An Anaesthetist’s Experience of Covid-19
Your normal encounter with an anaesthetist is to keep you safe and comfortable during an operation, but it is our role to provide care for the sickest patients in the hospital, as we are also the doctors that work on the Intensive care unit (ICU) and attend all emergencies.
Since the onset of the Covid-19 pandemic our work and daily schedule has significantly changed. Elective surgery has almost entirely stopped, barring the most essential cancer treatment. The need for staffing on our ICU has hugely increased. We now never work a ‘normal day’ and just transition from night shifts to long days.
To give some perspective of the impact on the District General Hospital where I work, we normally have a 12 bed ICU and capacity to ventilate 6 patients. Through this period we have escalated to be able to ventilate 25 people with even further capacity if needed. There are 3 different wards working as ICU’s with one to treat those without Covid-19 symptoms.
Reflecting on this time there are some things that are in the forefront of my mind. Necessity really is the mother of all invention, with unbelievable ingenuity being demonstrated. The very sad emotional impact and scar this period will leave on those affected and closely involved. Finally our NHS staff’s amazing drive and determination to continue to provide the best possible care for our patients in such a difficult setting.
To cope with the extra demands it is amazing how people have adapted. A small group turned a ward into a new 12 bed ICU, fully kitted out, in just 24 hours. People have learnt new skills and techniques, such as how to prone an individual (lay them on the their front when intubated to help their breathing). Individuals have 3D printed components at home to add to our supplies and equipment. Others have designed and written new protocols, how to guides and help for those working outside their comfort zone, all often in their own time away from their clinical duties.
On a more solemn note, we must remember to look out for those in any role or position who have had involvement with Covid-19 patients. The hardest thing is the emotional impact this has and will have. We have seen lots more death and morbidity, we have seen care worker colleagues laying in our ICU beds, we have seen individuals make amazing recoveries. Behind each individual are friends and family who can’t visit their incredibly sick or dying relative and we can only imagine how difficult this must be.
We have endeavoured to ring the families to update them every day, with loved ones clinging on for hope with your every word. This has been tough. The lack of face to face interaction is so difficult, so un-personable, so detached, not being able to draw on the many non-verbal cues you realise are so important when breaking bad news and discussing end of life care.
Finally our NHS staff are incredible! Our ICU nurses have become fantastic examples for an army of helpers. Other teams have adapted amazingly and stepped out of their usual roles and acquired new skills . Our support staff continue to provide us with an outstanding service in these most difficult times. The staff are what are bringing us through this. They are the people that need to be remembered when time has passed, treated with more respect and continue to be shown their true value in our society.
Dr Chris Redburn