I don't think I can go to work anymore

[bambinis]

I'm an AHP in a hospital. Currently trying to do my own job which is very difficult to do (we have to move around a lot of wards, PPE and infection issues with that), our service isn't particularly well respected even though we know we make a massive difference to the patients so giving us precious PPE isn't a priority etc. Constant threat of redeployment hanging over us because how important are we anyway? 🤷🏽‍♀️

Everyday at least 5 things change in terms of working, systems, policy, activity and every day we try to get answers, not do the wrong things, try and see the patients and the only message we get from above is 'what work are you doing? They need people to be redeployed / you need to be flexible and work extra or you might be redeployed' etc. Lots of fluffy 'isn't the NHS amazing being so flexible and doing what's needed to get the job done' nonsense but no practical help or support or even answers to basic questions.

Many people have tested positive in my team due to exposure in the hospital. There's at least 3 people crying every day and we're not a big team!

I'm due back tomorrow and I don't know how to do it. I've not really slept all weekend and lay awake with many scenarios and questions running through my head. If I do fall asleep, I have bad dreams related to work. My chest feels heavy and I'm short of breath (it's not covid, my test came back negative yesterday - it's anxiety), I'm on the verge of tears all the time and can't concentrate on anything at home except trawling news and figures for some hope that this will be over soon. I can't focus on my daughters and feel like I'm a leper in the house. I feel like I'm suffocating and I need to get away but I can't run, I'm stuck in mud and drowning. I don't know what to do. My worst nightmare is bursting in to tears at work because I've been told I must lead by example so other people don't get anxious.

I know there is nothing anyone can do but I just needed to get it off my chest I guess.

Our trust says "it is OK to not be OK". They have opened centres to support front line staff, be it with a cup of tea, a friendly face or psychological first aid and signposting to more specialist support. Please check out what your trust can offer as it may be more than you think.

Sorry to be ignorant but what is an AHP?

If you have a role in a hospital, any role, it will be an important one, I know. I'm sorry you are feeling the way you do. You are valued and needed. And yes, I'm sure it's ok to cry at work. I do, frequently, and I'm not in health care. These aren't normal times and nobody can be expecting people to have their hold it together, professional face on all the time or nobody would even make it to work in the first place.

I think the thing about heroes, and not feeling like you're a hero because you find it hard, is that you are a hero in part because you find it hard. It is absolutely heroic to be feeling as scared and anxious as you are today and to still say that you are going to go into work because you know you have a job you need to do.

Heroism isn't just because gung-ho and unafraid.

We are all allowed to be scared. I would definitely be making further inquiries re PPE as there shouldn't be different rules for people working similarly closely to the same patients. You may already have it, but the main guidance is here: www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-personal-protective-equipment-ppe

I would have guessed that was your job.
If referrals are still coming in, you are needed. It is thought the need for dysphagia specialists will increase for people in recovery post covid-19. The ppe issue is causing a lot of anxiety for SLTs at the moment, with RCSLT, saying one thing and the government an other. Do you have access to supervision with someone from your own profession? What you are feeling is not irrational and it may help to talk it through with someone. Alternatively is there an SLT working in a different area you could talk the issues through with?

@manicinsomniac an AHP is an allied health professional.
OP how much more essential can it be to stop a patient getting an aspiration pneumonia as they recover from Covid19?!
You SLTs are a feisty lot, I have admired your spirit and ability to say no and tell management where to get off over the years.
Bojo thanked his nurses which is as it should be, but maybe there was a dietitian working behind the scenes to ensure he was safely tube fed, and an SLT assessing his swallow as he got better. We don’t tend to get mentioned in these kind of dispatches.

Thanks again everyone.

In terms of our trust, there are lots of helplines and 'support' but it's mostly a publicity thing. We're not actually allowed to not be ok iykwim. It's frowned upon by our manager (who is a very no nonsense physio) and we're all supposed to be very hardy - as it's a pandemic don't you know - we're all struggling but we just need to get. on. with. it. Thank you very much.

I wish during the day I had time to actually think and talk to people but every day is trying to wade through a million changes and trying to get answers. I'm suffocating in emails and phone calls just to get basic answers about changes.

