Senior NorthTec nursing lecturer Christine Sapwell continued to work during lockdown despite being separated from her family while ill. Photo / Michael Cunningham
As we enter the third year of the pandemic we're running a series about the experiences of those whose work didn't stop throughout the lockdowns, Northland's essential and frontline workers.
In the first story in the series, Jaime Lyth talks to some of our nurses.
During the first lockdown in 2020, Christine Sapwell said she felt a sense of "irony" that she was the only one in her household of her husband, her two sons and their partners who had to work.
As a senior lecturer in Nursing at Northtec, she continued to teach and support students in a stressful new online world from home, while her family "seemed to be having a lovely time".
Sapwell had been diagnosed with breast cancer at the end of 2019, and originally she thought she would have completed treatment and be back at work early the following year.
"Of course then, they didn't get all the cancer. So I had to go back and have more surgery because it spread. I needed to have chemo."
Sapwell had planned to retreat home to Northland on the weekends after treatment to spend much-needed recovery time with her family, but the country was snapped into level 4 lockdown as the first Covid cases were reported in the country.
Sapwell's treatments continued in Auckland without her family beside her, and she found herself alone for weeks on end in order to keep her and her family safe.
"I had to be hospitalised once and my husband dropped me off at four o'clock in the morning and because we didn't know what was wrong with me. I just had a really high temperature and was really unwell. He just had to drop me at the front door, the security guys said 'no, you can't come in'.
"I didn't know whether I'd see [my husband] again and he didn't know whether he'd see me again. It was that vulnerability, it was incredibly frightening," said Sapwell.
Cancer treatment gave Sapwell "a really compromised immune system", which added further anxiety in the early stages of the pandemic when not much was known about how Covid spreads.
"There's the uncertainty about how prevalent Covid is, you know, you're surrounded by people who are really unwell."
Despite all of this, Sapwell didn't stop working. Her knowledge and role, she says, is very difficult to replace, so in between surgeries and treatment, she continued to teach and support her students online from the room she was staying in at Auckland Cancer Society's Domain Lodge.
"It was quite isolating while you're going through treatments and I was still having to support my students and not let my situation affect how I supported students and how I worked."
Sapwell's dedication to Northland's future nurses, and our health system's reliance on her work due to nurse shortages, overrode her own struggles, and she said continuing to work - while incredibly difficult - helped her achieve a sense of normality in a stressful time.
"I didn't want to wallow in being unwell. I was going to recover from this.
"As long as I put my wig and a bit of lipstick on nobody knew how rubbish I felt."
Sapwell finished most of her treatment at the end of 2020 and has been recovering well. But heading into the third year of the pandemic, with the Omicron outbreak, she says, "Normally I'm really excited about a new academic year ... but this year, I think it's that sense of uncertainty around everything.
"You've got concerns about your own health and the health of your colleagues and how the health system is going to cope."
At the beginning of the pandemic, Tracy Clarke was an oncology nurse at Whangārei's Jim Carney Cancer Treatment Centre, and the Advocate wrote a story highlighting the sacrifices their team and patients were making during the Covid outbreak.
"You can't stop surgeries ... You can't stop oncology. If you delay those there's going to be serious problems," said Clarke.
Clarke sacrificed six weeks isolated from her family, like many other nurses in the unit, to break the potential spread of Covid to her family and patients.
"It was really hard on a lot of us emotionally."
Clarke said while the safety measures were effective and the clients were appreciative, there was a lot of outside pressure and scrutiny around the clinic's Covid restrictions, which took a toll.
"When you saw people looking at you, and (they're saying) 'why can't we have people come in', you're like, 'do you understand what we're giving up to be here for you, instead of being there trying to support our family through something scary?'.
"I love being a nurse and I give it 200 per cent, but sometimes I feel like our families were coming second," admitted Clarke.
Most doctors worked from home, so Clarke said she worked with patients who found out they had cancer through a phone call and never even met their doctor in person before meeting the nurses for treatment.
The weight of taking on so many roles in what is already an incredibly difficult time in someone's life in normal circumstances, cannot be overestimated for the nurses like Clarke, who were often patients' only face-to-face support.
"You're never just a nurse. You were their emotional support and their caring person for them as well as doing their treatments. It breaks your heart a bit having to watch what people go through."
Burnout was widespread among the nurses who were working overtime and "broke themselves to make sure each other were okay" while they were unable to get time off to recover.
But when Clarke began a new role as a rural community health nurse in Northland, the burnout continued as the reliance of the Covid response continued to fall on the healthcare system.
Clarke said that as Covid testing and vaccinations were introduced, nurses in her rural community were expected to support the response on top of their other roles; no new staff were employed.
"The staff is not enough. When people say resources of money, I don't want money. I want more people so I can have a day off."
Roles as far removed as putting tents and signs up for pre-screening swabbing clinics were left to nurses, according to Clarke - and as the Omicron outbreak looms, reliance on these services is bound to increase again.
While Clarke is due to begin a new role at NorthTec in the Nursing department, her concern for colleagues doesn't abate.
"I'm really scared for the staff that are already working at full capacity."
She said when staff don't get time off, it impacts their personal life, their whānau, and can cause "critical relationship problems".
"When you're burned-out, you can make mistakes. So there's this big ripple effect and some of these health staff haven't had holidays for a long time."
Clarke said she wishes there was more support from outside of the health sector for the Northland Covid response, and she would like to see the Defence Force employed to help, even just to "direct traffic" to relieve the pressure.
"I say this because I was in the Navy, if we're not patrolling at war now ... shouldn't we be looking after our country? Isn't that part of the role?
"I think instead of a health profession issue, it needs to be a country issue."
At the end of last month, the New Zealand Nurses Organisation put out a statement saying it's worried the Omicron outbreak is going to trigger a national emergency and overwhelm the country's health system.
"NZNO agrees with the Association for Salaried Medical Specialists (ASMS) and the New Zealand Medical Association (NZMA) that the understaffing situation is an emergency which, left unchecked, will have severe long-term repercussions for the health of Aotearoa New Zealand," the statement read.
NZNO organiser for Northland, Julie Governor, said healthcare systems in Northland and throughout New Zealand are "under pressure in normal circumstances", let alone a pandemic, and the reduction of international health workers coming into the country exacerbates the issue.
"We have been, as a health system, reliant on [an] overseas health workforce, and we haven't been able to rely on it [now], which is unfortunate. I think it was very short-sighted way back, which has left us vulnerable."
Governor said the current focus is learning from Australia's outbreak as best they can while "continually trying to prepare on a stretched system".
Governor said that there are even rental cars pre-booked in the case that Northland nurses had to be redeployed to other areas in the case of larger outbreaks.
"It's huge. Going backwards, making sure there's availability of cars and accommodation and all those sort of things."
This year marks the third year of battle for nurses, and possibly a tipping point for a workforce and system that Governor described as "undervalued".
"Like everybody else, we're trying to keep up with the ever-changing landscape of what is happening," said Governor.
But keeping up is very taxing without a break every once and a while.
Marsden Point worker Semisi Tuivai forced his way into the woman's emergency housing.