consciousness, some behind weird plastic bubbles which Trish explained were C-Pap machines, a step down in intensity from a ventilator that helps patients breathe. The bubble was more comfortable than a mask.
We move further into the ward, walking past beds surrounded by medics.
“They’re changing the ventilator tubes”, Trish explains, as we keep moving. “Now they’re doing physio.” I watch a nurse lean closer and explain to her patient what’s happening.
It starts to get busier. Trish and I move back behind a desk while she describes how fast they’re learning about the virus, what they’re doing differently from the first wave at the start of Spring.
The screensaver on the desk in front of me catches my eye as the image changes, ‘Stay safe and social distance.’ Beyond this screensaver are medics gathered around a hospital bed.
As Trish and I move towards the exit bay she starts to explain the PPE removal process. Piece by piece, ensuring that there’s no cross contamination. Hand washing at every stage. There’s nothing quick about this. It occurs to me that I wouldn’t have been able to dash to the toilet or pop out to drink some water or grab something to eat. All the things we usually do when working long hours are not available to frontline medical staff.
Freed from the constraints of PPE, Trish and I walk down the corridor. I notice my normal day-to-day cloth mask I’m now wearing doesn’t bother me like it usually does. I usually find it really uncomfortable and can’t wait to get it off once I leave a shop.
The contrast between the ICU ward and normal everyday life on my mind makes me realise I would be hard pressed to recognise any of the medics I had just spent time with if I saw them on the street. Except for the tell-tale red marks on the cheeks and nose that the face mask leaves behind. I run my finger over the bridge of my nose and wince at the pain from the slight pressure. The red marks on my face were faint in comparison to the nurse I just saw.
My mind continues to shift back to normal everyday life. I picture the frenzy of activity among the rest of the team: writing social media posts, editing the Mayor’s voice over for one of our videos, working with the hospital to approve content and informing our partner organisations of what we were doing as we start to schedule the videos for the council’s social media feeds the following day.
I step into the fresh air outside the hospital.
A colleague calls from the office to find out how it went. We chat for a bit about what I’ve got and when we’re scheduled to interview the patient.
She groans as she drops pasta on her trousers and there’s a rapid back and forth about how multitasking doesn’t end well and the perils of wasting food.
When we’re done she says, “Camilla [our boss] has told me to check you’re ok.”
I say I’m fine and to tell Camilla not to worry. We had a very powerful story that needed telling.