If you are a HCP working with covid do you think anything of patients who have broken the rules

[Napqueen1234]

I am a HCP professional myself but haven’t worked front line for a long time. It looks horrendous and I want to say thank you for working in these awful conditions. I watched the video of Dr Hugh Montgomery begging people to follow the rules which I completely agree with.

What I am wondering is how do you feel as HCP if you are caring for people who you know have not followed the guidelines and since caught covid and become very unwell? I know generally we do not judge and treat every patient our best (eg smokers with lung cancer, obese people with related problems). But I found it interesting that it’s painted that people very ill or dying of covid are ‘victims’ with the rest of society causing their covid due to their lack of rule following. Presumably though a certain amount of people may have got covid due to not following guidance themselves. I know of course a lot of people get it through work/shopping even when following all the ‘rules’ so I do understand it’s not everyone. I don’t know many people who have died of covid however the two I know have been grandparents of families who met up regularly even during lockdown, had small parties etc. I’m not saying at all that they deserved to die at all of course but what I mean is when they became ill and died their families were shocked, devastated etc. But surely they knew their behaviour was putting their own relatives at risk?

I follow the rules myself but also haven’t ‘dobbed in’ neighbours for minor infractions. I just find this attitude of all the selfish people causing people to die of covid through no fault of their own quite strange.

I’m not a HCP myself, so perhaps not what you’re looking for.

But ... people have always abused their own health. I don’t get why you’d look on this differently. In fact, some of the ways in which people routinely abuse their health makes them more vulnerable to Covid.

Covid puts us in the unusual position where ‘abusing your health’ now means ‘having a cup of tea in a loved ones house’ or ‘going to work’. I couldn’t find it in me to blame people for these things. I doubt many people could.

You raise an interesting point about the shift. Once you are a ‘victim’ your own ‘transgressive’ behaviour is not a problem. But then, I think this is an issue with making regular human behaviour ‘transgressive’.

Bit of ramble, sorry.

I’d be really interested to hear what HCP’s think of the situation where people are forced to break “the rules” by legislation - eg teachers in classrooms who are less than 1m from the front row of 18 year old with no mitigations (except the window over the other side of the classroom open a crack)

If they're judging they're in the wrong job imo.

I don't judge my patients. It's not really conducive to a good therapeutic relationship. Unconditional positive regard!

But I found it interesting that it’s painted that people very ill or dying of covid are ‘victims’ with the rest of society causing their covid due to their lack of rule following.

Yeah I find this narrative very strange. If we are going to take the that people are to blame then surely at least some of the people suffering must have brought it on themselves. Not that I think this btw I am not sure blame is helpful but it doesn’t make sense that the spreaders are all wilful super spreading arseholes and the hospitalised all innocent victim.

No. It’s not my job to judge. Simple as that.

Interesting point.

I find it irritating that any covid victim is treated as a hero. I do remember a thread where posters were annoyed by tv showing covid recoverers being applauded and clapped out of hospital. Meanwhile in. a nearby ward a cancer patient is discharged with not even a wave goodbye.

@MadameBlobby yes it’s that message I find strange. Good to hear HCP are judgement free, I suppose to a large extent you don’t know where or when they caught it or how compliant they have been anyway!

HCP here. I don’t think about it on an individual level. We would rarely know that info anyway. It would annoy me in a colleague tho.
I feel
A more general annoyance that I can’t face covid for the foreseeable at work because people in my area are are breaking the rules.
Also the person who needs hospitalisation isn’t necessarily the rule breaker.

I think this is a toxic mindset to have, hcp or not. I hate the judgment of this, where did they catch it? Is it their fault? Who gave it to them? It's a virus, the virus is to blame.

You could apply this line of thinking to someone driving too fast who'd been in an RTC, a bungee jumper, a skiing accident (why ski if it's so dangerous), anyone with addiction issues. It's a very unpleasant can of worms.

Ridiculous! About 75% of people in hospital are there because they haven’t looked after themselves properly. Your trapped in a World, where Covid has become your only narrative.

@SmileyClare

I think this is a toxic mindset to have, hcp or not. I hate the judgment of this, where did they catch it? Is it their fault? Who gave it to them? It's a virus, the virus is to blame.

You could apply this line of thinking to someone driving too fast who'd been in an RTC, a bungee jumper, a skiing accident (why ski if it's so dangerous), anyone with addiction issues. It's a very unpleasant can of worms.

I agree

@SmileyClare I know and I understand that. I’m not saying people should point the finger and blame the patients. But why do we point the finger at individuals breaking the rules up until the point they catch covid and then we say oh dear poor them it’s not their fault it’s a virus etc.

