Consultant praises teams at the frontline of battle against coronavirus pandemic
PUBLISHED: 06:00 09 April 2020 | UPDATED: 10:51 09 April 2020
A consultant has described the “phenomenal” efforts of staff working in Norfolk’s intensive care wards supporting patients with coronavirus.
Dr Deborah Easby is based at the Norfolk and Norwich University Hospital and has given an insight into the work going on at the very frontline of the battle against the epidemic which has already led to more than 7000 people dying across the UK.
To cope with the number of coronavirus patients requiring intensive care, the NNUH has created a second critical care unit with 20 beds to look after those requiring high dependency or intensive care.
This is alongside 14 general intensive beds, as the hospital continues to treat patients who need care but have no symptoms.
Currently 84 patients are being treated for the virus, 16pc of hospital beds available, and seven of which are being treated in ICU at the moment.
There have been 30 confirmed deaths as of April 8 while 39 patients have recovered and released home.
The intensive care units (ICU) are overseen by four consultants, one seeing all the referrals, another covering the intensive care end, a third looking after the high dependency end of the yellow covid zone and the final consultant runs the green zone for non-cornaviurs patients.
While in the yellow zone, staff must wear protective personal equipment (PPE) and not leave the zone.
Read more: Norfolk and Norwich University Hospital opens second emergency department
Dr Easby said: “The one big difference is working in PPE, when you are in that yellow zone it is like sensory deprivation, you can’t hear each other as well, you can’t speak as clearly, it’s very hot.
“You can’t see as well as you normally would, it’s really hard work, it changes the way you work and the way you communicate and makes doing procedures more difficult and also we are trying to be careful with the amount of PPE we use so you trying to make sure you stay in for a period of time. The nursing staff are being absolutely phenomenal it is incredibly hard work for them doing a 12 hour shift in PPE.”
Patients being treated will either require help with their breathing through non-invasive ventilation such as a mask or hood to ensure they are getting enough oxygen to their blood or in the most serious cases, needing to put a patient to sleep to use a breathing machine.
She said working on ICU still remained the same in many ways apart from an increase in the number of people such bad respiratory illness at once.
The doctor explained putting a patient onto a ventilator is not something to be taken lightly.
Dr Easby said: “I think probably the hardest thing for people to understand is being on a ventilator doesn’t make you better. Being put to sleep and having a tube put down that in itself causes damage to the lungs but what it does oxygenates you and buys you time for your body to try and heal itself. Normally for a patient you put them on a ventilator if they have a bacterial pneumonia then the ventilator would be supporting them while the antibiotics kick in and their bodies own immune response kicked in. But for Covid-19 it is keeping you alive while you’re body heals itself. That sheer stresses of the ventilation causes damage to the lungs at the same time. It is a really serious step it is not to be taken lightly and something I think we have to only do it to people we think we can get better from this.”
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To reduce the spread of the virus, tighter restrictions are in place on the ward, with family members unable to visit, presenting some of the hardest challenges for staff.
Dr Easby said: “You know they cannot see their families and you have that opportunity to take a message from them. It depends if the patient will want them to phone the family before or after they have been put to sleep but often you are taking messages from that patient to their family, or from the family back to the patient, and you know that you saying to them ‘so-and-so says I love you’, and it might be the last time they hear that and that has come via you. I think that is quite hard, knowing you might be the last person and it has not been their loved one, at least you have been able to take them a message through. It’s not the normal set of circumstances and the loved ones can’t come and sit with them.
“I pride myself in the way I speak to relatives and I take time with them and when it comes to the point where I can no longer save a patient the thing I can do is be very kind and be understanding and take time with their relatives to explain things to them and help them come to terms with it. And it’s very hard I can no longer do that face to face with relatives and if we can we go outside the unit and we speak quietly on the phone but sometimes it necessitates we are sat shouting down the phone in PPE and that’s really hard, that’s a really different set of circumstances.”
But she said there are many positives such as patients recovering, staff support and donations from businesses and the community.
Dr Easby said: “We have seen patients not make it and we have seen patients get back to the ward we are always really pleased when we see a patient get back to the ward and that is quite heartening.
The thing is we have been through a lot as a team already. We see the worst of what happens in life and in a way in the team we have been through a lot, this is a step up but we have got a fantastic team.
“I think it is really hard for everyone thinking am I going to take this home to my family? I think that is always a worry particularly if people have loved ones that they are concerned about at home. You wear your PPE you do everything the best you can and you have to remember for the majority of people it will be a mild illness but it is so contagious and the sheer volume of people getting it means we are getting large volumes of people are getting very sick.”
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To offer support working in the ward, the consulting team have been staying in the hospital for a four day period to reassure nursing and junior team.
But, even when they do walk through their front doors, there is much discussion going on to implement ever developing plans in the department.
The doctor said: “I’m afraid I have two young kids so when I come home it’s “mummy we have missed you”. Jumping on me and cuddling me and that the way is. That’s a balance even though I am not in work today I have still had a teams consultant meeting I have still dealt with concerns from the trainees because I manage the trainees. I do a lot of wellbeing work so I have been doing that, everything is changing, guidelines are changing, the ways we work is changing there is a huge amount of work in the background to do that and keep that working.”
Dr Easby said staff and bed numbers continue to increase everyday with further capacity to expand as they need to treat patients.
She added though it was hard to tell Norfolk has not yet been as badly affected as other areas in the east of England or London.
The doctor said; “Our demand is within what we are used to coping with at the moment but it may be that as it spread further in London before the lockdown we are not quite seeing the surge of numbers as quickly as they saw in London, we hope is helping but it is really hard to say.”
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