seahorse
@seahorse4000
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acute medicine doctor, reads novels to stay sane, northern
Joined November 2019
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It's so shit at work. I don't want to be a war doctor any more.
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Someone I resuscitated against really... all odds... has been discharged from hospital.
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Well, here’s wave 4.
In hot ICU we’re getting young, young and pregnant, young and disabled, unvaccinated covid deniers & (unfortunately) some older vulnerable & vaccinated.
Please stay safe.
Please go get vaccinated.
Don’t forget the decisions that led to this.
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That was a shift from a horror film
Get vaccinated, you don’t want to meet me
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"I'm 23, I didn't get vaccinated, I didn't think it would happen to me"
"I'm 70, I'm vulnerable, I've barely left my house for 18 months, I've had both vaccines, I did everything they told me to do, I've been so careful, I don't understand"
The two faces of covid right now.
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worked all the bank holidays: days, nights
it is very, very busy
everyone is very, very sick: acuity sky high
lots of covid
half the day team were off sick
ambulances queuing
quite a lot of people turning up dead, or dying shortly after arrival
... that ain't good mates.
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I can't count the number of times today I wrote "40 years old" (or 30, or 35) "fit and well, no medical history, not vaccinated"
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in the teeth of winter
total system overload
my whole family has covid 😢 but I am still working nights
over half the night team are off sick
it is not safe
it is miserable for patients
it has been so bad since July
we can only do what we can
my moral injury has a body count
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do you remember feeling mad guilty when so many people died & one of the younger doctors was crying and you took him into the kitchen to hide for a minute, you made two cups of tea and took your masks off to drink them, do you remember wondering if you should
EXCLUSIVE: No 10 staff held ‘wine-time Fridays’ throughout pandemic with Boris Johnson regularly witnessing the gatherings.
Sources say PM encouraged aides to "let off steam" despite indoor socialising being banned under lockdown rules.
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Bad shift.
Lotta flu.
Lotta covid.
Lotta pneumonia.
Very sick people.
Long waits to offload ambulances.
No beds.
No flow.
ED crammed (broke records).
Dangerously long waits and indignity pain & harm/death resulting.
Very tired & upset staff.
Post bank holiday will be even worse.
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My summer wave, so far.
-kid with PIMS-TS in multiorgan failure
-a teenage death
-kids in their 20s in ICU
-deaths of healthy unvaccinated 30 & 40 yr olds
-clinically vulnerable vaccinated patients who thought they were protected, dying (one had just got married)
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another shift like the depths of winter
how are all the alarms not flashing red right now?
man i'm tired, everyone so sick, worked 13 hours and felt so guilty leaving
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October; but we're opening the winter pressure wards.
Every (currently understaffed) ward has to contribute 1 qualified nurse and 1 unqualified to staff them.
A neighbouring hospital is bedding patients in their ambulatory clinics.
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ED is fucked.
So me and the ED reg are stood there in the middle of it, and we looked at each other like, "there must be some kinda way out of here, said the joker to the thief"
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25 covid cases in my kids school since last week
lalalala everything 's fine
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my boyfriend's mum died of covid-19 yesterday
it happened exactly like every patient I'd had over and over this terrible terrible winter
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I'm jaded as fuck, my grief cup spilled over a long time ago. The suffering washes around me like a sea
Don't get old, don't get sick, don't be poor.
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Lots of people are off sick
Senior & junior
Lots of normally mellow people being snappy, telling me they've had headaches for weeks, telling me they're scared of coming to work
We're not robots
It's been relentless for ages
We know the public are angry & scared too
Winter to come
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September
65 in ED at 8am
15 waiting for medical beds
further 15 on medical unit waiting for drs
night team hammered
no beds in hospital
I was in ambulatory care seeing patients direct from ambulances to try and keep beds free
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An increasingly standard shift:
We tried to shut ED overnight due to patient volume / safety, this is a last-resort thing to do; but we can't divert, because all the other hospitals are in the same position, so there are over 100 patients in ED
Ops managers pacing
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So now it can take over a day to get an ambulance, and two days to get a hospital bed, and thousands are dying as a direct result, can we say the nhs is overwhelmed, or do we still have to pretend it’s fiiiiine
Thousands of people could be dying waiting for ambulances or because of long waits on trolleys in A&E. While
@sajidjavid
talks about elective backlogs, emergency care in the NHS is collapsing. Today's
@thesundaytimes
report here:
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Absolutely overrun with covid, 2nd icu full of covid, converting theatres to a 3rd covid icu
Begging for mutual aid
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we rant, laugh at the awfulness, do pretty dramatic things in resus, have nowhere to park, miss breaks, snatch 5am cuppas in ICU or the back of resus, have breaking old equipment & don't get me started on the computers, do our best, cry on the drive home & make very black jokes
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I had to go to IT dept and there was a small room of 20 people no one was wearing any masks. I goggled at this, and they were like, "oh we don't have to any more, don't know how you cope all day"
....!!!
