NHS workers, will you carry on for the duration?

[thesunisoutout]

So for vast swathes of NHS workers, normal NHS has stopped and we have all entered a covid19 NHS where the only priority is this virus. Most of us are being redeployed and cannot do our jobs for what may be months.

There may be relaxing and tightening of rules until a vaccine is rolled out but really, the NHS won't go back to the normal we know for a really really long time. Eventually we will be allowed to go back to our jobs and try to pick up those patients and start the backlog and work out the damage.

We were told today not to expect to go back to our usual jobs for 6-12 months. I've seen patients today not be offered any exploratory procedures to look for serious illnesses, virtually no 2 week wait procedures anymore, no life saving procedures, no speciality teams, chemo is nearly all being stopped, not much cancer treatment starting, people being left with no rehab which will change the course of their functioning in life...the list goes on. These things aren't just going to start in 12 weeks. Once the curve is flattened it's to keep hospitals at a certain capacity for the duration.

I'm an AHP who provides a service which saves lives. But that isn't important to the NHS now. Care for people with covid is all that matters. We're all having real ethical uncomfortable discussions about this. We know by doing very little, we're reducing spread but at what cost to the non covid patients? And we obviously want to do our jobs, not someone else's that we aren't trained to do and there were many today saying they would be handing in their notice soon as this isn't the NHS they wanted to work for etc.

It's just all very sad and very very difficult. I LOVE working in hospitals but I don't want to be there anymore. Never thought I'd say that.

Anyone have any idea what we as returning Nurses will be asked to do / what areas we will be asked to work in ?

@Carrotcakeforbreakfast no not therapeutic radiographer. I work in therapy services though. In my trust radiotherapy is going ahead but most chemo is stopping.

@Babyroobs all wards in my hospital pretty much are corona wards. They need nurses on the ground on these wards predominantly respiratory nursing I guess.

Community nursing teams will need support due to the caseload increase of EOL care
They are still needing to do dressings and legs and injections and in my area we are pooling nursing so that we can make sure that the non COVID patients get the treatment they need from nurses and doctors and the COVID get some form of EOL care

menorah - I have 15 years of palliative care Nursing experience. I hope I will be able to help in that area if nothing else.

I work in forensic mh unit

My training is psychotherapy and I work in management

I am now expected to provide health care - of course I have done this before to a degree but nothing like this. We were shown how to put on and dispose correctly of PPE but we don’t have enough

How we work has completely changed and now residents are becoming bored and one self isolating

It’s just a nightmare we think we have dealt with one issue and it leads to another hen another

I’m waking up in the night emailing myself lists of things that need doing

A lot of people on community caseloads will either choose to die at home or acute are not going to admit them at some point.

If they are frail with many comorbidities then it will be more about assisting them with syringe drivers and EOL care and community teams will need support with their whole caseloads. That is why we are pooling nursing and sorting out competencies so that we have the best skilled in the right places but many teams will just find themselves overwhelmed quickly

But I am thankful I am not working in hospital I am not on the front line and feel for all those that are or about to be

CMHN here. We have been asked to say where we would be comfortable transferring to in cases of short staffing but no sign of it yet. Our hard times will be in the aftermath, when the surge of depression, anxiety, PTSD and general trauma will come. I worry for the patients I would usually assertively follow up, who have no skills of self advocacy and usually a SMI.

My thoughts are with my general colleagues at the moment. Can't imagine what it's like for you.

Community nurses are going to be very busy supporting all the patients who have been discharged at a moment's notice. Last week we did a procedure (I'm trying not to give tmi for obvious confidentiality reasons) which enabled someone who has been in the hospital longer than anyone I ever heard of to be discharged. (Very complex patient obv). They went home the next day. TBH whilst I am very worried about the future of the NHS after this, which for sure will be leaner and meaner, in some cases a tough love approach will be an improvement. I think Covid was the catalyst to get this person home.

How else would you manage this OP? There are no great swathes of people in the community to pop in and man the wards. This is a pandemic. Staff are dropping like flies as they pick up the virus and have to self isolate. Who do you replace them with??? Yes you may be doing another job for a few months but you can't expect trusts not to do everything in their power to man the essential services.

