NHS Scotland: Frontline workers in the week before Christmas

"That happens quite often - it seems to be happening more and more."

It's Monday December 18 and Lois Gaffney has just finished the first of a string of nightshifts on the acute medical ward at Gilbert Bain Hospital on Shetland.

The 33-year-old has worked at the hospital for the past 16 years, initially as a healthcare support worker but latterly as a nurse. She qualified via the Open University in December 2022.

As the island's only hospital, with just two wards - one medical and one surgical - the staff must respond to a vast range of ailments.

"You need to be a jack of all trades, but good at all the trades as well, because you're 200 miles from any specialist consultants or any sort of technology.

"We don't have an MRI scanner up here. Patients can't just be sent for an angiogram the next day - it might take three weeks before you can get a bed in Aberdeen and then there might be mist, so the planes can't fly.

"There's a lot of challenges to being on an island.

"As time has gone on, nurses have been expected to do more - the demand is far higher on our workload, but we're enhancing our skills so I don't think it's a bad thing.

"We're a cardiac ward and a stroke ward, we deal with respiratory, and diabetes - so we have people with diabetic ketoacidosis [a life-threatening complication caused by a lack of insulin].

"We do alcohol detox on our ward, and we are actually the psychiatric ward for Shetland as well so we'll be dealing with acute mental health like paranoid schizophrenia or intentional overdose and self-harm.

"We have our palliative care as well, and we became the Covid ward on Shetland.

"We deal with a lot of paediatrics too because of respiratory and this is when we start to get in all our ill babies with the winter bugs, as well as the community-acquired pneumonias, more falls.

"We do tend to fill up over the winter.

"When I came on shift, we had three free beds and then we got six admissions overnight. We ended up with 23 patients but only 21 beds. That's when we have to decant to the other ward.

"By the end of the nightshift, we only had one bed left in the hospital so then you're in a bit of trouble."

READ MORE: 

• NHS Day in the Life: On the frontline in A&E in the week before Christmas
• NHS Day in the Life: What's it like to be a community links worker in Glasgow? 
• ANALYSIS: The NHS crisis - Have we finally dug a hole too deep to get out of? 

Ms Gaffney spends most nightshifts working alongside one other staff nurse, with assistance from two healthcare support workers.

Like other parts of the NHS, the hospital is struggling to fill vacancies.

"We currently have three agency nurses on my ward and there's a couple on the surgical ward as well.

"At times there's had to be bed closures because the staff just can't meet the patient need. Recently we've had some beds close on the surgical ward because they just didn't have the staff to accommodate a full ward of patients.

"That then puts pressure on the other ward because you might be getting in more patients that you're not familiar working with.

"I've done 16 years working in medical, and I love surgical as well, but it puts you slightly more out of your comfort zone if you might be dealing with a haemorrhage or a hip repair."

Lois Gaffney collects the award for Student Nurse of the Year at a ceremony in Edinburgh in June 2023 (Image: RCN Scotland)

Ms Gaffney, who was named Scotland's Student Nurse of the Year for her work encouraging others to take up nursing in remote and rural areas, says she loves the close-knit feel of island life and has been proud to set an example to her 11-year-old daughter.

"There's still one or two patients that I look after now from when I started 16 years ago - or you might have the same person coming in every other week, or the same patient in for months at a time.

"Because it's the stroke ward it can be really rewarding because you can take them through that whole rehabilitation process, then watch them walk out of the hospital at the end.

"You do get really close to people and because we are a small island you get to know their relatives as well. You do feel very appreciated a lot of the time.

"I've loved having my daughter watch me qualify and realise that you don't have to be in a rush to do something for the rest of your life straight out of school.

"You can study at home, and study when you're older. There's so many different approaches to education."