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The rollout: 1. The district nurse

Julie Fletcher administers a dose of the Covid-19 vaccine to a housebound patient in Chesterfield, 14th April 2021. Photo: Oli Scarff / AFP via Getty Images

This is the first part of a four-part series. See also our profiles of the people who turned Salisbury Cathedral into a mass vaccine centre, the researcher combating vaccine disinformation and the volunteers putting their bodies on the line for new jabs

Julie Fletcher
NHS district nurse

“Sometimes we were the only people they would see week in, week out,” says Julie Fletcher of the vulnerable patients she’s visited in homes and care homes since the start of the pandemic. “Before the vaccinations began, when I was doing wound care, if you tried to get some of the patients off the books because their wounds had healed, they’d say ‘Please don’t stop coming, I don’t get any other visitors.’”

In January 2020 Fletcher, a district nurse with an NHS community health trust in Derbyshire, took the lead of a small team vaccinating housebound people in Chesterfield. Being in the room when patients receive their jabs has been extremely rewarding. “Everyone’s so grateful when we see them,” she says. “So many people have not seen their family in a long time and just want to get back to some kind of normality. It’s been such a worrying time for the elderly and the vulnerable, so getting vaccinated is a great relief. After the first dose they often ask me ‘Can I see my family now?’ and I have to say ‘Not just yet, not until you’ve had your second one.’”

The job has been exhausting, both emotionally and physically. Fletcher has been working 60 hours a week, even though she’s only contracted for 30, and she’s driving around 1,500 miles each month, just from home to home in Chesterfield, a market town with a population of less than 90,000. The days may be long, but this isn’t the kind of work that can be hurried. Sometimes the patients need help removing several layers before they can present their upper arm. “And sometimes they really want to tell you their life story,” says Fletcher. “Other people want to make you a cup of tea, so you have a cup of tea. You can’t guess how long you’ll be in anyone’s house because if you turn up and they’re in a mess you can’t just leave them, you have to make sure they’re comfortable and cleaned up. You can’t just jab and go.”

The biggest challenge Fletcher has faced has been making appointments. Many housebound people don’t own mobile phones, and many others won’t answer their phone to unknown numbers. “We’ve had to do lots of cold-calling,” Fletcher says. “We’d just go to the house and vaccinate if we could get in, but often people couldn’t get to the door to open it.”

Fletcher has also experienced the sharp end of vaccine hesitancy. “I went to vaccinate one gentleman back in January and got verbally attacked by his son in the garden,” she recalls. “He told me I was a murderer and that I was giving everyone poison. It really upset me because although I knew there were some non-believers out there, I didn’t think anyone would believe that I’m killing people. We also had carers in a nursing home tell us that there’s a chip in the vaccine and that we’re bugging everybody. I told them to stop carrying their mobile phones around if they’re that worried about chips.”

Thankfully, the vast majority of people have been delighted to receive their inoculation. “It’s been an emotional rollercoaster, but far more good than bad,” Fletcher says. “There have been so many visits when I’ve arrived somewhere and said that I’m here to vaccinate them, and they’ve just broken down in tears. Then they say to me, ‘Thank you. Thank you so much.’”

We hope you enjoyed this sample feature from issue #42 of Delayed Gratification

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