TRAINEE district nurse Lucy Shaw and her team perform a vital, highly skilled role in homes across Glasgow every day.

During the pandemic, this work came to the fore as nurses were under stressful circumstances to help keep patients out of hospital and care for them in the community.

In what Lucy describes as an “often undervalued” service, district nurses perform acute, complex and end-of-life care in people’s homes.

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Last year, as they watched the news coming from China and Italy, it became clear the service would have to adapt to cope with the approaching pandemic.

She said: “Because of the pandemic, people were being discharged home, where possible, so we were doing a lot of work that would normally be done in hospital. 

“Initially they were saying it would take 12 weeks to get the pandemic under control so we thought we were planning for the short term.

“There was a lot of work we did to prepare. We had to reassess all our patients and prioritise those who, if we didn’t go out to them, they would have to go into hospital.

“Some people might not be very high need but they had no other support so we had to prioritise them.

“We had to have discussions with patients and families to see if they could cope with carrying out some of the procedures we do. 

“Some people weren’t wanting us in, unless it was really needed, because fear of the virus was quite high.”

Patients’ families were taught how to change dressings and do basic care, knowing the district nursing team was just a phone call away.

Certain clinic services stopped and so the nature of the work changed to include a greater volume of end-of-life care and cancer care, such as Hickman lines.

Every visit took longer due to donning and taking off PPE while every item taken into a patient’s home had to then be sterilised.

One of the toughest things for Lucy and her colleagues was the lack of peer support.

Normally they would be able to head back to base for a debrief, but the base closed.

Lucy said: “It was a time we needed it most, because we were living in fear and that support was taken away.”

Instead they had to find new ways of looking out for one another – and a WhatsApp group became an important tool.

Lucy remembers her first patient who died of the virus, a particular shock given the man and his wife had been shielding but caught Covid-19 despite that.

She said: “There was another patient who died and was a really young woman. 

“She didn’t die of Covid but because of the restrictions it was terrible for the family and it was terrible being there for end-of-life care watching the family struggling through this.

“You wanted to reach out and give them a hug but there was this invisible barrier and that was extremely tough.

“The PPE was difficult too. You go into people’s home and you look like this alien coming in but once you get the rapport going they can see you care.

“You know you have done everything you possibly can but you wish there was more you could do.”

Lucy began her Masters degree at Glasgow Caledonian University last year, a vital component of becoming a district nurse. 

She also has two young children, a two-year-old and a six-year-old, and, to make the past year even more pressured, her husband is also a nurse.

Lucy said: “My husband is theatre trained, an operating department practitioner, but was seconded to ICU. 

“He hasn’t got the training for working on a ward but because of the equipment they use in ICU and theatre, he got asked to go up, so that was tough for him. 

“We listen to each other and allow each other to go through the emotions involved. 

“It’s good that both of us know what the other is going through as it was a lot to deal with.”

Lucy says she loves district nursing because of the relationships that are built up over months and sometimes years of going into patient’s homes. 

During the pandemic, she was shocked to hear that district nurses were receiving verbal abuse in the street as people thought due to their uniforms they were hospital workers risking carrying the virus into the community. 

But she found the Clap For Carers support for the NHS to be moving.

She said: “I actually found it more difficult to deal with people being nice to me. 

“Emotions were quite high – it only took for someone to smile appreciatively in the street and you could feel the tears start.”

Lucy has had Covid-19 twice now, catching it in February of last year and again in January this year – just a week before she was due to receive her vaccination.

She is also suffering from Long Covid.  

While Scotland begins the delicate process of easing out of lockdown, NHS workers like

Lucy are desperate for the chance to rest and recuperate. 

The second wave, she said, was harder than the first.

Glasgow Times: Lucy Shaw, who has two young children, began a Masters at GCU last year Lucy Shaw, who has two young children, began a Masters at GCU last year

Lucy said: “In the first lockdown we benefited a bit from naivety because we didn’t know what was coming. But when you know what’s coming, it’s emotionally and mentally draining. You have to ground yourself, stamp your feet down and get on with it.

“We were disheartened by the second wave because we thought people would be getting some annual leave and any counselling where they needed it – instead we were dealing with a second wave and there was a lot of trepidation.

“We’re still in ‘keep your head down and power through’ mode. It will be when you get to take a breath that it will hit.”

Some of the changes implemented during the pandemic have worked well for patients and will be kept post-lockdown.

READ MORE: Inside the covid wards: Nurses and patient speak about life in Glasgow's superhospital

It was found that patients thrived with having more autonomy in their health care so they will be supported to do more for 

And remote visits have worked well to support self-management so video calls will be another positive to take from the lockdown.

As will appreciation for the role of district nurses. 

Lucy added: “District nursing is often an undervalued service as our skills are not well known.

“However this pandemic has shown that we do complex, highly skilled care in the patient’s home – we are a ward without walls.”