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I have just learned that some of my service has been shut. I work in sexual health and I am currently on annual leave and should be relaxing in North Devon, but like everyone else am currently under house arrest.
I have been nursing for over 30 years and last week was one of the most extraordinary weeks that I have ever known. Our service changed daily in response to the current Covid-19 pandemic and I have absolutely no idea of what I am going back to.
“As nurses, we are used to having the needs of the individual person our prime concern and now suddenly this has been turned upside down”
Our immediate response to the crises was to move as much sexual healthcare as we could to telephone consultation and online testing. A tight system of triaging was put in pace and numbers in the waiting room were reduced. It felt counter-intuitive to be diverting, rather than encouraging people to attend.
As nurses, we are used to having the needs of the individual person our prime concern and now suddenly this has been turned upside down and the needs of the public and the greater good are now the focus of our work.
Routine appointments for procedures such as fitting contraceptive coils and implants were still being offered last week. Half of my patients didn’t turn up and although I understand this, who knows when they might next be available?
It felt good to be carrying out these procedures using my specialist nursing skills. I know very well that these precious appointments are time limited and I don’t know if I will be doing them even next week. We all take free accessible contraception for granted and I fear the advent of Covid-19 will bring with it an unprecedented rise in sexually transmitted infections and unplanned pregnancy and we won’t have a service fit to cope.
Last week I did public health, like I’ve never done before. I showcased handwashing, I talked about tissues, I explained social distancing and asked everyone to take care. I handed out bundles of condoms encouraging their use. The current UK lockdown with the closure of almost every form of entertainment will certainly increase opportunity there will be little else to do!
It will be harder to access HIV post-exposure prophylaxis (PEP) and it’s crucial that men that have sex with men need to employ consistent condom use or access pre-exposure prophylaxis (PReP) as they carry the heaviest burden of STIs. We must avoid an STI pandemic.
Now, more than ever we need to revisit the provision of abortion care. There are currently calls for temporary changes in abortion law to enable medical staff to provide consultations and prescriptions for abortion treatment over the telephone so that women can access treatment in times of UK lockdown.
Changes in legislation are needed to widen the process that currently requires two doctors to consent for treatment and to enable women to take treatment for medical abortion in their own homes when safe. This would minimise the need for contact and reduce the risk of spreading Covid-19. Abortion care is an essential service and women needing it simply cannot wait.
I know that redeployment is inevitable, and I am ready and willing to rise the challenge. It’s been over 20 years since I put up a drip or gave IV drugs. Once upon a time I could practically do these in my sleep, and I am hoping these skills lie dormant in my muscle memory and can soon be unearthed.
I want to play my part within the boundaries of my competence, but I need training, support and equipment to be able to do it. I am using this week of leave to prepare.
I have the read the Royal College of Nursing’s guidance on re-deployment, I am working my way through some online learning and I’ve got my A Level in the BBC News.
I don’t know what next week will bring, I can only do my best. I will keep flying the flag for sexual health because the demand for it through the global pandemic is only set to rise and whatever happens in the next few weeks, we need to be ready to respond.
Ruth Bailey is nurse team leader, Sexual Health and Contraception (SHAC), Brighton and Sussex University Hospitals Trust