On the front line

On the front line


With Clinical Research Nurse, Jose Maria (‘Lloyd’) Nunag 

By May Woods

When Jose Maria Nunag – known as Lloyd – accepted a position as a Clinical Research Nurse this January, he was blissfully unaware that his first few months in the job would be consumed by a fight against a global pandemic.

“The past few weeks have been unlike anything we have known or could have imagined” Lloyd acknowledges.

In his new role, Lloyd’s job is to bridge the divide between research data and patients, tying together clinical science and patient care. Unsurprisingly, COVID-19 is the all-consuming focus, with all regular research studies temporarily on the backburner.

In helping to deliver research to better understand the novel virus, Lloyd is one of the tens of thousands of frontline workers for whom we clap each Thursday evening. While his role isn’t what comes to mind when imagining an archetypal nursing job, it is one intrinsic to the fight against the virus.

“The job is about protecting patients in the trials, keeping them safe and maintaining the rigors of a clinical trial or of a protocol. There is perhaps no more dramatic illustration of the vital and ongoing need to fund research than the current COVID-19 outbreak” Lloyd explains.

It’s a conflicting time for every nurse. On one hand, the profession is enjoying an unparalleled level of public respect. We bake rainbow cakes and organise fundraisers; our children write poems in awe of their hospital heroes. While the appreciation has meant a great deal to Lloyd; “it definitely boosts morale”; he is wary that the sentiment may be short lived.

“Deep down, I hope that the public will continue to advocate and support healthcare workers, not just during the difficult times, but every day” he says.

Healthcare workers have been parachuted into uniquely dangerous territory. None signed up to risk their lives, or indeed the lives of their families. The long-term consequences of the pandemic will be all-encompassing: economic, social and psychological. Pushed to the limit, healthcare workers are at high risk of developing PTSD, as well as associated psychosomatic conditions such as Burnout Syndrome. During the Ebola crisis of the mid 2010’s, the World Health Organisation declared the spike of PTSD occurrence in the caretakers of those suffering from the virus “an emergency within an emergency”; a worrying precedent considering current circumstances.

Such concerns haven’t evaded Lloyd. He hopes for the implementation of mechanisms to offer sufficient mental health support for healthcare workers, and quotes the WHO’s State of the World Nursing Report 2020, which shows that nursing shortages will persist through to 2030 without additional investment in education and employment.

“When this pandemic is over, we must not forget the structural and systemic issues around workforce gaps, and public health funding. The spread of COVID-19 reveals where investments in workforce development haven’t been made.”

Hailing from the Philippines, Lloyd has experienced the reality of health inequality first hand. While Britain has scrambled to source essentials; from ventilators and PPE, to oxygen supplies in hospitals; it is sobering to consider the impact of COVID-19 on developing countries such as the Philippines. The archipelago, named in the Global Peace Index 2019 as the most susceptible country to hazards brought about by climate change, is fighting multiple unenviable battles as it braces against intensifying and deadly typhoons.

“There are still major challenges to overcome (in the Philippines), and the pandemic is pushing us further behind. Aside from dealing with the pressures of COVID-19, we suffer from high rates of tuberculosis and child pneumonia” explains Lloyd.

According to 2019 House of Commons library data, around 18,500 Filipinos work for the NHS, making them the most numerous nationality working in the health service after Britons and Indians.

The ONS reports that the “risk of death involving the coronavirus among some ethnic groups is significantly higher than that of those of white ethnicity”, while data from Nursing Notes indicates that healthcare professionals from Filipino origin make up 19% of the more than 100 health and social care workers believed to have died on the COVID-19 frontline.

“The COVID-19 crisis is not simply a health problem but one of existing inequalities” explains LLoyd.

“It is crucial that decision makers address more systematically that BAME communities have a higher COVID-19 mortality rate. PPEs provided won’t fit an average 5 ft 1-inch Filipina woman. They say that PPEs are made for a 6 ft 3-inch rugby player.”

Communities and essential workers need more than a weekly clap, more than post-boxes painted blue and £8.99 badges. There is no better time than in 2020 – the Year of the Nurse and the Midwife – to insist upon the implementation of policies that are rooted in racial and gender equity; policies which properly protect our healthcare workers. To paraphrase Florence Nightingale: very little can be done under the spirit of fear.


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