Nicola Cottington, temporary registrant

Just before the national lockdown came into effect last March, I was working in the emergency department. Cases of Covid-19 had begun to increase, but the scale and seriousness hadn't been truly realised yet.

I recall the feeling that this would be similar to previous experiences when we were dealing with SARS and other types of infections. In those early months of the pandemic there was a dedicated hospital in the north of England where patients were sent if they returned a positive test for Covid-19.

I remember consultants and nursing assistants gearing up in full hazmat suits and testing patients in their cars outside the hospital. As the stream of patients began to increase it was apparent that this would be a UK-wide issue and that the hospital would soon have to start treating patients who had the disease.

It was also during this time that the chief operating officer asked if I would work full time on the Covid-19 response and as part of the resilience team.

I'd allowed my registration with the NMC to lapse a few years earlier due to progressing in my career, and working in roles which meant that I didn't have to practice on the frontline. For example while I was the director of Ops for medicine.

However, following the national lockdown announcement, I received an email from the NMC about their Covid-19 temporary register and I signed up immediately as I realised being a nurse is part of my identity.

"Being a nurse is part of my identity"

While I wasn't on the 'frontline' delivering the hands-on care, I was directly involved in managing and supporting those who would be providing the care for patients. My experiences as a nurse allowed me to draw on the pressures nurses face and helped me to be empathetic towards my staff's needs and concerns.

Leading my team throughout this period was incredibly challenging and at times overwhelming as entire days were dedicated to the Covid-19 response. While chairing the operational response meetings in the beginning of the pandemic, there seemed to be 20 pieces of different guidance being issued every day which I needed to fully understand and relay to staff.

At the same time, staff at all levels, myself included, were really scared and there was a feeling of panic. As chair, I helped to bring some calm and order to each day, looking at the issues experienced and thinking about the way forward.

For me, a key realisation during this time was the need to be completely honest with staff and colleagues, and to admit that there were some things that I just did not know. For example, at this time we didn't know if and when a vaccine would be available, how much personal protective equipment (PPE) was needed and how transmissible Covid-19 was.

I also experienced scenarios I would never previously have imagined, such as thinking about how we would have to monitor and ration our oxygen supplies, as well as reassuring staff that the PPE provision was as safe as it could be to ensure they can practice.

Healthcare staff willingness to just get on with it really struck me

As I look back it also really struck me just how brave healthcare staff were. While images of ITU in Italy were being broadcast on the news, healthcare staff just got on with it as they knew they had to (and wanted to) deliver the care which undoubtedly saved many people's lives. I was in awe of some staff. I recall a nursing assistant putting on their PPE without hesitation and asking, what do I need to do to help?

It was around this time, after I had joined the NMC's temporary register that I participated in a three day refresher clinical training course which was put on by the trust. I realised that I had not forgotten as much as I thought I would have and started to think about whether I should re-join the permanent register -- which I have now done!

Whilst I am not on the frontline delivering hands on care for patients, my experiences over 20 years in health and care, and my knowledge of what nurses do meant that I have become a better leader and have effectively shaped strategies and responses to the pandemic.

Healthcare professionals, at all levels, have worked closer than ever to make sure high standards of care are delivered for all patients despite the huge demands and pressures they face.

Read more nursing and midwifery stories from the pandemic.