Covid ICU a stone's throw away...!! more covid patients died on my shift!
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when it’s 0745 on your last night shift and you’ve kept the hospital’s head above water (just) all week and everyone is bonkers sick but handover is at 0800
NOBODY DO ANYTHING INTERESTING
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some of the unvaccinated people who told us they didn't believe covid was real or serious are dying now, and some of the others who said the same are not quite as sick yet, and not fully sedated, and by no means out of the woods, and are in the same bay, and can see it all 😣
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just fyi
I immediately block anti-vaxxers
and from now on will also immediately block people slagging off GPs
solidarity to primary care who are weathering a hell of a storm
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I rekcon COVID is a 10 level game. Lots of people thought it would be a 1 level game.
I think we're on about level 6.
Level 6: Variants
Can I select a different government to play as?
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1. if you're pregnant, please please please get vaccinated, too much sadness
2. can we vaccinate the teens a bit faster and all
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not waving but drowning: so I hit a wall, having few days off but I'll go again, I've not given up but my PTSD is bad, working conditions are shit, the situation feels unending, I have too much cumulative grief and my mum has just tested positive for covid
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Bay A: pt tests positive for covid (on routine 2nd swab, admission swab was negative). Needs to be moved to side room or covid ward. 5 pts are exposed, need retesting. No one can be admitted to this bay
Bay B same day: oh look, same bloody story
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@BBCPolitics
Hi, this is what was happening at the end of shifts, thanks
At the end of their shift, as I arrive, one of the night doctors tells me that nine patients died overnight and they can't face going to handover, can they just go home now
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My boyfriend didn't see his mum at christmas because that was against the rules, and then a month later she caught & rapidly died of covid and he said goodbye over facetime. We had a tiny masked funeral. He is struggling now, with christmas approaching again.
And they laugh.
EXCLUSIVE: Video obtained by ITV News shows Downing Street staff joking about a Christmas party on 18th December last year.
No 10 has spent the past week denying any rules were broken. This new evidence calls that into question.
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It feels like disaster medicine. I can do it but I don't know for how long, I feel like I'm gonna need chunks of time off to do this long term. I worry about the new doctors.
My skin has gone to shit with FFP3. Exhausted but can't sleep.
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A long shift in PPE in the summer is complete shit, by the way!
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The junior doctors seem to think it's their fault. It feels like it's your fault when you're there. Some are staying 2 hrs late after 13 hr shifts, they can't bear to leave. Half a day team, half a night team, last men standing
Poor junior docs.
I leave, so I can come back.
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the hardest part is walking from the carpark to handover
if you're nhs, you know
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There is a lot of staff sickness and I get asked to work extras every shift. I work my shifts but rarely extras because I am totally knackered after 18 months of this, and I feel permanently guilty.
This does not feel like a strong position to enter autumn.
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If I get sacked I'll sleep for a month then sort out that ice cream selling business my kid wants me to do instead of being a doctor
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everyone is so sick
we go on divert, again
resus is full, again
ambulances are stacked, again
I have compassion fatigue
I feel nothing when people die
I phone/bleep my juniors a lot and tell them things aren't their fault
I am simmering fury in morning handover
I am very tired
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-meanwhile ED at record attendances. Medicine with record admissions. 100mph every day. Mainly non covid but covid adds pressure too.
-Every morning: no beds. Ambulances queueing.
-not-quite-joking discussions of when do we start putting up tents outside ED?
-This is August.
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Patients came to ED on sunday and I saw them early monday morning and tuesday night they were still there, waiting for beds
Sick patients, who need specialist input and procedures and and and. In corners of ED
On Tuesday we opened another winter pressures ward. It's April
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6 hours after going home from my last 13 hour night shift, after a week of day and night shifts, I got a very polite & desperate message asking if there was any chance I could come back in to work some extra hours?
