Wednesday, January 26

As a Melbourne ER doctor during the delta wave, I can only function in survival mode for so long | Junior Emergency Physician


It was no surprise that working as a junior physician in the emergency department of a Melbourne hospital during a pandemic comes with challenges.

Covid-19 will be one of the greatest challenges of our generation, but despite pleas to politicians and the public to do everything possible to help us safely overcome the pandemic, there are new reminders at every turn that the coronavirus will continue to wreak havoc on our jobs and lives.

I find the time before going to work to be the most difficult. Even with free time to take a walk in the sun or phone an interstate friend, the fear that settles in my chest before I get to the hospital is unshakable.

Once there, we contacted each other and asked how we are doing, but we already know the answer. Our resilience is running low when lockdown means that many of the things we do to recover and recharge are off limits. But work gives us purpose, so we put our pain aside, put on our N95 masks, and hit the ground.

Waiting times have been extended to unreasonable hours and the list of patients to be seen sometimes exceeds the length of the computer screen. Tensions are high, but due to the blockage of access, there is no appropriate place to assess or examine patients, so we hope that no one still on an ambulance gurney in the corridor will deteriorate acutely while waiting for a cubicle.

Without space, we are temporarily paralyzed by inaction, helpless in the face of the overwhelmed hospital system.

The things I used to love about my job – connecting with and diagnosing patients, working efficiently with the hospital team, being able to reassure and comfort patients at their most vulnerable time – don’t happen as much as they used to.

And yet connecting with patients often means that they share how deeply they have been affected by blockages with deteriorating mental and physical health. My goggles fog up with excitement because there isn’t much comfort to offer; we are all fighting too.

Months after this current wave of cases, it is devastating to see the damaging effect that misinformation and ineffective public health communication have had on our vulnerable communities.

I go over the common questions on the checklist: “Have you or anyone in your household ever had any respiratory symptoms or been to an exposure site?” and “Have you been vaccinated against Covid?”

Both questions are answered so often with “Don’t worry, I’m never going anywhere. “

But this cannot be true: the virus is spreading and no one is so isolated as to have no family, a job, or even receive grocery deliveries. The mere fact that they are in the emergency department now shows that sometimes you have to leave home and the risk of encountering Covid in an unexpected way increases every week.

It is heartbreaking to have to inform a patient that although he has come to an emergency for help for something unrelated to Covid, unfortunately the patient in some cubicles down the hall has tested positive, so now they are a close contact and need to isolate themselves. serious discomfort, as well as a source of uncertainty, anxiety and fear.

The emergency department is no longer always the safe place it should be, and I empathize when this discovery is met with anger and frustration. I am also concerned that despite long conversations, sometimes with an interpreter, my patient and I are out of step with understanding the urgency of getting vaccinated, getting tested early, and the potential harms of the spread of Covid in our community.

People expect things to reopen and their lives to get back to normal, but I find it difficult to feel optimistic when there is no roadmap to regain the safety of our healthcare system.

There is a lot of pressure on emergency physicians who are forced to take more risks and uncertainty with each shift. There is so much guilt when colleagues have to call to report that they are ill, knowing the greater pressure this will put on our colleagues.

As a team, we are committed to keeping our doors open and providing the best possible care to those in need, and we are no strangers to hard work. But we are not an inexhaustible resource and we can only function in survival mode for a while.


www.theguardian.com

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