THE FRONTLINE OF NURSING Abby-Rose Schmidt

The frontline of Nursing

Abby-Rose SCHMIDT (2012)

At the height of 2021’s COVID period, Abby-Rose was (and still is!) on the frontline as an ICU Nurse in RPA’s COVID ward. Providing fascinating insight into her experiences and how SCEGGS’ emphasis on helping those in need led Abby-Rose to a career brimming with possibilities, this young Old Girl is making a difference to the lives of those needing it most.

Having completed your nursing degree just five years ago and with the opportunity to work in environments such as GP clinics, community or telehealth nursing, what attracted you to work in a hospital setting and in particular in ICU?

Most Registered Nurses (RNs) go on to apply for a “new grad” position in a hospital setting. The hospital environment is where you gain a variety of clinical skills as you are exposed to a range of clinical areas and this is beneficial for career progression. I was lucky to be offered a position at St Vincent’s Public Hospital. It was a steep learning curve and a challenging year! I spent six months in a busy surgical ward involving 13 different specialties and six months in the Intensive Care Unit (ICU). In 2018 I applied for a two-year ICU program at RPA to consolidate my skills in critical care and be supported in a large teaching hospital. I was drawn to ICU as it’s fast-paced and challenging, with a variety of complex patient presentations. It has given me a great understanding of the pathophysiology of complex diseases as an ICU RN works closely with members of the multidisciplinary team including physiotherapists and social workers, as well as the various specialist medical teams. I love the challenge of being able to manage critically unwell and rapidly deteriorating patients. It’s an honour every day to provide comfort for the patient and their family who are experiencing what is often the worst time in their life. I personally think every new RN should have experience in a big hospital setting and I believe that my qualifications and experiences will open a range of career opportunities for me throughout my life. I know many RNs in their 50s with fascinating jobs in healthcare – and they don’t do shift work!

How does working in ICU differ from other areas of the hospital? For example, are there more specialist skills and training required?

An intensive care RN will normally care for one or two patients usually with very complex care needs. An RN on a ward will normally have 6-8 more stable patients and they may have an AIN (Assistant in Nursing) in their team. I feel I have more autonomy working in ICU as we are trained in operating

Abby-Rose ready for her shift!

various life-supporting machinery such as ventilators, dialysis and ECMO (Extra Corporeal Membrane Oxygenation). The ICU medical team relies on our clinical observations and any concerns we have for our patient/s to direct care and initiate investigations.

How have your experiences in ICU transformed your career?

I completed my two-year ICU program in May 2021 and this has given me experience in all specialties of the ICU, including the Neurosurgical unit, Cardiothoracic unit and the two general units. The general units admit patients with a variety of presentations, for example those requiring a liver transplant, medical and surgical oncology, respiratory failure, autoimmune disorders or acute deterioration of chronic illness. In the last two years, one of our general ICUs was transformed into a COVID ICU. While I’m still early in my career, I feel I am well qualified to look after critically unwell patients with complex care needs. This will make me very employable and could allow me to travel and work in any area of a hospital. I’d also be well qualified to work in a remote or regional area too.

The frontline of Nursing continued

During the peak of the COVID pandemic in Sydney last year, you were looking after patients in ICU due to COVID. Can you provide insight to our readers about your experience and how COVID impacted not only patients, but their families and the community?

I found working in the COVID unit stressful in 2020 when there was no vaccine. I was concerned about bringing the virus home and infecting my housemates and loved ones. The ICU where I now work has been transformed into a purpose built COVID ICU and I was caring for COVID patients in ICU every day from June 2021 to when the vaccines took effect. As I type this in January 2022, we now have the Omicron variant and while COVID hospitalisations decreased towards the end of 2021, giving us a much-needed break from PPE, our unit quickly reverted to a full COVID unit for the third time at the start of 2022.

COVID patients often progress rapidly from high flow oxygen, to being intubated and put on a ventilator and some on to ECMO. Some COVID patients remain in ICU for months. While we were well supported by senior staff, it was tough, gruelling work, spending 12 hour shifts in PPE during the winter 2021 lockdown. It was even hard to take a toilet break as the “donning and doffing” of PPE is a long process! Every day the staff would feel dehydrated and hungry. We developed pressure areas on our face and nose from the tight fitting N95 masks and goggles. We had to shower and wash our hair after each shift and then shower again when we came home. We had the anxiety of bringing COVID home to loved ones and of course, we needed surveillance PCR tests every 72 hours – often queuing at testing centres on our days off.

Our issues paled in significance when we were with patients who were alone and afraid, without loved ones by their side. Many would die with the RN holding their hand. Our ICU had about three iPads which we would use to FaceTime family members during our shift. Witnessing a goodbye to a loved one via a screen was heart-breaking. This caused families a lot of distress and there was always the fear of the unknown. On a shift last year, one of my COVID patients being kept alive by a ventilator, was rapidly deteriorating. I had her whole extended family on Zoom to say their goodbyes and they were singing her traditional songs. When the time came, I had her six children on Zoom and it was very confronting to see and hear them say their goodbyes and pleading for her to live. I had to explain what was happening and talk them through the whole situation. It was a tough day, but a few days later I received a beautiful letter of thanks from the family via the Hospital social worker. I’m so glad I was able to help in some way.

“I feel honoured being able to play such an integral role in the Pandemic. ”

The Nursing profession has been in the spotlight more than ever. How does it feel playing such an integral role in managing the Pandemic?

I feel honoured being able to play such an integral role in the Pandemic. It almost feels as though our profession is being valued more than ever; however, it was frustrating for us seeing protests

in the city and people refusing to get vaccinated. Burnout is a common experience for nurses, but we know how integral our role is in the Pandemic and to be there for our patients when their loved ones are unable to visit. I’m grateful for experts in infectious disease, research and scientists in being able to provide vaccinations to help protect our community. I think of fellow nurses overseas who died while fighting the Pandemic before vaccinations were available.

A career in Nursing can offer opportunities for leadership roles both within the hospital and in other areas such as academia, research or policy making. What trajectory do you envisage your career taking?

I envisage completing a Masters of Critical Care Nursing and becoming a Clinical Nurse consultant or a Nurse Practitioner and specialising in a specific area of critical care. As I’m still young, I also envisage travelling with nursing and using my skills in regional Australia. The work of the Royal Flying Doctor Service interests me too. I have a keen interest in a future management role where I can provide an empathetic and supportive approach to management and help new graduates during their overwhelming formative years.

What advice would you give to current students considering a similar career path?

My advice would be to apply for a nursing work experience program in Year 10 and attend any Bachelor of Nursing information day at universities. SCEGGS encourages a sense of helping others in need. I loved taking sandwiches down to Woolloomooloo with Rev Garry LeeLindsay and chatting with people who

Pressure injuries caused by 12hr shifts in PPE

were sleeping rough. I also completed my Duke of Edinburgh community service component at Wayside Chapel. I learnt that many guests had complex health issues and this sparked an interest to study nursing. My advice would be to find an area of nursing you’re passionate about and just go for it! We need more nurses and you will have a job for life with so many fascinating career opportunities.