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tool. now on bbc news, birmingham heartlands hospital has one of the busiest intensive care units in the region. we followed three nurses over the course of a night shift to find out what it's really like to be an intensive care nurse. no one dies alone in intensive care. it's me that sits there and holds your relative's hand. it's me that talks to them in their last few minutes. it is me that makes sure they're comfortable. no two days are the same. you don't know what you're going to walk into. our aim is to make patients better so they can go home to their families.

covid has changed - intensive care completely. the demand for the service isjust extraordinary. - we need to look after ourselves to be the best nurses we possibly can be. we cry together, we feel our emotions together and i think that's so important. i do like a busy shift, it makes you think a lot and puts your nursing skills to the test. i'm really proud to be an itu nurse. it's a really special place to work and i'm proud to make such a difference in people's lives and i'm even more proud of the team i have got around me.

working for the nhs, it does fill me full of pride, to be honest. i know it's hard and i know a lot of people don't feel the same, but it is something i personally enjoy. who are you on with today, then? i'm on with niamh and charlene. it should be a good shift. i'm proud to be part of the intensive care team. come on, everybody, dinner is ready. - family is so important to me.

i have got through some of my toughest times because of my family. how was work today, dad? busy, very busy. that is lovely. is it nice? rating out of ten. zero. laughter yeah, zero. excuse me! we have family time together before i go to work. it just adds that kind of togetherness. ok, i'm off then. see you later. i enjoy work because no two days are the same.

you don't know what you're going to walk into. i love myjob and it's down to a few reasons. i love my team, first of all. if we didn't have the team we have, it would be a struggle. ourteam are amazing. we are full of love and we really try to radiate good vibes because it's been so difficult lately. we're not fake about it. and then in bed two, 64 years old, out of hospital, cardiac arrest... we cry together, we feel our emotions together and that is so important. everybody understands that and everybody has empathy. 76, presented with a history of shortness of breath... birmingham is just so diverse.

you get people from every single background and i think that is a beautiful, beautiful thing. oh, thank you. thank you very much. singing you 0k? yeah, are you? good. on intensive care we care for critically ill patients. i think we have a huge responsibility to our patients, to each other, to theirfamilies to keep that person safe. our aim is to make patients better so they can go home to their families. she's got better over the last few days. i've dropped her support down to 14. lovely. see you later.

just look in all - the drawers and see if you've got any goggles. yeah. got some. neelam is one of the most beautiful souls i think i've ever met. she's the most caring, considerate nurse i think i've ever worked with. she really takes her patients into her heart. i love niamh so much. she's just the light. like, at work, she is just the light. i reckon we are going to get stuck together for a while. have to take you to the ward like this. like that. laughter that feel 0k? just cold? some people think in itu we have this magic machine called life support.

and it has a button we can switch on and off and itjust runs. in reality, there isn't this magic machine. there's multiple things we can offer, but it takes us in the bed space to keep doing those things and keep those machines running and respond to the changing needs of the patient to keep them alive. right, antibiotics are in. to work on itu, it is very much you either love it or hate itjob. we are very particular about things. we go through lists, we're meticulous. right, i'm going to go and get some drugs out. i've grown up in birmingham pretty much my whole life. i remember always wanting to be a nurse. when i was 12, my dad had quite a nasty brain haemorrhage. he was only 40 and he spent a month_ in intensive care at good hope.

unfortunately, he passed away and in those last hours when we were called in to spend time with him before he died, i sat at his bed space with the family around him. once he had gone, everyone was hugging each other. in the midst of the chaos i think i was forgotten about. and no—one was hugging me and i remember crying and i rememberthe nurse coming to me and holding her in my arms and just telling me it was going to be ok. i rememberjust sobbing to this nurse. and i still remember her now. she had a massive impact on my life. you know, my dad's final hours, to know that she cared enough and she was crying with me. ijust wanted to be able to make a difference like she did for me for someone else, to give something back

like that, because she was a really special lady. so, he is quite settled. i have put him onto the big cpap mask to sleep tonight so that he can get some rest. we can take people from the brink of death back to the start of theirjourney. to be able to offer someone that in their worst time of need isjust an honour to be part of. all right, take care. bye! at home, there's the three of us. there is me, my husband gary

and my 18—month—old son. a lot of the night shift workers on the itu are the mum crew. a lot of the new mums coming back to work after maternity leave tend to get our fixed night shift because it does work better with childcare. i think being a night shift worker does have an impact on your relationship, more than you realise initially. gary really has to pick up the slack at home with me working nights. so, he will swap over the childcare role. can mummy have a lie—in tomorrow? gary's always been really supportive with my career. we've been together from when i started training. we've, kind of, grown up together, with nursing as the third person in our relationship. she sings the juggling aspect of mum life and work life is intense. like, i finished a night shift last night and i've had

probably two—and—a—half hours' sleep, but i know i have to get up because i have a small window to get a fewjobs done before lenny's home from nursery and then we start the bath and bedtime routine with him. and then i'll need to go back into work again. it can turn into this 24/7 rolling list ofjobs. when you have good teamwork on the intensive care unit, it is like very well—oiled routine. you have to be prepared for every eventuality. that's why our staffing ratio is normally one—to—one because it's so risky. it is a riskyjob and if something happens and you are not anticipating it, you have got to do something very quickly. that's why there is an adrenaline rush. your patient could be fine one minute and then not fine the next. you have got to use your brain and definitely stay on your toes.

