Exhaustion, pride and camaraderie: a London hospital’s experience with the pandemic

When Segun Olusanya, an intensive care physician at London University College Hospital, learned of a new and highly transmissible strain of Covid-19 in November, he felt the worst form of seen already.

After more than 18 months battling the pandemic and seeing both fellow medics and patients die, he had to wonder if he could withstand yet another wave. “Every wave leaves a scar. . . so my big concern with Omicron is that this will be the scar that will make me stop?” he thought.

While London is no longer the national center of the Omicron wave, with numbers now rising in the north of England, staff in the capital continue to work hard, in part due to very high absenteeism rates among colleagues who are ill or isolate themselves from the disease.

Interviews with a series of frontline workers from UCLH, one of the capital’s largest hospital trusts, revealed a group buoyed by camaraderie and institutional pride, but permanently altered by disturbing experiences. They spoke of personal relationships deteriorated by the intense professional demands of the pandemic, and of exhaustion and burnout after being pushed to their limits.

Tensions have been exacerbated by staff shortages. The number of staff who voluntarily left the UK’s government-funded NHS rose by more than 40 per cent in the quarter ended September, compared to the previous three months, according to official data – an exodus that has left an understaffed service in bad shape. can afford.

Line chart of NHS England Covid-related staff absence* shows the number of hospital workers out of work during the Omicron wave

Amid a jumble of impressions of the peak of the outbreak, Olusanya recalled “the heat and the stickiness. . . when I remember things, I remember them through this very hazy haze of visors.” He added: “You’re trying to do a job that I’ve certainly been trained for a very, very long time, but you’re trying to do it while you wearing a spacesuit and barely hearing people, with 10 times the [usual] number of patients and try to provide the same level of care.”

At UCLH, as across the country, Omicron hasn’t filled the intensive care beds like previous types. Still, the cumulative impact has been huge for the personnel who have been fighting on the Covid frontline for so long.

“People are burning up. . . We all come here to take care of our patients, but I feel like people get to the point where they just say, ‘Oh God, I can’t bear to do it all over again,'” said Louisa Weighill , an IC physiotherapist.

Olusanya added that he loves his job and cares deeply about his patients “but no one should be forced to do something they love at the expense of themselves”.

Psychologist Anna Batho points to an entrenched NHS culture of putting the collective before the individual needs © Tom Pilston/FT

Still, there were positives: new, more collaborative ways of working have emerged, along with a culture where employees feel more free to recognize that they struggle with mental health issues and to get the support they need.

Sarah Burton, the trust’s chief cancer nurse, said: “We’re much better at checking in on people and noticing when people seem a little quiet, or said they haven’t slept well, and we tend to pick up on that.” much more and take care of each other.”

The spirit of the body who helped them get through the emergency, however, can be a double-edged sword. Anna Batho, a psychologist who works with both staff and patients in the intensive care unit, emphasizes a deep-rooted NHS culture of putting collective needs before individual needs. When colleagues ask her for help, “every time I say, ‘Have you thought about taking some time off because you’re telling me you’re having a hard time’. And they’ve said ‘but what would my team do?’”

Elaine Atkins: “I’m lucky enough to be able to come to work and interact with people. But I’m also exhausted’ © Tom Pilston/FT

All interviewees felt changed by the experience of the past 22 months. Elaine Atkins, a radiographer who now works as a “vascular access specialist,” said she has become much more anxious and so concerned for her safety that she has seen her friends only three times since the start of the pandemic. Instead, she returns to her home around the corner from the hospital after each shift, always alert for a call to return.

She emphasizes that she enjoys her role. “I’m lucky enough to be able to come to work and interact with people. But I’m also exhausted,” she says.

Batho has found that the pressures of the pandemic have forced relationships to be renegotiated. “I had friendships or relationships that ended because they didn’t want to interact with me because of where I worked,” she said, adding that “even now, with Omicron, people have canceled social arrangements” because they think I’m high risk.

Olusanya, who has combined his work in intensive care with preparing for graduation exams, describes herself as “quite broken, quite exhausted. In fact, I have to relearn how to live a normal life.”

Memories of those who have been lost are rarely far from the minds of UCLH staff. One of Burton’s most poignant moments during the pandemic was receiving her first dose of Covid vaccine. Relief that she and her family were being protected was accompanied by guilt “that I had come this far when so many other people hadn’t.”

In addition to the emotional strain on staff, the number of people whose care has been delayed, sometimes with catastrophic consequences, has been witnessed.

Olusanya remembered the first patient he saw, in another London hospital, whose condition had deteriorated to the point where life-saving surgery was no longer possible. “It is very morally troubling. . . it was someone who had their heart surgery delayed by six months and they couldn’t have it anymore because they showed up and were too sick.”

Arup Sen: ‘It’s quite difficult to deal with as a clinician’ [patients only seeking help several days after falling ill], knowing that if they had come in sooner we could have made more of a difference’ © Tom Pilston/FT

He said he and his colleagues were starting to see more and more people “with delayed presentations of heart disease, cancer and it’s so hard to keep up.”

Arup Sen, a stroke counselor, faced similar painful situations, with some patients seeking help only days after becoming ill. “They missed the time-critical period for treatment, which is usually within the first few hours,” he said. “It’s quite difficult as a clinician to deal with that, knowing that if they had come in sooner, we could have made more of a difference.”

But for all the psychological support provided to the staff, Batho believes it’s important not to “pathologize” a natural and human response to everything they’ve been through and seen. “I think in the end we don’t need so much wellness support, but more people to help. It’s trained doctors, trained nurses, trained therapists,” she said.

Her comments speak of the endemic health care workforce shortages. The NHS, which last published a detailed workforce plan in 2003, entered the pandemic with around 100,000 vacancies.

Olusanya also emphasizes the need to address recruitment and retention. “I’m still six months away from being a consultant, and right now, if I throw a rock, I’ll get a consultant job because there are vacancies everywhere,” he said, adding that while this may seem positive, ” It’s not great for me because I’m still going to work in a system without enough people to handle the slack.”

Flo Panel-Coates, chief nurse, said the trust worked hard to accommodate staff seeking a break “so they wouldn’t leave the profession”. However, she also highlighted the number who were transferred to intensive care at the height of the crisis and chose to stay: a phenomenon she calls “post-traumatic growth.”

Even as the staff comes to terms with what they’ve endured over the past two years, they all want to highlight the extraordinary rewards of their work.

Batho said: “Our teamwork was such that more people survived in our intensive care unit than died and you witness the people there and you talk to the families.

“They were the ones who showed this resilience and hope. . . As often as I talk to [my] family and friends I will say ‘you don’t realize how lucky I am to see that’.”

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