Consultant Dr Irene McEleavy talks about her role caring for intensive care patients during the pandemic
The thing I love most about my role is being able to help the sickest patients and be that fixer and supportive figure who travels around almost every ward and sees every type of patient young or old.
I’ve been a Consultant at Northumbria Healthcare for around 7 years and my time is usually split between Intensive Care and Anaesthetics.
This year has been very different with the challenge of a new global pandemic that has impacted on almost everyone in the NHS, but none more than the teams in intensive care and respiratory medicine.
As a clinical team I think we’ve moved away from that initial fear of Covid19, because we’ve been treating patients for so long now. In the first wave staff were scared because it was something new, something that we might catch at work but also we all have families at home as well, so there was that fear of taking it home with you.
Like everyone else it’s tough for our staff not seeing an end point where we can go back to normal life and do things like booking foreign holidays or seeing relatives.
What is really difficult for us – and heart breaking at times – is the way we have to inform families when things aren’t going well. We don’t have the same opportunity to build relationships with families or explain over time what’s happening to their loved ones because of all the restrictions.
Doing this part of our job over the phone or by video conference is not the same and is often upsetting for staff and the families of patients.
Patients are able to use ipads and lots of other ways of communicating but it’s still not the same as seeing their families every day.
It’s difficult to convey how patients are doing over the phone and people are not seeing their family members deteriorate or improve because they’re not visiting, so as doctors or nurses we have to tell them and it comes as much more of a shock.
As clinicians we’re now having to play multiple roles because we’re also the relative and friend to these patients who are in ITU. Often patients will be too breathless to even tell you what they want or how they feel.
Pre-covid the average length of stay was probably around 3 days but now people can be here for 3 or 4 weeks plus time back on a hospital ward afterwards. The danger now is that this takes up a huge chunk of NHS resource as we move into winter which is always busier anyway.
I’m finding that patients can be scared and lonely and it’s difficult to comfort them in the way we usually would. It’s still pretty strange on the unit at the moment because everyone is walking around in full PPE which makes it hard to tell us apart.
One big difference about this condition is that many patients are on CPAP machines that help them breathe but are otherwise awake and lucid. They’re very aware of what’s happening to them and reading the news or seeing things about Covid19 deaths on their phones which can add to the stress.
On a brighter note we now have a wider mix of drugs and treatments for patients so we’re much more optimistic than we were in the first wave.
One important thing to point out is that it’s not just older people who are getting Covid and in this second wave we’re getting younger people who need treatment on ITU.
While the risk factors have been well publicised, trying to stay fit and well, lose weight and lower blood pressure will hugely improve your chances of recovering quickly if you do catch Covid19.
While they’re with us patients get a diary filled out by clinical staff to help them recover psychologically and come to terms with what’s happened to them. This often helps the staff as much as the patients because any stay in ITU can be traumatic especially for people who need life-saving ventilation.
During the first wave we saw a big rise in out of hospital cardiac arrests which is very unusual and I’ve also noticed an increase in mental health problems, suicide attempts and acute liver disease caused by drinking excess alcohol.
We’ve got lots of plans in place to deal with the growing numbers including expanding the ITU into the surgical area of the hospital if needed.
The key thing is that the NHS is still here for you and we can all do our bit to protect each other by getting the flu jab if you’re in the eligible group, wearing a mask, socially distancing and washing your hands regularly.