We're back after a short break, Ben Myers KC is continuing to ask Ms Letby about the various tasks that had to be undertaken by nursing staff at the Countess of Chester
Court is being shown a blood gas record for Child Q - Ms Letby is being asked what goes into filling in a chart like that (she is talking through the process of taking the reading)
Ms Letby is asked to what extent nurses assist each other on the unit, she said 'you're always working with another person when doing anything to do with medication or fluids'
Ms Letby says, about the June 2015-June 2016 period, that the unit was 'noticeably busier' and that there was 'a lot more' babies with 'complex needs'. She said staffing levels weren't changed to reflect this
Ms Letby is asked if nurses could request specific babies to care for, she says 'generally no', but said if you were working a run of shifts, you might be designated a baby to maintain continuity of care
Ms Letby is asked what impact the death of a baby on the unit has, she says 'it effects everyone'. She said there is a 'noticeable change in atmosphere' on the unit
She said there was no formal support offered, staff just leant on each other - asked how she coped with losing a child on the unit, she said she used a method that she learned at Liverpool Women's Hospital
She said 'they encourage that if you lose a baby you go back into that unit as soon as possible, as a way of processing things, don’t ruminate on that one particular baby being in that place', she said
You have to carry on and have to be professional for the other babies you're caring for', she added
Mr Myers KC asks Ms Letby what a 'memory box' is - this was given to bereaved parents after they lost a child on the unit. The boxes are provided by a charity and enable nurses/staff to take hand and frontprints, lock of hair for them to keep
Ms Letby helped make up several boxes for parents in this case
Usually after the death of a child, there is a debrief with doctors and nurses. She said these events were 'very upsetting', she added: 'You don’t forget things like that they stay with you'
Ms Letby is asked about colleagues at the hospital, she lists a number of people she was friends with on the unit. She is asked about one doctor in particular, who cannot be named for legal reasons
Ms Letby said the pair would go for walks, meals, coffees together and he would sometimes come to her house - she said he was a 'trusted friend', but said it wasn't anything more than a friendship
The doctor moved to another hospital in 2016 and Ms Letby said they they stayed in touch until 2018, when the friendship 'fizzled out'