I think this is a new record...
*mutes all whatsapp groups*
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It only took 13.5 yrs and 28 jobs and being pregnant & breastfeeding on an SHO rota and beating childhood cancer and a lil pandemic and >20 sessions of EMDR but
CCT ✅
Substantive consultant post ✅
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-the worst ever patient journey, from angrily arguing with us in ED that they don't believe in covid, to CPAP, to ICU, to ventilation, to death, those wretched family phone calls
-tears and panic attacks and anger (staff). Hugs too
-PPE in a heatwave is shit
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There’s a lot of abuse to staff at work and it’s not good.
Also:
A doctor I know has had a written complaint put in to PALS saying that they are a lizard. They do not yet know if they have to respond.
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Double vaccinated covid was a rarity in July but it's not now
Someone dies of covid every shift, usually weeks after admission
There are sick children with covid on the children's ward
We've had sick prem babies on neonates after early sections to save mum on ICU with covid
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@RhonddaBryant
We absolutely did nothing of the sort
We did not even sit near each other in the staff room
Several people did not go home to their families or sent their families elsewhere to protect them
I used to scrub every inch of everything after every shift before I let my kids touch me
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Seeing working age people with long covid who have nothing I can treat but are too breathless & tired to function or work, waiting for long covid clinic appointments. Confused & angry 45 yr old plasterers and busdrivers, "never been sick in my life" types
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ED and medicine remain significantly busier than the worst winter crisis I've ever seen. The entire system is overloading.
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-ICU full to winter levels and higher than 1st wave levels
-"non clinical transfers" from ICU to other hospitals (ie we've got no space! help!)
-the covid wards open again
-some more covid cardiac arrests, they don't survive
-readmitted patients who we thought were getting better
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-very sick unvaccinated pregnant women
-early sections to try and help pregnant women with covid survive
-lots of covid + pneumothorax!
-surgical emphysema like a horror film, faces and chest blown up
-january covid patient readmitted, deteriorating, now needing heart transplant
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Where I draw solace
There was better staffing the night after I massively kicked off at morning handover
Jaded A&E regs who give me cups of tea and black jokes in between the battles
Excellent brave and hardworking junior doctors who have only ever known it to be like this
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Thread:
When I ask if they're ok, about half of nurses and doctors casually describe ptsd-ish symptoms to me (insomnia, anger, distress, intrusive thoughts, panic attacks, sleeping pills)
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I thought I was over this but I'm furious all over again and having a fucking ton of memories hit me.
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At the gates of winter:
Volume & acuity are sky high. Covid remains a significant pressure, 5 months into this wave.
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It's been 100mph for ages now
Some coffee on the go, black humour, bumping into mates in corridors, that's how you get through
As you leave the begging messages start, can you stay for some extra hours
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if you want to know what’s really happening in a hospital, ask the med reg
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If my hospital were a patient, I'd describe it as "critically unwell but stable" right now.
This is better than "peri-arrest", which is where we could have been heading 3 wks ago.
We're admitting as many covid patients as die or we discharge. ICU is half covid. It's holding.
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flu jabbed in one arm, covid boosted in the other, you wanna come at me viruses?? YOU WANT SOME?
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The best thing I did last week was take 5 mins to dash and buy a cake for my patient because he'd been admitted to hospital on his birthday. We sang him happy birthday (masked & distanced). He was 93 and looked so chuffed.
He's not got covid. I hope he'll go home.
/end
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People always ask me, is it covid? Well it's not mainly covid coming in, but there's enough; & it's not stopping, & covid tangles everything - infection control, staff off with covid, staff off with kids with covid, the grim horror of the covid wards, still/always half of ICU.
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When ED is already a derailed train, on fire, going over a cliff, & over the course of a single shift it turns from a line of covid cubicles to half the dept a hot zone, oh & they cancel all hospital visiting midshift again, that kinda messes with my ptsd tbh
Round 6?
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@clairabellejp
GPs have always seen patients, as well as doing telephone/online consultations. We are 1000s of GPs short, they are overwhelmed
But this is not due to GPs. This is social care collapse plus exit block plus staffing crisis plus pandemic
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Immediately after going viral, I make a coffee, take a breath and do a quick block session of twats
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I've now been off work with covid for over 4 weeks (apart from attempting a few night shifts where I spent large chunks lying on a trolley)
I mean it was good I didn't catch it until now despite all the waves I've worked, but this is really shit.
