• Richard Cree

Private Patient

Figures for 4th June

UK COVID Deaths 357 / Total 40,261

James Cook Hospital – Total COVID deaths – 241

All COVID cases within South Tees Hospitals Trust – 23

James Cook Critical Care COVID cases – 2 / 2 ventilated

James Cook Critical Care non-COVID cases – 41 / 15 ventilated

I’m still enjoying my staycation with the family although have been a little overwhelmed about just how much stuff needs doing around the house. Mostly, this is due to us having been unable to or wanting to focus on much other than work over the past two months. The change in weather hasn’t helped as I now don’t have an excuse for not staying inside and getting on with it.

I'm not going to dwell on the fact that we have now reached the unenviable official milestone of 40,000 confirmed deaths due to COVID-19. I shall try to divert attention from this with an entertaining story.

I came across something the other day that I thought you might find amusing. It’s a communication flash card that I kept when they were being thrown out.

When our ICU patients are being ventilated they require the balloon cuff on their breathing tube or tracheostomy to be inflated. This allows the pressure from the ventilator to inflate their chest properly but effectively seals off their vocal cords and mouth from their lungs. This means you can’t talk.

This can obviously make communication very difficult. Patients can still try to mouth words but our lip-reading skills are very poor, especially when the patient is very weak. Sometimes we get the patient to write down what they are trying to say on a small whiteboard but this is often difficult. Your handwriting is never at its best when you are critically ill and so trying to decipher writing that looks like the death throes of a dying spider is taxing. The other problem is that the patients are sometimes confused when they are emerging from their induced comas and this can make it impossible for us to interpret what they have written or are trying to say.

In the past, we have had communication flash cards with pictures on which have sometimes been useful. The patient would select the card that has a picture of someone drinking and show it to the nurse if they were thirsty. There would be cards for all sorts of requests like ‘I’d like to get back into bed’, ‘I’m tired and would like to sleep’ or ‘can you turn the radio on/off’.

However, these are not always as helpful as you might think. I remember a few years ago, one of the patients trying to ask me something on an evening ward round. After a few minutes of increasing frustration at my lack of understanding, he shuffled through the flash cards and thrust the following one at me:

I turned to Sister and asked if this was a private patient? She looked puzzled. I explained that the gentleman appeared to be asking for a Martini but without an olive. Sister shook her head, sighed deeply, took the card from my hand and turned it upside down before returning it to me. She then smiled and nodded at the patient before leaning over and turning off his bedside lamp…

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