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Leyla Ahmet, Duncan Smith, Caroline McGraw
Health Series: Expert Comment

Reflections from the NHS frontline

Staff from City, University of London’s School of Health Sciences are working within the NHS, in the fight against COVID-19. Here are their personal accounts into the challenges they face and the insights they have gained.

by Shamim Quadir (Senior Communications Officer)

As the crisis caused by the novel coronavirus, COVID-19, continues to put our National Health Service under increased pressure, many have chosen to return to the frontline to provide the much-needed capacity and expertise required to deliver patient care at this challenging time.

This includes many health professionals from City, University of London's School of Health Sciences who are now undertaking clinical roles within the NHS; three of whom share their insights and experiences below.

Duncan Smith, Nursing Lecturer in Advanced Practice, City, University of London

Duncan Smith, NIHR/HEE Clinical Doctoral Research Fellow, Nursing Lecturer in Advanced Practice, School of Health Sciences, City, University of London

“As part of the effort to avoid intubation (the insertion of a breathing tube into the windpipe), a respiratory high dependency unit has been rapidly developed at University College Hospital to care for patients with COVID-19. I am working on this unit alongside colleagues from the Patient Emergency Response & Resuscitation Team (critical care outreach) and the Intensive Care Unit.

“Specifically, we are providing care for patients receiving CPAP (Continuous Positive Airway Pressure - high flow oxygen through a pressure mask). The unit is predominantly staffed by ward nurses, many of whom have no prior experience of looking after high dependency patients.  My role has been to work alongside nursing staff to provide support, education and to help troubleshoot clinical problems.

Whilst the circumstances are challenging, I have been utterly amazed by what has been achieved in such a short space of time. The leadership provided by the matrons and ward managers has been exceptional and the compassion, resilience and dedication shown by the bedside nurses is truly humbling. I am reminded of the importance of teamwork in healthcare, particularly when we come together and work towards a common goal.

Leyla Ahmet, Research Nurse, City, University of London

Leyla Ahmet, Research Nurse, School of Health Sciences, City, University of London and Staff Nurse Cardiac Care and Bart’s Health

“I have been a Research Nurse at City for over two years, working on a Burdett Trust funded project. However, I am also a nurse at St Bartholomew’s Hospital in the Heart Attack Centre.

“Our ward is continually evolving to adapt to the ongoing pandemic. Half is now an ITU (Intensive Treatment Unit) for COVID-19 patients, and the other half for well or recovering COVID-19 patients. We are wearing masks throughout the ward all day, which is now becoming the new ‘normal’.

“However, it’s the small things that as a nurse I miss.  Being able to smile at patients as you walk by, but now having that smile hidden by a mask.  Being able to get close to patients, sit beside them and talk to them for as long as you want without fear.  Getting to know patients’ family and friends as they visit daily.  Whereas today, no one is able to visit their loved ones in hospital.  

“All the little things we took for granted that I can’t wait to be able to do again.

Nevertheless, with every negative is a positive. I can’t believe the sense of camaraderie, the ‘we are all in it together’ attitude, the small gestures of thanks, like free food available to all staff. Not one thing has gone unnoticed and I can’t speak for everyone, but walking into the hospital onto the ward I feel proud and prepared to take on another day.

Dr Caroline McGraw, Lecturer, City, University of London


Dr Caroline McGraw, Lecturer, School of Health Sciences, City, University of London


“District nurses deliver complex care to people in their own homes, in ‘wards without walls’.  Prior to joining City in 2013, I worked as a district nurse in North London for more than 15 years. Whilst I never imagined returning to clinical work, I now have an honorary contract with Central and North West London NHS Foundation Trust to work in the district nursing service in Camden two days a week.  

“Having spent seven years out of the practice setting some of the key challenges I have encountered have included difficulties navigating my way around the neighbourhood (which has been diced and sliced by work on HS2), wearing PPE (which is not comfortable), and feeling super tired at the end of every shift (as I’m not used to doing 30K steps a day).  

“Nevertheless, it has been a life affirming experience; the patient contact has been great and members of the nursing team, whilst socially distancing themselves from one another, have been welcoming and supportive of me.

Rightly, critical care has received most of the focus of media attention over recent weeks. However, when the pandemic has abated, my experiences will ensure that I remember not only the extraordinary efforts of our hospital colleagues but also the efforts individual families have made to ensure the safety and wellbeing of their older relatives. I will also remember the constancy of the carers who visit their clients every day to ensure they are washed, dressed and helped to eat and drink, and the small kindnesses of local communities, such as the supermarket which gave district nurses chocolate eggs to distribute to all their patients over the Easter weekend.

Further information

Find out more about the School of Health Sciences at City, University of London.

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