I really hope I get better.
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We're here lads, and it breaks my heart
Have you ever wondered what the collapse of the NHS would actually look like? It's in the small things - my latest
@Independent
newsletter:
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@MichaelRosenYes
People have been helpfully telling me their sister works in the NHS and the hospitals are empty, when I'm just home from a shift where we have minus 15 beds to start the night
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new med reg bleep: duty radiology called me hopping mad because "the surgeons are lying to my face" "listen to this am i going crazy" "I have to tell someone"
is it lonely in radiology at 3am... come to the AMU office if you can stand the light...
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All teaching/training cancelled until further notice
You apologise to every pt you see for their 16 hr wait. Falling asleep in chairs. Or in pain, angry
Even in the designated "cold" assessment area, a good chunk of patients were in with post-covid problems
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Dear Santa, for Christmas I'd quite like to be able to vaccinate my kids
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Running on empty
Grief at home
Grief at work
A&E: breaking, not safe
covid wards: still grim as fuck
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last week I was angry, but now I'm just sad, exhausted & sad
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you know what? I can't enjoy this. I am just seeing all the begging faces again, the gripping hands, I am just counting out the damage to my own mental and physical health, my family, the funeral
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Winter, full throttle
No beds
Lots of covid (again)
Lots and lots of deaths for me recently which every doctor has sometimes but it is so tough when you have a run of it
PTSD like a wolf at the door
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Did one day in a "cold" clinic, it was like a weird relief. I was telling some wild stories about my usual job. I randomly started crying about the winter at one point and all the nurses hugged me and started shouting at each other "this is what the public don't see!"
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@joncstone
I remember this, it was framed like this woman was unemployed, when actually she had a full time job
BBC was forced to apologise
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Like a mug, I have agreed to switch from day shifts to night shifts this weekend as both are short but the night team way more so. Gaps/sickness. So many gaps and sickness. I can do a night shift practically on my own I'm sure... I mean I'm the fucking med reg
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Trying to ignore the gaslighting and rewriting of pandemic history
Some of us were there, you know.
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... Resus calls. Horrendously sick covid patients coming in. One dies in resus. ICU creaking at the seams.
Covid inpatients have doubled in the last fortnight. Everything's FINE...
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@danbloom1
Stop using pictures of people relaxing on the beach to illustrate 40 degree heat.
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the flashbacks are bothering me again, and I guess I'm adding some new ones too... I can keep going, and it's not about me, but it sucks.
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so I am having trauma counselling which i am finding brutal
then EMDR
and I have come off the oncall rota for a few weeks while I do this
so I'm still at work but not doing - the howling heart of it
it's never been more broken & we have no doctors
feel shit about myself tbh
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clinically vulnerable people are also coming to ICU with covid despite double vaccines, some of them are dying too
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I just think people have no idea
Emergency care was starting to creak before covid - but that was nothing compared to now
Including new figures for Nov...
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There have been serious incidents in backs of ambulances, waiting.
Saw a patient who had waited 12 hours to see a doctor in another hospital then given up gone home, family dragged her into our hospital, finally saw her after another 9 hours. She was sick.
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Could have basically written this statement
'My worst day was losing eight patients in one shift. I cried for two days'
Heart-breaking testimony from NHS staff at the Covid Inquiry.
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Whole families in hospital with covid, scattered across wards.
A crying old lady on the ward round today.
"I don't know how we caught it we were so careful all year"
"I know my husband's going to die, but please save my son"
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@Femi_Sorry
"Are you going to break international law"
"Yes"
Great to be led by a group of criminals. Our global reputation is doing well right now isn't it...
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"it's ok they're asymptomatic and vaccinated" - in cubicle C was a frail patient admitted for something completely different and benign. Awaiting discharge for social reasons. Tested positive, documented as "asymptomatic covid". But on oxygen a few days later. Then died.
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hi
I'm all better from covid, but 2 months of that wasn't fun.
I'm not all better from ptsd, but working on it.
The hospital is worse than any winter. It's tiring.
Nothing witty to say.
The boy, the kids, mates, keep me going.
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