Thread for NHS staff

[LucheroTena]

How prepared do you think your place of work is? I work clinically in large teaching hospital and not at all confident we’re ready. Outside of wards there is very little planning and yet we have massive outpatient services. Elective stuff is being limited now but nowhere near enough capacity will be created. Millions in deficit so we’re operating on skeleton workforce and even when we can recruit no one wants to work here. Dozens of calls to our small team each day from worried patients, it’s taking up so much time to answer them all on top of already manic workload. Loads of staff with symptoms that are concerning but we’re not swabbing them and 111 uninterested unless they’ve travelled. Admin staff gleeful that they might soon be ‘working’ from home when truth is it’s difficult to get them to do much work on site let alone unsupervised. It doesn’t feel as though there is much consideration for clinical staff and now we’ll no doubt also be burdened with doing the jobs of admin. Never been as close to saying stuff it and quitting.

Do you think from the budget yesterday. That at least you'll get some money thrown at the situation? Not as in derogatory. But is that even going to help you guys?

I mean I don't work for the nhs. But I'd have no problem being hired in an isolation ward to do admin.

I’m in primary care.

We have no PPE beyond our usual gloves and aprons. I think we have an Ebola kit gathering dust somewhere... no face masks, no visors, no suits.

It’s pretty much business as usual. Our website has big notices emblazoned across it saying don’t come in with ANY viral symptoms. Same signs on the doors.

We do telephone triage daily but that has ramped up and the GPs are minimising F2F appointments where possible.

I think patients forget we are vulnerable too 😕. If we’re out of action they’re stuffed.

Junior doctor rotating into a&e in April, also have a child and partner in similar front line role...
Been given ZERO training on coronavirus or PPE and being told I won't get an induction period (where I would have hoped these things would be addressed) to be bought up to date. Yay.

Midwife here. Extra cleaning so far but nothing re patient contact beyond universal precautions. None of the core night staff have been fit tested for masks. I've been off for a few nights so interested to see if it's clearer where items are etc. when I go back in tomorrow night. Very worried about being redeployed but realistically we can't keep up with pure maternity work so doubt it will happen. I have worked during a major incident (admittedly one night only) and we lost our junior doctors to the emergency department but didn't see a reduction in quality of service as consultants picked up the work on the shop floor. Similar during the strikes. Anaesthetists will be in very short supply though I imagine, but as I only work at night I'm used to that.

Mental health nurse in forensic services. Our trust is rationing hand sanitizer and we have the basics of ppe but no masks. The trust are recalling all unused laptops, presumably so that they can be redistributed to non essential non clinical staff to work from home.

I hope there is planning behind the scenes that we arent aware of. We seem to be mainly getting the same advice the general public is getting but no advice on what happens if we get a positive patient. We have no way to isolate and staffing is a real problem as it is. If the government guidance changes to all potential respiratory complaints go into isolation for 10 days we're fucked.

I asked my manager what happens if school closes, he said the usual, you have to find care from somewhere just seems so unorganised.

Well it seems we're all OK. Just had an email to say our trust are limiting all essential meetings to 7 people. What a totally random decision. Why 7? Who decides who gets to go or not? Can't believe people think the NHS is going to be able to cope with this at ll. 😂😭

NC for NCov as my name suggests...Large acute teaching hospital, PPE measures seem to be variable with no one quite sure what should be deployed, when. Strategy meetings moved from weekly to daily. Just keeping on keeping on for now. No idea what will happen if schools/nurseries close, already getting a bit chaotic and noticing other services already indirectly impacted by this virus

Critical care outreach nurse here. We support ward nurses and see deteriorating patients. I've failed the fit testing and would have to use the hood but hoods yet.

We have positive cases already and I'm dreading the deluge of sick patients in the next two weeks.

Anecdotal accounts from Italian doctors are as follows:

• Patients needing 1L NC then NIV then Intubation (increasing demand of oxygen until the body needs artificial intervention)
• Severe ARDS necessitating proning. Some get better then wham PEA (asystole). ARDS is acute respiratory distress syndrome. Both lungs become clogged with fluid as he body fights off the infection.

