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.

I know a junior doctor who was meant to be rotating into the area she'd like to eventually specialise in, but now it isn't really running, and she's been sent to work on the corona ward. I know it isn't the most important thing, but I feel very sorry for her - she was very miserable during her last rotation (nobody's fault really, but it was very different to what she expected and 'her' registrar wasn't the easiest to work with) and she was so happy to go to the one she really wanted to do.

I wonder whether it'll end up taking doctors a bit longer to specialise?

I’m in primary care, and as our routine workload has stopped/reduced then we’re being asked to work at the Hot Hub, or in the community.

So we’ll probably be doing a mixture of surgery, the hub, and community.

It does make me wonder how much training we’ll get. I can’t work at the hub, am happy to go into the community but haven’t set up a syringe driver, for example, for 20 years, nor catheterised someone. I imagine it’ll be like going back to the old days with a see one, do one, teach one mentality!

Oh and all without much in the way of PPE of course...

@Sidge
I'm in the same boat, it's scary isn't it? Wanting to do the right thing but protecting your pin.
We're still busy with childhood imms, urgent dressings and CDM online but community are going to need all hands on deck. There's talk of us going in pairs so at least there'd be safety in numbers.

@mustyDuck it’s concerning. I’m a hugely experienced primary care sister (20 years) but know nothing about palliative care, catherisation etc. I am obviously willing to learn but am not risking patients’ welfare (or my pin) to do anything and everything asked of me.

We are busy seeing F2F essential patients but there as so much routine stuff has been cancelled and a limit to what we can do over the phone I have no doubt we’ll be utilised in the community. Makes sense but it does make me nervous.

Have people on here seen the letter from the NMC & other agencies "reassuring" staff?
I found it anything but reassuring. Basically saying you may be redeployed to work in unfamiliar areas and under extreme pressure. If when there's a cock up we'll take a forgiving view. Something along those lines.

I'll see if I can find it when I get a chance.

I saw that letter fannycann I agree it was really not reassuring or supportive.

@FannyCann yes something similar from HCPC, basically if/when you do something wrong (because your trust made you work in a role that you aren't trained for) - there will leniency in judgement due to the circs....not reassuring or help at all.

Utterly shocked today, I can't believe what I have been told. Chatting with the Trauma Nurse practitioners, and asking how there are suddenly so few patients on a large ward that is normally busting at the seams..loads of people sent home early obviously. I was told they are stopping operating on hip fractures! All the junior doctors, registrars and F1 F2s have been redeployed leaving the ward in the care of the (very competent) nurse practitioners. But seriously - no hip fracture surgery? Conservative management only. But that means bed rest, pain, immobility and the need to be nursed by someone. They can hardly be left at home in this state.
I just can't wrap my mind around it. I'm speechless.

Also, it all makes no sense. If such hard decisions are going to be made maybe it would be better to refuse treatment/hospital admission to very elderly/frail with coronavirus and allow other regular services such as trauma surgery to continue unchanged? The coronavirus seems to have a high mortality rate among the very elderly, and the hospital is already limiting ventilators to age 65 and under (I sneaked a look at the bed board for the new respiratory ICU) whilst on the main coronavirus ward every patient is 80/90 +.

On the plus side, not all humanity and individualised decision making has gone out of the window yet. We admitted an elderly nursing home resident today for 24 hours IV antibiotics even though their ceiling of treatment plan is oral antibiotics only. But it was the right decision - they are one of our regular patients who come for a tube change every so often. It's appropriate to treat infection related to the particular indwelling device as part of the maintenance care we give. Lovely, caring junior doctor sorting admission.

Are you certain it was fractures not replacements ? Does seem a bit strange

Yes. She's the trauma nurse. I was incredulous and she re-emphasised what she had said.
I'll keep a closer eye on the bed board over the coming weeks.

There is an alternative to all this redeploying of NHS staff: keep all other services going and don’t treat patients with Covid. They stay home, they either recover, or they die.

Completely inhumane, not going to happen.

We’re really between a rock and a hard place. We simply don’t have the capacity to treat everyone who needs it. Someone’s got to make the decisions.