Colleagues who recently handed notice in have offered to stay longer. I usually tell myself I'll give the job another 6 months, but I can't imagine I'll leave now within 12 months. But my job will not be rewarding in this time as I can't use my main skills.

Babyroobs. I really hope you will be placed where you are able to use your experience. I feel devastated for these Covid patients who will be dying a lonely and by all accounts unpleasant death. And if not dealing with cancer patients then I think there will be a great need for palliative care in the community. Elderly people who might previously have been admitted for treatment will surely be sentenced to an earlier than expected death.

thesun 👏👏👏 I'm so shocked at what's going on in my trust and it's putting people who would need services without C-19 at risk. Our staff have been forced to take up roles they don't want and don't feel capable of doing. Admin staff especially have been treated awfully by managers who work from home and put them on the front lines, we had a bank staff member fresh out of uni who was pushed into being a HCA on a ward!! The NHS we have after this will in no way be the same as it was before.

Mental health nurse here on an inpatient unit. We rely on our community nurse colleagues to monitor our patients with severe mental health issues (bipolar, schizophrenia, dementia etc) to keep them out of hospital, but they are now not seeing patients except with telephone support (not helpful if you have people too unwell to answer the phone), and many are being redeployed to the wards to cover wards that are short staffed due to people self-isolating etc. Combined with a period of massive anxiety, stress and financial hardship for people ; the mental health implications of coronavirus will be huge.

That's not even looking at all the people being denied access to routine operations, chemo, etc for months which will result in more people dying

There's a risk the 'cure' to coronavirus may end up being as damaging as the virus.

FannyCann - Thanks. I hope I can be useful somewhere. I also hope my current employers will let me take a period of unpaid leave to help. I only left palliative care nursing in a hospice about 15 months ago. I guess hospices wont be taking these covid palliative cases. I expect hospices will be over run anyway if a lot of palliative cancer patients are no longer receiving palliative chemotherapy or it's being delayed? In my local hospice some of the Nurse specialists, OT's , complimentary therapists and even managers are working on the wards.

@jellymaker as I said, I don't have an answer, I don't think there is one. But for many of us, we can't work like this. It's not what we signed up to do. I'm sure some people will think of us as cowards though and I accept that. It might be a little different for those of us that are therapists rather than in nursing...we have never been trained to 'care' for patients, but to 'diagnose and therap' them. The whole of therapy has just been removed from the equation in our trust.

I think a lot of the skills are the same for therapists and Nurse are the same though. As long as you can be caring and empathetic and reassuring you can easily learn skills like how to give care and bed baths. that's just my opinion anyway - as long as you can be compassionate you can help in some way when we are in a crisis situation. In returning as a nurse there are going to be many things I wont feel confident to do again but I can do the basics.

Having said that I guess it still depends what you are expected to do !

What worries me is how many people will be very ill but not considered to need hospital treatment

This is so worrying. How many will be cared for, medication missed, isolation, less appointments with their team that supports them (becuase I work in forensic they have cut back but not stopped appointments), increase in drug use

My specialist service has not stopped, we have postponed anything elective, we are upskilling so we can help in critical care but we will also be staffing and looking after our normal patient case load. We are very much aware of maintaining an effective service - cancer/blood disorders.

This thread is horrifying. I knew that all ‘non essential’ treatment had stopped, but I didn’t realise that included things like cancer treatment. How utterly awful for all involved.

@MsJaneAusten Not all cancer care has stopped. Wea re still treating our patients as we normally would but trying to minimise admissions.

Yes, a lot of my work as a therapist is unpicking symptoms, diagnosing the problems, getting medical investigations, dealing with the sequela and problem solving etc. That's all been stopped for all therapists and it feels like we've given up on everyone (I know we haven't and it's not a choice it's just the way it feels). Someone told me yesterday that the NHS is basically getting to do an experiment with peoples lives that never would have made it through ethics - something people will be writing papers on for years.

Honestly - I'm no good a basic care. I don't have the stomach for it at all (very squeamish with some phobias). If I do have to do that role for 6-12 months that will cement my decision to leave unfortunately.

In my trust 'red flag' outpatients and investigations are still going ahead, as is chemo/radiotherapy, as far as I am aware.