I'm a HCP. We are there to do a job not judge. Doesn't stop me rolling my eyes at people not following the rules but I don't bring that to work.

I've had to work with known child sex offenders, abusers and generally unpleasant people in the past. Again it's part of the job.

I find it all odd tbh. Pretty much most of what people use the NHS for is in some way linked to lifestyle choices at some point or could be shoehorned in if that's the way you choose to go. Having children is a choice for many people.... Do we judge pregnant women for needing a scan?! Ludicrous line of thinking.

Covid is like glitter. It's been sprinkled around and now it's everywhere. You'll find it it in places uou could swear it shouldn't be. Trying to attach and apportion blame is fruitless and pointless and unkind. Having a moral hierarchy of what is deemed necessary or essential interaction with the outside world is divisive and dangerous.

It's interesting that so much energy has been given to this line of approach. It maybe useful for the government to make it all someone's else fault...

You can catch Covid from a supermarket, are you blaming those people for catching it? How do you know whether someone’s sick because they’ve broken the guidelines or whether they’re sick because it’s a virus that’s extremely easily transmitted? Why would you judge anyone that was sick?

I am in a non tier 4 area and as a midwife we have seen women come from other areas to stay with family as they feel it's safer. Some who have tested positive without symptoms. I must admit when you look at the news of some areas of london about the state of some of the hospitals and the pressure they are under, it must feel very scary for people not knowing what the care will be like. I would never judge those families.

Do you judge people for catching the flu? Chicken pox? Do you blame people who end up with STI’s? Such an odd odd thing to do.

it's painted that very ill patients dying of covid are "victims"

They are victims. Blame has no place at that stage surely? I suppose I would compare it to berating someone in the 80's for not practicing safe sex but having only compassion if they were dying of AIDS?

That's a bit of a clumsy comparison. I suppose it's fine to hammer home prevention measures but too late for that when we are trying to treat or cure.

I would imagine that by the time a patient is admitted into hospital with it, they are most likely not in a state to discuss how they got it and HCPs do not have the time to mull over such things.

Knowing who to 'blame' doesn't change the state of things either. The patient still has the virus.
DM has been shut away in her care home since March and still caught it - from her carers we presume, even though they were constantly in PPE. She doesn't deserve blame and I certainly cannot lay blame on them. They have been working in a very difficult and demanding job over a very stressful period, with no chance to distance etc, and most likely with children at schools where there is also no distancing.

No. I don't judge my patients for anything. I have looked after people who did much worse things than just break Covid rules without fear or favour. In general healthcare people usually are not judgemental.

Mostly people don't know where they got it from anyway. Very few can point to one single exposure. Even fewer would admit it if they did know it was eg at a party!

I don't think my patients are heroes either. I mainly feel sorry for them. Even if it was their 'fault' they caught it it's not their fault how badly it affects them. That appears to be fairly random.

I think that being cross about people in society generally behaving like idiots and spreading illness is not the same thing as being cross with a specific patient which I would never do.

Arguably haven’t most peoooe who have it broken the rules?

@TrustTheGeneGenie

If they're judging they're in the wrong job imo.

Exactly this.

Do they judge those who smoke, eat unhealthy, obese, engage in risky behaviour which results in needed hospital treatment.

Covid is like glitter. It's been sprinkled around and now it's everywhere. You'll find it it in places uou could swear it shouldn't be. Trying to attach and apportion blame is fruitless and pointless and unkind. Having a moral hierarchy of what is deemed necessary or essential interaction with the outside world is divisive and dangerous

Agreed. People never got blamed in the past for catching a virus, or indeed giving it to someone else unless it was extremely reckless/negligent (eg knowingly having HIV and unprotected sex)

I can remember a little boy sneezing on my sisters birthday cake and giving everyone mumps. Did he and his mother become pariahs? No they did not. But mumps can have nasty long term consequences.

If you want to throw blame around, why not throw it at the overweight? diabetes sucks up a huge proportion of the healthcare budget and we have all known for 9 months that being overweight increases the risk of COVID complications. Plenty of time for people to lose weight, yet they haven't. Maybe make that a COVID rule? Everyone with a BMI over 25 to have a 500 calorie deficit a day. Just as sensible and easy to enforce as all the other bullshit they come out with, but at least there is a scientific basis to it.

I wouldn't say so. I had it. I didn't break any rules. I got it at work despite all the PPE, handwashing etc. I gave it to DH. Not his 'fault' either. Loads of my colleagues have got it at work. Loads of our children got it at school and passed it on to their parents. Other people I've known had outbreaks in their workplaces eg a shop and a factory All these people were where they were legitimately allowed to be (indeed forced to be) and followed all the rules.