Completely agree Puzzled. I wouldn't like to be making those kind of decisions. It's very fine balance between treating Covid patients and not compromising the care of everyone else and when the people trying to do the planning can only anticipate numbers and what the need may be it must be a nightmare of a job for anyone.

My DD who works in theatres told me they have stopped all laparoscopic procedures except some gynae as they are aerosol generating procedures. So appendix will be done the old fashioned way with open surgery.

I agree, patients are being discharged home too early and without any supports. (nurse here). My uncle just died an hour ago in another part of the country. Had a respiratory arrest lastnight, and was only discharged 2 days ago after major abdominal surgery for enormous hernia repair, stoma reversal and severe COPD (He was admitted over 3 weeks ago before CV was taking hold).

Sent home with no home oxygen, no home nursing support/carers and nothing to help my 70yr old aunt care for him. She did CPR on him, and is now awaiting tests on both for CV.

We haven't even reached the peak yet and this is going to be happening all over. Everyone should tell their family how much they mean, because we just don't know what is around that corner. Stay safe everyone x

Will I carry on for the duration?

Yes. Of course. What choice do I have? A sick line for stress?

After this is all over I have to live with myself (hopefully).

Re: the hip surgery. I suspect there aren't the aneasthatists, theatres or ventilators. #NOF has a 50% mortality.

@hopefulhalf I've slightly rationalised it. Tbf even before Covid there are some frail elderly/pathological fractures and so on that I question operating on so it's probably not wholly unreasonable with regards to some care home residents.

However my mother (91) broke her right hip six years ago, made a good recovery, had another, more serious, fall down stairs # pubic rami and humerus about three years ago, longer recover and osteoporosis continuing but she's pottered along quite well, had another fall at the beginning of March and broke the left hip. She's made a good recovery, we got her out just in time to a care home, has had a few physio sessions and we have plans in place to get her home with a live in carer in a couple of weeks. Very lucky, of course, that she has been able to find this.
But I'd have been outraged to deny her the operation.
Fingers crossed she doesn't have another fall anytime soon.
Also for a live in carer there's a difference between caring for someone a bit doddery with some mobility and an independent spirit and caring for someone who is totally bed bound.

Elouera. Im so sorry, that is terrible to read.

Posted too soon.
Your poor Aunt.

@Elouera so sorry for your loss.

Our Clinical nurse manager was admitted to itu yesterday - we all so unsettled now but plodding on.

@FannyCann and @Pomegranatepompom- thankyou.

Sorry to hear about your manager. It does seem health care workers are being affected so much more by CV.

So sorry for everyone with friends or family unwell.
Has anyone elsecheard that the easter bank holidays have been '"cancelled" for NHS staff ?

NHS worker resigns after being told by her trust she was not allowed to wear her own face mask even though the trust failed to provide her with PPE.

www.theguardian.com/world/2020/apr/04/nhs-worker-quit-when-she-was-stopped-from-wearing-face-mask

I am writing to inform you of the recent issues over the last two days. As you are aware, I have been in self-isolation for the past 14 days due to my daughter having symptoms of Covid-19 and, upon returning to work, I have attempted to wear a surgical mask, which I have supplied myself. The reason for wearing the mask is to reduce the risk of me potentially spreading the virus to patients and colleagues whilst also protecting myself from contracting the virus from said patients and colleagues.

Whilst carrying out my duties on Monday, I made sure to ask the patients if they felt comfortable with me wearing the protective mask and all gave their consent, with some also stating that they felt more comfortable with me wearing it due to being in such close proximity.

Upon arriving to work on Tuesday morning, whilst still wearing a mask, you asked me for a word in your office. You outlined to me that wearing a mask wasn’t following the trust policy and asked me to remove it. I responded stating that I wasn’t pleased with this instruction and defended myself stating that I was uncomfortable not wearing a mask while dealing with patients who may be carriers of Covid, however I adhered to the request.

Later that day, whilst taking blood from one of our patients, they accidentally coughed in my face. I told you what had just happened, however, you informed me I was still unable to wear my mask.

With a heavy heart and sadness. I feel I have no alternative but to hand his letter in as my formal resignation and will be unable to work my notice due to not being allowed to wear sufficient PPE for the duties I perform.

I got told to take my mask off last week.

This week was allowed to wear it.

Galling to see patients in FFP3 ones while we only have surgical ones.