Our referrals have dried up a bit but that's mostly because wards are staffed by redeployed staff outside their role who have absolutely no idea what a swallowing problem is, looks like or what to do with it (completely understandable quite frankly, how can they know everything) We're blind in the hospital and just trying to feel our way. People just want to kick patients out to free beds, they don't care if they are sent home on thickened fluids and can't actually make a drink for themselves for example.

I know I will go in tomorrow and each day after that until I just can't anymore but when that point comes, I don't think I'll ever be able to return. But then the NHS that we've entered into isn't really one I want to be part of anymore.

I was going to guess OT or SLT

You are an amazing and important part of the team

I felt a bit the same as you in the beginning, I think I've just adapted to this as the new normal but still have the odd wobble! Plenty of my colleagues are where you are now and good management and support makes a massive difference so I'm sorry you aren't getting what you deserve on that front.

I dont like the heroes/war analogies either and I definitely wouldn't have become a nurse if I'd known then what I know now! But at the same time I'm strangely grateful for this opportunity to make such a big difference to peoples lives.

It helps if I remind myself that most of the population are going to get this virus at some point in the next few months, us frontliners are just getting exposed to it first. We could quit tomorrow and barricade ourselves in at home but the virus isn't going anywhere The majority of people will be fine, I'm limiting my intake of horror stories because otherwise I will go mad!

Sending you and

Just read your update, your boss sounds rubbish and there are loads of amazing and rewarding NHS roles so maybe you are just unlucky where you are and need a change xx

All the government and media propaganda about NHS heroes makes me feel sick; it's designed to guilt-trip people into going into work with sub-standard PPE, that the government refused to buy a few years ago (when recommenced by pandemic scientists), as they didn't want to spend the money. The wartime language and imagery is deliberate, but I don't fall for it for a second.

I do not blame you one bit for being worried OP, and I think you are well within your rights to refuse to work without full PPE, call in sick, or whatever. This government has truly fucked up, putting money before HCPs lives, and now telling you that you're heroes in order to guilt trip you into risking your life. Why the fuck should you? You have my absolute sympathy, and if every NHS worker refused to look after any patients with Covid unless they had proper PPE I would still applaud them.

Some of the war analogies and the hero propaganda and the semi organised clapping makes me think of men being given white feathers, during the first world war to guilt them into signing up.

Would a radiologist be expected to expose themself to radiation, knowing how harmful it is?
Yet all of a sudden people are being expected to put their lives in danger, whilst the government has the fucking cheek to chastise them for using 'too much' of the barely there PPE, which the government declined to buy a few years ago, in order to save money.

Sod this shit Bambinis. If RCSLT are saying you need PPE For aerosol generating procedures then that’s your professional guideline.

I’m an SLT too.

No way I’d be doing dysphagia assessments without the correct PPE. I’d refuse. How dare they out our lives at risk?

I'm sorry you're not getting the support you need and deserve at work.

I am in total awe of anyone working in the NHS at the moment, let alone without the correct PPE

As much as we (the potential
Patients) REALLY need you all, every single one of you, I'd totally support anyone of you refusing to work without the PPE your governing body says you need. Not PHE who appear to be arse covering.

Whilst it would be VERY scary to see mass walk outs of NHS staff (due to lack if suitable PPE) I would definitely support you. I don't expect NHS staff to put their lives at risk due to inadequate PPE to save my life.

Thanks for all the support everyone.

Weirdly, I'm not as bothered about the PPE (I mean, I am but it's not what's bothering me the most) as I can do end of the bed assessments etc and minimise risk myself. What I'm struggling with is the constant stream of changes to every single fabric of our working life and no answers. We don't know if we're coming or going.

I slept badly last night but I'm here today. I feel sick and shaky. Latest news is our working patterns will change. Something that has been refused for years on the basis of lack of funding and staff members to make it safe. Now it's being pushed through with no discussion (and less staff than ever) because we're 'doing it for the nation' rhetoric. Obviously, we will never come back from that and will always have to do it with not enough safe staffing numbers. I'm really trying not to cry and hold it together as crying at work won't change anything.

Do you have an HR department in your hospital that may be able to help? Or a Union? I really feel for you. It's a tough situation and SLT aren't seen as a priority.