i always think if it was my family member in that bed, how would i want them to be treated? and treat them to the best of your ability and do your best with them. hello. my name's neelam. i'm looking after you tonight, 0k? you're perfectly safe here in heartlands. it's ok, it's ok. she can hear what we're saying, so i think the reassurance for them is really important. it's something they often remember when they wake up, so i try, we all try to talk to our patients all the time. let me listen to your chest, darling. any doctors around there? why? her heart rate is ridiculous. you're joking? yeah. at the desk.

i think she's having a vomit. she's got loads of secretions. she's got loads of - secretions and it's coming out from the mouth. with that patient, she was getting extremely, extremely agitated. it is a state you don't want your patients to be in. they get really agitated then all their numbers start to go off — hers did. they don't look right in the face, she was coughing. she was a little bit too awake and not appropriate, i would say. where are we?

and she was kind of trying to move her arm. you have to be very mindful because if they move their arm up too much they can unhook theirfinger around the tube, they can pull it out. and that's something we never want to happen. that's an emergency situation. just give her, like, five milligrams - if she's still tachy like this. by that, we knew she wasn't ready to be woken up properly and she needed to rest overnight. sometimes some patients need an extra few hours on some sedation, just letting the ventilator take over and do the work again, just to get a bit of a rest. it can help a lot. this patient wasn't going to survive, and i knew his family, if they were here, would have prayed for him. i am the same faith as them, so i did that for him.

there were a few of us in the bed space. we didn't leave his side. he passed away really peacefully. about a week later, i still had the son of the patient on my mind, and ijust wondered if he knew what had happened, or what i did, so i asked my manager if i could ring the son. she said yes, so i gave him a call. and i think the son was really grateful for that. it gave them, as a family, a lot of closure. we really need to get him on the bed and get him to the ward. it's charlene here. i need to take that line out of your neck. i am a brummie born and bred,

so working within _ one of the hospitals within birmingham, looking- after the people of birmingham, i absolutely love it. _ where else would i want to be? i'm going to take i this dressing down. just like a big plaster coming off your neck, all right? - charlene will always have your back. she's the go—to for a cup of tea and a chat when things are a bit tough. she's a really good shoulder to cry on. she's a strong, mother—like figure, i think. that's all over- with now, all right? i do like a busy shift. it makes the shift go veryl quickly, so i don't mind it. it makes you think a lot and put your— nursing skills to the test. it is only when i sit back and look at myjob rolel and what it entails, it's actually quite - intense and demanding.

at any given moment, i a patient can deteriorate, and their lives are, - ultimately, in our hands. you've really got . to know your stuff. our friend and colleague, amy, she worked with us. we were really, really close with her as friends. she took her own life before the pandemic. and, outwardly, she was the happiest person that you could meet. she was so funny, so caring. everything that you'd want in a friend, was amy. but little did we know, she was obviously struggling. and that was difficult. she wasn't going to tell us. so i think since then we make the conscious effort

to look after each other. we say, "i love you," all the time. like, even if we'rejust going for our break, we say, "i love you, bye." we all really, genuinely care for each other. notjust because we have to, because we want to. we value each other so much. tonight we've had admissions, discharges, deaths, balancing patients dropping blood pressure, becoming sick. it never stops, especially in a hospital as busy as this one. the demand isjust always there, no matter what time of day or night it is, so it is intense. i'm going to do a mid—week roast tonight. you need it with this weather, don't you? j and post night—shift as well, cosy. beef stew. mm!

crusty bread. oh! — loads of butter. oh, god. - plenty of pepper. literally talking i dirty to me now. if you haven't got anyone - to have a laugh with on shift, it's going to be a long night. and sometimes going for- a quick walk around the unit, we've been known to dance to wake ourselves up. - just having someone to have a chat with l can definitely lift the mood. i need to go back. coot _ let's go. death is a really big part of working in intensive care and to work there you have to be prepared to face it. i'm just closing the window. the patient in this bed space has passed away.

it's a bit of an old wives' tale on the wards that if your patient has passed away, you need to leave the window open to let the soul find its way out, otherwise it gets trapped in the hospital. it's something that's stuck everywhere, to always have the window open. so, we have these. so, it's a memory box. it's got a little sympathy card that we've started to fill in with us off the unit, just saying, sorry for your loss. so, they have little things like this in, they're all quite different. so, they have teddies in so one can stay with the patient and one can go with the relatives, they've always got a matching teddy bear. we never leave a patient. no—one dies alone in intensive care. it is me that talks to them

in their last few minutes. it's me that makes sure they are comfortable. i try and play the radio. i don't like people to die in silence, so finding the radio. sometimes i even sing to them. we went home one night after a day shift and then came back the next day and it was carnage. siren wails it had flipped upside down overnight, and we had no idea what was happening. we knew so little.

