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  • Richard Cree

Ruling the Roost

Tuesday 9th June 2020

Figures for 8th June

UK COVID Deaths 55 / Total 40,597

James Cook Hospital – Total COVID deaths – 245

All COVID cases within South Tees Hospitals Trust – 28

James Cook Critical Care COVID cases – 3 / 1 ventilated

James Cook Critical Care non-COVID cases – 37 / 17 ventilated

Today was my first day back at work. I was surprised at how little I enjoyed getting up early again although it was nice to ride my bike into work in the sunshine.

I arrived in time for the morning handover to find the room had been ‘social-distanced’. This meant big green tape squares had been placed on the carpet at two metre intervals to ensure we all keep apart. It looked like a giant’s game of Twister. The end result was that we unfortunately couldn’t all fit into the room.

Over the past couple of months we have managed to obey socially-distancing as much as we could. Initially we had so many members of staff working within Critical Care that it wasn’t always possible. We have all been wearing surgical masks to minimise virus transmission when in the same area together but there has been even more emphasis placed on this recently. The government have announced that all NHS staff must wear facemasks from 15th June unless in those areas designated as a ‘COVID-secure workplace’.

Now, as I understand it, this means keeping staff two metres apart, organising seating areas appropriately, having handwashing facilities and disposable tissues available and displaying appropriate literature to educate staff on handwashing. Hopefully by now, none of our staff need to learn how to wash their hands and the only standard we haven’t been achieving all the time is the 2 metre distancing, hence the big green squares.

I was looking after one of the non-COVID ICUs today which made for a refreshing change. For the past couple of months I have been spending most of my time looking after the COVID patients. During the first few weeks, this was inevitable as this was the lion’s share of the ICU workload, but as time went on I had become conscious of the fact that I was choosing to work in the COVID units wherever possible. Part of this was in order to gain more experience of treating COVID cases but I also wanted to find out how these patients were getting on over the weeks that they were spending with us.

In contrast, my patients today had a variety of problems that necessitated them being in Critical Care. These included meningitis, cholecystitis, pneumonia, spinal cord injury, heart failure, drug side-effects, ischaemic bowl, muscular dystrophy, drug overdoses and a traumatic brain injury. Looking after patients with such problems seemed strangely familiar and almost comforting after the uncertainty that has surrounded some of the COVID-19 cases.

As usual, due to new admissions we were beginning to use up all our available beds by the afternoon. The focus therefore shifted to trying to get those patients who have improved and no longer need ICU discharged to a ward to create space for the new ones. Bed management is one of the most frustrating things associated with operating any Critical Care department, and I began to realise how little I’d missed it during the course of the outbreak. During this time, juggling beds was less of a problem as our non-COVID numbers were low and we had generated so much extra capacity that we nearly always managed to find a bed for a COVID patient very quickly.

Later in the day I dropped into the ICU coffee-room. I found Sister Pugh arranging chairs in order to provide socially-distant refreshment facilities. It’s hard to eat your lunch through a surgical mask so the two-metre rule is important here. Janet looked pleased to see me but it turns out that she simply wanted to use me as a ruler as she didn’t have a tape-measure. I’m two metres tall and so she asked whether I could lie down in between the chairs so she could make sure she had placed them appropriately apart. I avoided this indignation by using my arm span (which is roughly the same as my height) instead. Despite all those years of medical training it would appear that all I’m good for is being some sort of ‘COVID-secure’ yardstick.

It’s good to be back…

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