Please read the Resus Council (UK) on the guidelines when resusitating patients with COVID 19.

100% on dreading the deluge of sick patients - feels like standing on a beach watching the approaching tsunami, powerless to stop it or, indeed, escape!

Midwife here. Some of us have been fit tested. Anecdotally fit testing is not being done as well as it could be due to worries about stock of masks. No clear plans being communicated on some things. We have one room (for a massive inner city maternity unit with thousands of births a year) for potential covid patients that doesn’t even have a window so not great for ventilation!

Most of us aren’t nurse trained so not sure if we could be redeployed and anyway we are going to struggle with staffing once people start going off sick/quarantining. No guidance on self quarantine policy except if definite exposure to infected person.

My worry is that women will present to us, become unwell and deteriorate enough to need care but we won’t be able to get a bed for them outside of maternity so we will end up nursing multiple Coronavirus patients at a time taking up delivery suite beds.

We have enough ppe if we literally only get one or two women with Coronavirus. If there’s a lot we’re going to be stuffed.

I also don’t see how we can provide care safely without using PPE for everyone with any fever or respiratory symptoms since so many cases are mild. Let alone the people without symptoms.

Another question for you all: what are your plans to reduce the risk of passing it on to your families? I am so worried as we have young children and it would be horrendous if my partner was having to try to care for the kids alone whilst being ill because I would be expected to be at work all the time. Not to mention even young adults have a small risk of serious illness/death.

In my hospital there isn't enough PPE and the left hand doesn't know what the right is doing. We are screwed.

I'm worried about if they close the schools. There is only so much passing around of family you can do and my partner and I both work full time?!

Another question for you all: what are your plans to reduce the risk of passing it on to your families?

I have no plan. Given my area of work (mental health) my chance of coming into contact is probably only slightly higher than the general population but I know I will be required to still go to work if one of our patients gets it so I just have to hope good hand hygiene and the limited ppe with have is adequate.

Cant even go to work in my own clothes and change into uniform either, only 2 toilets that arent on the wards to use for changing for 20 people at each shift change. Infection prevention are going mad about it.

I’m a student nurse out on placement at the moment. The staff on my placement are being/have been fit tested, and there’s been some people here with hazmat suits. Students not fit tested, not sure whether we have to stay at home if things go south. A newly qualified nurse heard today from a friend that people are getting official emails saying they don’t have to complete their third year of training, they need people pushed through to be qualified for Covid. This is the first I’ve heard of it, but she’s confirmed at least one person has got an official letter. Unsure if this is actually real or not!

Also in MH secure services. Our trust have so far provided each patient with a poster about washing their hands and we have all been witnessed washing our hands to make sure we’re doing it properly. We’ve been provided with no extra PPE, luckily our ward do have a stock of masks etc. We did run out of soap last week and haven’t been given any extra hand sanitiser.

I asked what will happen if one of our patients gets it, and was told we don’t really know. I’m pregnant and directly patient facing, there’s been some talk that they should move me to office based work for the time being but nothing has actually been done about this. I’ve still been expected to have contact with patients with chest infection symptoms and patients that are barrier nursed so far.

Frontline ahp here.

I work for a very large teaching hospital with an extremely busy emergency department.
We have confirmed cases the infection control where they're currently placed is very good as is my understanding

However, ED where I work mostly. Well, it is a fucking shambles tbh.
For the ? Corona we have to wear surgical masks as there aren't enough fit masks to go around.
I haven't been FIT tested yet despite working mostly where they're coming in.
I am at work for the next 6 days straight and I've still not even has a mask discussed with me.

My parents help with my childcare. One is immunocompromised and one asthmatic.
I really don't want to pass this over to my children who will then take it to my parents as it could be catastrophic.
Yet I have to work and I am so, so worried. Not for me for my children and parents.

This has made me reconsider my NHS career.
As much as I love my job I've been made to realise that I no longer want to risk me and my family.
That could be something like covid. Or it could be being abused or assaulted ( and I have been) or missing yet another family event.
It isn't worth that , nothing is.

