Advice from a Junior Doctor on the NHS Front Line | Dr Imogen Heaton | #LetsResetNormal

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In the middle of her first year as a junior doctor, Imogen found herself working on an acute medical ward in the midst of the coronavirus crisis, West Midlands, United Kingdom

Coronavirus sucks. There are no two ways about it. As a doctor working on the acute medical ward, I am on the front line caring for the patients that have been most affected by this disease. We see them as they come into the hospital and must make quick and brutal decisions about whether a person should be taken to the Intensive Care Unit (ICU) if they deteriorate. A lot of the patients are already frail or have underlying health conditions – in these cases, we have to say that they will not benefit from an ICU admission. We do our best for them on the wards, treating actively where appropriate.

A lot of the time all we can do is make people comfortable. We always have to make difficult decisions for our patients; however, the crisis means we have to make tough decisions more often and earlier than we normally would. Already, we are seeing a rise in patients being treated palliatively. We have already lost a significant number of patients to this disease. It’s tough.

Being on the front line at the moment is emotionally demanding as we have to tell patients and their families, often over the phone due to visiting restrictions, that there is very little we can do for them and we anticipate they will not survive this disease. It is also physically draining as we don personal protective equipment every time we go to see our patients: the masks make it harder to breathe and the gloves and constant hand washing has made my hands crack. The masks and visors are there to protect us so we can continue to look after future patients, but it makes it feel very impersonal as we deliver bad news through a plastic sheet.

Through all of this though, I have never been more grateful for my amazing colleagues. The team spirit on the ward has strengthened as we face this together. Every day we check in with each other, asking if we are OK (and wanting a genuine answer), making each other cups of tea when upset, having team debriefings after significant events so we all have time to process what is happening. No one expected this, no one was prepared, but the resilience of people astounds me. We all continue to come to work every day and put our patients first despite the risks to ourselves. I am prouder than ever to work in the NHS alongside these incredible nurses, healthcare workers, cleaners, porters and other doctors.

How can you help to do your bit amidst this crisis? Firstly, you need to do your bit to prevent the spread of this disease. Our understanding of the disease is increasing every day, but we are still fighting it blind to some extent. We do, however, know that it is spread by droplets that can live in the air for several hours and on surfaces for up to a few days. It is, therefore, important to wash your hands, especially when food shopping or when preparing food.

Social distancing is also so important. You may not have symptoms but who knows if you are asymptomatically carrying it, or have the virus on your clothes; you might then pass it round to a friend without realising, and that friend then visits their mother and passes it on again. There is only so much we can do to stop this disease, but we can slow it down. Hospitals and Intensive Therapy Unit departments are already reaching their capacity; you need to give us a chance to cope with all the extra patients we will get. If they all come at once there simply won’t be enough staff, beds or equipment to look after everyone. We need to flatten the curve. So please stay home as much as possible, limit your food shopping and outside activity.

But sitting at home all day on your sofa can be much harder than it sounds. We all appreciate that. While we do it to protect our physical health, we must equally try to protect our mental health. While sitting at home, surrounded by the news, it is hard to think of anything other than coronavirus; it leads to high levels of anxiety, loneliness and fear. We are all feeling like this, you are not alone. Please reach out to people, call a friend, message a family member, facetime your partner. Ask someone how they are and really mean it. Try to verbalise how you are feeling and share it with a loved one. Don’t forget to let people know how much they mean to you and how grateful you are for them. I’m sure I am not the only one moved to tears by the clapping for the NHS event.

It is also important to try and detach from talking or thinking about coronavirus at least once a day. I think practising meditation or mindfulness can really help in times like this. There are lots of resources online to help with this: try a YouTube video or download an app to help guide you through it. Go on a walk or a run to make sure you are getting a bit of fresh air and a change of scenery each day. Watch your favourite TV programme or film and get engrossed in the lives of familiar characters.

I know a lot of people are particularly worried about what to do if they start to get symptoms. The advice changes all the time so I cannot give you hard and fast rules here. The main symptoms are fever and a dry cough or shortness of breath. If you are feeling these symptoms you should not leave the house. The best thing to do is visit the NHS 111 website – they are constantly updating this with the latest advice. However, if you are very short of breath and struggling to breathe, you still need to call 999. If you feel you have mild flu or cold-like symptoms then take regular paracetamol (two tablets, four times a day) and make sure you are isolating yourself, even from others in your house. If you need to share a bathroom with someone else, make sure you wipe down the surfaces with a disinfectant wipe afterwards to try and prevent passing it on.

There is a lot of conflicting advice flying around the internet about the coronavirus. I have heard a lot of rumours that are not true and not helpful. For example, please don’t start drinking extra-hot tea to ‘kill the virus before it gets to your lungs’; this will just burn your mouth! Please don’t waste your money on any ‘miracle cures’ or preventative drinks you see advertised online. These scams definitely won’t help and they may do some harm. Only trust reputable sources, i.e. the government or NHS websites. If the information comes from your friend’s cousin’s boyfriend who may or may not work in a hospital or the civil service, it is probably untrue!

Stay safe everyone, look after each other and don’t forget to have hope.

For further information

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Advice from a Junior Doctor on the NHS Front Line | Dr Imogen Heaton | #LetsResetNormal

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