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Antibody Angels - Jane's Story

What is the Blood Donation Centre?

NHS Blood and Transplant, manages NHS blood donation services in England and transplant services across the UK. Every year they collect two million voluntary blood donations, prepare them for use, and distribute them throughout hospitals in England.

The Centre in Birmingham is currently collecting plasma donations from recovered COVID-19 patients under the REMAP CAP study.

And the Randomised Evaluation of COVid-19 thERapY (RECOVERY) trial, which is a national trial testing existing treatments that may help people hospitalised with suspected or confirmed COVID-19.

What is our role in the process?

Network staff Ruth Johns, Alastair Mobley, Juan Doblado Pavlon and myself are currently on work placement as Donor Carers at the Birmingham Blood Bank, and Julie Timmins is working there as part of the nursing team who will have oversight of the Donor Carers. Due to the REMAP CAP study, we’ve been recruited to help out an already busy service and we are known as the ‘Antibody Angels’. A bit like Charlie’s Angels, just a lot less glamorous and with permanent back ache and sore feet.

Donor Carers are the people who health-screen new donors or potential new donors, run through a health check questionnaire with the donor, and test their haemoglobin levels via a copper sulphate test which involves taking a pinprick of blood from the donor’s finger and putting it into a vial of copper sulphate solution. If the blood sinks to the bottom in a set time, the donor can give blood.

We’ve been trained to take a needle out of a donor and secure their donation to ensure it’s preserved and safe, and also be confident the donor feels well and is ready to leave the Donor Centre.

The Donor Carer role is split into two distinct obligations for us, working with Whole Blood donors and Platelet/Plasma donors, and although there is a cross-over there are distinct differences.

Blood platelets are very small fragments that circulate in the bloodstream along with red blood cells white blood cells. The blood platelets work with clotting factors in the plasma to form blood clots needed to stop or prevent bleeding.

Plasma is the fluid portion of the blood. It comprises protein, salt, antibodies, and coagulation factors. White blood cells fight harmful germs and prevent infection. Red blood cells transport oxygen from the lungs into the tissues.

Platelet/plasma donors are attached to a Trima machine (pictured) which essentially draws blood from the donor’s vein via a needle and processes the blood while the donor is donating. The plasma is collected in bags and the red blood cells are returned into the donor’s arm during the process of their donation. This process takes anything from 60-90 minutes depending on the size/weight of the donor and their veins!

Our job is to load the machines with the cartridge which runs the machine and enables the blood collection, and after donation we ‘take down’ the machine, ensure the plasma/platelet donation is secured and remove the needle from the donor’s arm.

The human element of this job is people skills! You need to be relatively comfortable looking at blood, needles, seeing needles put into people (!), seeing the bags of plasma and handling all of these following a donation. But arguably even more importantly, you need to be able to recognise when a donor might be feeling unwell, ensure they’re as comfortable as possible throughout the process and alert the staff with the medical skills when it’s clear someone is not coping or has begun to feel unwell.

During my first week I spent around 20 minutes assisting a regular whole blood donor who felt faint whilst donating blood. The mantra of the Blood Donation Centre is to preserve the donation, but equally you need to ensure that person is safe and if they tell you they feel faint or unwell you need to act. In this case, the donor thought she was going to pass out, so her needle was taken out, and it was my job to ensure she got a drink and a chocolate biscuit, we put a cold air fan on her, and she and I chatted nonsense until the colour returned to her face and she felt well enough to leave.

This is all a bit serious, where’s your usual self-deprecating humour and tales of cats in your Blog, I (might) hear you ask..?
Well, my humour has sort of left me on this’s a tough placement. The training is very intense. We've been fast-tracked into a role that takes many months of training under normal circumstances, but the virus has made the world anything but normal.

I have never worked so hard in my life! I have pretty much always had a desk job, I sit around all day moaning about sitting around all day, and then I see what the reality is for folks who don’t - and I know which option I prefer!

I have so much respect for the staff who do this day in day out. For nursing staff, anyone who works in healthcare who stands for hours on end and works long shifts.

The permanent staff are like a mini army, they work tirelessly, they are efficient, they are literally saving lives with their work. The donors are incredibly selfless and humble, they donate their time and their blood to help save lives, they are heroes to me. Many times, regular donors tell me, they hate needles, they hate the sight of blood but they donate because they want to. They want to make a difference, they want to contribute if they can.

This is even more prevalent during the pandemic. We are asking recovered COVID-19 patients to travel to the centre in Birmingham and be subjected to needles and questions, and they do it because the antibodies in their plasma might just help us treat seriously ill patients and ultimately, through research, help find a vaccine or successful treatment pathway.

I’ve spoken to a lot of recovered patients now, who have some shared symptoms but many have experienced either different symptoms or their experience of the virus itself has been different. Many of these donors struggle to donate at all, they don’t get through the health check process, their iron levels are low, their veins aren’t suitable for donation, but they are willing to come into the centre and give their time. They don’t care that we are new staff or even in training - they are willing for us to practice our newly learnt skills on them and they do it with grace and willingness.

They’re rapidly becoming my new superheroes, they are selfless and they are inspiring.

Case in point this week, a female donor came to donate Convalescent Plasma. I just happened to be the Donor Carer who screened her and I was a bit worried for her. She was very emotional. She cried when she told me her circumstance, how she thought in April when the ambulance came out for the second time to treat her for breathing difficulties, that she was going to die. It was her son’s birthday and she said, ‘I didn’t want to die on his birthday, how would he live with that?’. She is petrified of blood, needles, won’t even go to the dentist on her own, but she survived and she feels she owes it to anyone else who
needs help, to overcome her own fears, and donate her plasma, even if there’s the slightest chance it would help.

She donated a whole bag of plasma, exactly what we need and a normal collection. When her needle was removed she burst into tears because she was so elated. She was proud of herself for being brave enough, relieved for herself for recovering, but most of all hopeful that her plasma has the potential to help someone else struggling with this disease.

These are unprecedented times but donors are always needed to support patients who need either a blood or an organ transplant. If anyone who reads this feels in any way inclined to look into the possibility of donating in future (or now, there’s plenty of patients still needing blood donations), please check out the NHSBT website.

By Jane Mitchell, Assistant Project Manager
June 2020

The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR or the Department of Health and Social Care.