We are already stretched and exhausted, before all of this.
This is going to shatter staff morale.

A newly qualified nurse heard today from a friend that people are getting official emails saying they don’t have to complete their third year of training, they need people pushed through to be qualified for Covid. This is the first I’ve heard of it, but she’s confirmed at least one person has got an official letter. Unsure if this is actually real or not!

I've read that something like this has happened in Italy but I doubt has happened here... it would be in the news for starters and I dont think we're quite at desperation staff levels (any more so than we have been for years) to warrant it.

Paeds nurse Scotland. Ward based. Our entire ward has been fit tested already we have Ppe and as an acute receiving unit we have protocols in place for any child with suspected covid19 and if they are tested positive but as for staffing/childcare and what happens next who knows how it will work it is scary ex is police so will also be needed but no one to care for kids than the two of us

I've read that something like this has happened in Italy but I doubt has happened here.

It's already happening for medical students. There's been guidance issued jointly by the GMC, the four UK Departments of Health about medical students being shifted to provide frontline care:

www.rcpe.ac.uk/sites/default/files/supporting_the_covid-19_response_final_002.pdf

Our current expectation is that there will be increasing requirements for trainees and trainers to support NHS Healthcare providers in managing the care of acutely ill patients. This may result in disruption or cancellation of training activities and trainees being directed to alternative tasks and / or locations to support the COVID-19 response. This could mean trainees in non-acute areas being asked to support urgent and unplanned care, such as medical admissions and the subsequent management of those patients, but may also in exceptional circumstances include providing support to clinical teams in other disciplines. Flexible working by healthcare professionals, including doctors in training, to support patient and population needs in a significant outbreak will be essential

Well after weeks of inaction my mental health trust have finally emailed today with an "action plan". Despite the interminably long email, the plan appears to consist only of setting up a coronavirus emergency committee amongst senior management with a commitment that they will be meeting on a daily basis and regularly evaluating the situation.

Typical of the trust that their answer to everything is just to arrange a meeting and discuss endlessly rather than actually doing anything.

Still no answer as to how to manage home visits, how to deal with patients coughing and spluttering all over our waiting rooms, what to do if we have a cold ourselves
.. but at least it's good to know management will be meeting over tea and biscuits.

We only have one side room. So we won't take any infections anyway. (Peadiatrics) closing schools will create a huge issue as many of my colleagues have school age children.

I used to be the 'fit tester' for the masks. A job I loathed. Fortunately it's being felt dealt with by infection control not health and safety.

We will be prepared by Monday at the latest to be the main ward outside icu in our hospital treating acutely unwell coronavirus patients.

I'm an HCA on an elective surgical ward.
All OPs are cancelled & our patients are being moved out.
We're in the process of being fit tested for masks & trained in use of ppe & gowns etc.
Infection control & matron try to answer our many questions but plans are changing all the time.

We've been told the press must not find out.

Staff are not going to be tested for the virus at any point so that could have serious consequences for ourselves, patients, and our families. Very concerning.

As an HCA I'm thinking of practical things that could go wrong like serving dinners from the kitchen trolley then putting everything back in the trolley to be washed in the hospital kitchens - surely a huge infection risk.
Water jugs & breakfast dishes & breakfast trays.
Staff cups??
Will we be allowed to have lunch in the canteen?
What about food we bring in?
We may get scrubs but there aren't enough & what about footwear? Etc etc

So many questions & worries.

I'm surprised the government hasn't set up a hotline/sign up etc for registered staff that CAN work. I'm with an agency now but have experience of working with viruses in an isolation unit, swab collection etc etc.

Rather than potentially dragging people out of retirement, surely they should be looking at those than are suitable to work right now!

It's already happening for medical students. There's been guidance issued jointly by the GMC, the four UK Departments of Health about medical students being shifted to provide frontline care:*

Moving students to meet demand is not quite the same as not having to complete the final year of training as suggested by the pp though.