BerlinOn the way to ward 59 at Campus Virchow-Klinikum in Wedding, signs warn of a risk of infection. That's because beyond them lies one of the six Charité wards where patients suffering from Covid-19 are being cared for. We met Thomas Klotzkowski, 55, the head of the ward, and Thomas Große, 57, an oncology nurse, during their break. 

Both have been working in infectiology for 15 years - these are experienced nurses who have seen a lot. Even so, corona has been a challenge for them. For our meeting, Klotzkowski and Große wear simple disposable masks and the typical blue hospital uniform.

Berliner Zeitung: Is this how you go into the ward?

Thomas Klotzkowski: No. We each wear a protective gown, two pairs of gloves, a hood, an FFP2 mask and a face shield.

Do you have to change your clothes every time you go to a new patient?

Klotzkowski: We are very lucky to be on an isolation ward. We have an air conditioning system that is equipped with a special air filter. In one area of the ward we only have to go through one single airlock and can then move from room to room without having to change. In another area we would have to enter and exit each time.

How many patients are you each taking care of?

Klotzkowski: If we have four nurses on one shift, then each one has five people.

What condition are your patients in?

Klotzkowski: Many of our patients are receiving oxygen. But no-one's on a ventilator. That happens at the intensive care station. If we have a patient who's 85 and is hardly independent anyway, then caring for them can be demanding. Looking after people with dementia is difficult too.

What is different about caring for patients suffering from Covid-19?

Klotzkowski: People can't have any visitors. That means we're the only people they see, besides the doctors and physiotherapists. So the relationship with them is quite close if they're on the ward for a long time.

So that means you're not just coming and going quickly from the ward?

Klotzkowski: You have to take your time, have conversations. The patients have many fears. Imagine that you are lying there, finding it hard to breathe and it's only getting worse and worse. You need a lot of encouragement and sympathy.

How full is your ward right now?

Klotzkowski: We're completely full. Altogether we have 20 patients.

Does the risk of infection make your work more difficult?

Klotzkowski: If someone got infected on the ward, that would mean someone had made a mistake somewhere. Infections happen in private, but not here.

How does the staff situation currently look?

Thomas Große: We get support from other wards if necessary. Entire areas have been closed to free up nursing staff for the Covid ward. That was already the case in the first wave, and it works quite well.

Photo: Berliner Zeitung/Markus Wächter
A sign marks off the restricted area surrounding the Covid ward.

In summer, a certain carefreeness set in. Corona often seemed far away. How was that for you?

Klotzkowski: For us, corona was never gone. Since we had the first Covid patient on 1 March, we've always had least five or six at a time, even over the summer. We knew the numbers would go up again in the autumn. But we didn't think they would increase so rapidly. 

Does it help that you know more about this disease now than at the start?

Große: My respect for the disease has certainly increased. A patient's condition can deteriorate within just a few hours. You stand next to them and see on the monitor how their oxygen saturation is dropping. It's very alarming to witness this rapid change. We hadn't seen that with other diseases. We sound the alarm earlier now.

Klotzkowski: You wouldn't want to get this disease. No-one should dismiss it as "just a little flu", even young people. The virus does things to the body that we still can't properly assess.

When you hear on the news that people are calling Covid-19 a harmless sniffle, you just think: come with me mate, I'll show you the reality.

Thomas Klotzkowski

Are the majority of your patients older?

Klotzkowski: People come from all age groups. The oldest are the weakest - many have pre-existing conditions, like diabetes or high blood pressure. They are most at risk. They get sent to intensive care and require ventilation more quickly. But there are cases like this with young people too, time and time again.

What have you found particularly burdensome in your work?

Klotzkowski: For me, it's the cancer patients who are already having a miserable time anyway, but then they catch Covid as well. Their pain gets to me. And the phone calls to the ward from their relatives, when you can hear in their voice how scared they are, and you have to find reassuring and comforting words for them.

Große: Dealing with the desperate families is the worst thing of all. In our everyday work, the constant protective equipment is very onerous too. We never take our masks off.

Klotzkowski: We have hard physical work to do, so you really start sweating. The protective equipment also makes communication with the patients more difficult.

Große: We miss having personal exchanges with our colleagues too. In the past, we used to sit down together and discuss difficult cases. Now we have to keep a distance of two metres from each other, we eat alone during our breaks. The closeness that otherwise characterises our profession has become very difficult due to the protective measures.

Are you afraid that you might infect someone at home?

Klotzkowski: I care for my mother, so of course I'm worried about that. If a colleague who I'd done a shift with tested positive, that wouldn't be easy for me.

Große: I'm single, so that's not a problem for me. But I notice that my neighbours in my building take a step back when we run into each other. They're nice, but they keep their distance - that happens every day. There's a lot of uncertainty surrounding our work. But we're completely safe here.

Probably safer than on the S-Bahn.

Große: Absolutely. The things you see there! Some people will take their mask off to sneeze. It's unbelievable.

Have you found ways to make things easier day-to-day? Is laughing allowed on a Covid ward?

Große: The worst thing would be to lose our sense of humour. People laugh here all the time. Of course there are days when you don't feel like it. But your colleagues notice and they pick you up. We all stick together.

Do you have to perform triage?

Klotzkowski: Not yet, thankfully. Sending sick people away is a nightmare - no-one wants that.

Große: We have to do everything we can to prevent that. Our message to people is to follow the recommendations from the RKI and support us that way!

Recently there have been more large demonstrations against the corona regulations. I can see you're already shaking your head....

Klotzkowski: We've got no time for that sort of thing. When you come straight from looking after patients with corona and then hear on the news that people are calling Covid-19 a harmless sniffle, you just think: come with me mate, I'll show you the reality.

In the first lockdown, people were applauding the nurses. Now you're getting a bonus of €450. Is that enough?

Große: The applause from people was great. People were acknowledging the importance of our work. And of course, money is always nice, too. But there really needs to be an improvement of working conditions for everyone, throughout Germany, in the social welfare centres too. Achieving that is a lengthy process, but things are moving now, and we're happy to see it.

Klotzkowski: What's even more important than the applause is that people wear a mask outside. That would really take some of the load off of us.