Putting one foot in front of the other

The UK is now enduring a devastating third wave of the COVID-19 pandemic, and the overwhelming burden on the NHS continues. It is clear from the headlines and social media that frontline workers are persistently feeling the physical and emotional impact and reality of this ongoing crisis.

At the time of writing, the number of new positive COVID-19 cases and the number of people who have died within 28 days of a positive test are decreasing (UK Government, 2021). However, the fight against this virus is not over. Hopefully, the lockdown stay-at-home guidance and the huge drive of the national vaccination programme are starting to reduce these numbers further and provide the glimmer of hope that we have been waiting for.

Although this is good news, working in the community during the pandemic has had, and still does have, its risks and challenges: personal protective equipment (PPE) shortages, staff shortages, rapidly increasing caseload numbers and the potential of contracting COVID-19. Managing these types of challenges is embedded in district nursing intuition; district nurses begin risk assessing as soon as they step through the patient's door, and COVID-19 has added a whole new dimension to this. This includes hospital avoidance, which is a huge part of community nursing work. Nurses are having difficult conversations with patients and their families about acute and chronic care management, while strongly considering the serious risk of contracting COVID-19 outside their home environment and the associated implications. We often experience the devastating reality of losing some of our patients if hospitalisation cannot be avoided because of COVID-19.