What do you mean working pattern will change? 7 days a week?

Yes 7 days a week. We don't have enough staff to cover a 5 day service, never have and they won't pay for more staff to do a 7 day service because they don't really see that it's important enough. Our manager now says we have to regardless. All we can do is take what staff we have and spread them across 7 days. This will mean some days there will only be 1 staff member in - we have to have at least 2 (1 green and 1 red bare minimum and even then, you struggle to get round all the patients - big hospital) so there will be pressure and judgement if we don't work more to cover that (and none of us want to have to work alone or leave teammates and les qualified staff alone, it's shit enough as it is).

You're right @Mylittlepony374 SLT is not considered a priority. People cough (particularly with covid) and no one wants to hear us say they have a swallow problem which may delay discharge. Patients often don't realise until you point it out let alone staff who don't have time to watch people eat. I think part of my stress is realising I'm doing a job no one bar me and my teammates actually value. If we weren't here, no one would even notice or care (and would probably be glad to see the back of as we get in the way).

Your feelings completely mirror mine OP! I am a midwife and I feel like this will finish off my career and mental health. As soon as this crisis is over I am looking for a ‘normal’ job. My managers are careless with our lives in practice but can talk the talk in briefings etc. I hate the fact that we are putting our lives at risk on a daily basis and that my managers are sat behind desks with no patient contact making decisions. There is no answer and no way to be ok with this. As the saying goes ‘when you are going through hell - keep going’ xx

We’ve had additional staff added to our inpatient and community teams from outpatients, paediatrics and learning disabilities. This will allow us to go 7 days should we need to and means there is cover should we go off sick. We are still busy with the increased staffing as our staffing levels have been really poor for years.
Are there any other staff who could be brought into your team temporarily?

I really feel for you OP. I’m a HCP community based (on mat leave currently). But when I return it won’t be the service I left. Colleagues have reported increase to service hours, lack of PPE and other equipment. No support from managers. Our service was on its knees when I left almost a year ago... I didn’t think it could get much worse but now this pandemic has happened. Unless some drastic change to the NHS is made I shall probably leave once this has settled. Good luck OP

Paeds SLT team have already been redeployed in to HCA roles and our community team is very small, made up of some at risk people working from home and 1 or 2 who could come into the hospital but don't really have the necessary skills (not dysphagia trained etc) the whole thing is a mess. I'm so worried about all the people missing their healthcare. I just can't see the end of this at all.

My God, you don't want to be there and I don't blame you.
I'd tell anyone to get out of healthcare atm, your gov don't give a stuff about you
Please leave and keep yourself alive for your family.
Thank you for the work you have done

Sorry, it sounds like a really rubbish situation. I wouldn’t necessarily advise leaving. This won’t be forever and if you enjoyed your job before, you can again.

My friend manages an SLT department. Not in UK, in Ireland. I spoke to her about your story. She said she knows there's probably not much she can do but if you want to talk to her she would be happy to. She advised go to RCSLT documents, look at standards of service and stick to that. Tell your manager what is ok and what is not. She said look to your registration body code of practice and advise your manager, with reference to that document if you are being asked to work outside of that. She said especially highlighting risk, in writing, even if just an email, is important. If you have highlighted risk to patient it's difficult for manager to persevere with unsafe practice.
Her SLTs have been redeployed (they are swab testing for Covid) but she has kept a number of them from redeployment to ensure safe service levels in hospital.
It seems like she may just be a more caring manager than yours unfortunately. I hope that helps. Take care of yourself. You can't help others if you are not well. Can't fill from an empty cup.

This is completely unrelated to the situation you are in now OP, but as a parent of a TOF/OA child I have nothing but respect for SLT who specialise in swallowing. They have been there for us every step along the way and our local feeding and swallowing team are amazing (including the dietician). DS can eat ‘normally’ now at 2.5 years old, something I would never have dreamed possible given where we started with weaning. I can still remember the SLT in NICU watching his first feeds to make sure he was safe.

So no matter what else, know that you are appreciated and you would have had such an impact on patients and their families. I’m sorry that you feel unimportant at the moment and you I find yourself in such a horrible situation.