covid has changed intensive care completely. the demand for the service isjust extraordinary. the world has tried to carry on, but covid's still rife and just taking over our intensive cares up and down the country. if i'm completely honest, people are burnt out, people are exhausted, people are frustrated, overworked. the demand doesn't stop. we still need to be there, and we still want to give 110%, but it gets difficult. at this point i actually feel 0k. i'd like to say it's a wind down, but it's more like a mad rush to get everything done. i want to make it a smooth transition for the nurse that comes on in the day.

just tidying up, just so it doesn't look too messy when the next staff come in. there's nothing worse than coming into a messy room to start your day because then you're already starting off on the back foot. we wouldn't be at this point where we're ready to go if it wasn't for teamwork. we rely on that help and support from each other, because even though we only have one patient, what we have to do, we're just run off our feet. he came to us at about 2am this morning. the plan is to wake this morning. hopefully it will go plain sailing. is that all right? yep, that's lovely, thank you. beautiful, thank you. the best part of ourjob has got to be my colleagues. i think with anyjob, anywhere in the world, your colleagues will make or break your shift, and we are one big family there. yeah, i absolutely love the people i work with.

yesterday, what they tried to do was wean her off the drug. they switchd both them off and started her on something else. she is just quietly settled. going home now, my darling. i hope you get well soon. got to get better and go home, 0k? i really enjoy, when i look at a patient at the end of the day or the end of the night i think, i have actually made a difference here and i have made them a little bit better. that is just the best feeling. see you later. he was really quite breathless last night and dropped his stats before i put him onto cpap. then he seemed really settled overnight. is that all right? i am really proud to be itu nurse. i think it's a really special place to work and i think there's so much potential to progress there and the knowledge i have

picked up in four years, i can only imagine what it's going to be like in another four. i'm proud to make such a difference in people's lives, and at the end of people's lives. i'm proud of the work i do and i'm even more proud of the team i've got around me. bye everyone. have a nice day! let's go, girls. i'm going out tonight! i'm going out...

hello there. we've got the battle of the air masses taking place this week, certainly for the next few days, we will have a north—south divide, much colder air across northern areas with some wintry showers. further south, it'll be very mild indeed for the time of year, and there will be some sunshine around. so, the dividing line between the cold air to the north and the mild air to the south is this weather front, which will be hanging around through central parts of the country throughout tuesday, so thicker cloud for northern ireland, southern scotland, northern england, outbreaks of rain on this weather front. to the north of it, it's brighter with sunshine and blustery showers. these are wintry on the hills of scotland, and it will be windy here. further south, also quite breezy, but dry with sunny spells, a bit more cloud for wales and southwest england. a blustery day, as you can see across the board, but gusts will be reaching

in excess of 50 mph across northern scotland into the northern isles. temperatures in single digits, to the north of the weather front, to the south of it, 11 to maybe 14 celsius, so very mild indeed, particularly where you get the sunny spells. through tuesday night, that weather front hangs around through central areas, outbreaks of rain on it, slowly pushing southwards into england and wales, to the north of it, again, further snow showers. and these will be blustery, accumulating snow on the hills of scotland. very windy here, breezy in the south where it'll stay mild. so, into wednesday, then, that weather front slowly pushing its way southwards across england and wales. again, the mild air to the south of it, but more areas will be in the colder air on wednesday. so, that'll be scotland, northern ireland, northern england, perhaps north wales later in the day, plenty of snow showers across scotland. significant accumulations across the scottish hills, and it'll be very windy, gusts of 60 mph in northern scotland. a breezy day to come for all, but our weather front will be bringing more cloud

across southern england, south wales, where it'll remain very mild. the mild air eventually gets pushed out of the way as that weather front slips into the near continent. keeping an eye on this feature, this little low pressure which could bring severe gales and some snow to northern scotland on thursday, but then for friday, there is a ridge of high pressure building in to settle things down. so, it is turning colder for all into thursday. you can see single— figure values there. it's chilly on friday, but light winds with some sunny spells and the return of overnight frost.

welcome to bbc news. our top stories. the russian and french presidents say their talks in moscow on defusing the military crisis surrounding ukraine have been constructive. protestors in london harass opposition leader sir keir starmer as the prime minister boris johnson faces more calls to withdraw a false accusation he made against him in parliament. hundreds of moroccans attend the funeral of the five—year—old boy who died after being trapped inside a well for five days. israeli police face allegations of using spyware against public figures — including aides of the former prime minister benjamin netanyahu. we are going to the pictures. he is taking us to titty titty bang bang. what in the name of god is that? and the nominations are about to roll in.

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