04-01-2021, 08:30 PM
This account is of life in the JR Hospital Oxford. It has already been posted on Facebook, so I'm not breaking any rules by posting on here. Let me add that this account was not penned by my daughter, but a close colleague of hers.
On the 11th of December, the respiratory ward on the hospital had 12 patients, some COVID-19 positive, some with other illnesses. During the following week, the cases started to increase until the whole 12 beds available became full with COVID-19 positive patients.
On the 21st December, the decision to increase the number of beds to 16 was made. Somewhere around Christmas time, can't remember the day, that number increased to 20.
A few days ago, we were told about the plan to increase the number of beds to 25, meaning we'd open 5 more beds for patients with COVID-19.
Yesterday those beds were open and we were told that no more than 5 would be opened because it would be unsafe for the respiratory staff. We ended the day opening 5 more beds, increasing our total capacity from 25 to 30 beds. 30 beds distributed across two wards on two different floors.
The patients keep on coming and they are on CPAP, Airvo or wall CPAP. If you don't know what those things are, I suggest you look on Google images. Two of these treatments require a mask on you face that is worst than the normal surgical mask that we are required to use. Patients come and we put that mask on them, and they refuse and don't tolerate it. Which is ironic, considering that's the same treatment that can save their lives. Wall CPAP on 15cmH2O, 100% of oxygen with 70L of flow rate are the max settings and the last treatment before being transferred to ICU, if you get there. Because ICU is so full that we are selecting the patients with the most capability of surviving it. It's very sad having to escalate a patient because he's deteriorating, and hearing the doctor on the other side of the phone asking me the age of the patient and saying that someone will come to review, but there are no beds in ICU, so if the patient is already on max treatment, that's all we can do for them. And I can't imagine the doctor's role in this, having to go inside the rooms and explaining to the patient or to their families on the phone why ICU thinks they're not a very good candidate for surviving.
For me, this sounds like the nightmare I hoped I wouldn't go through again, and the news say that some hospitals are worst than we are at the moment.
We've been doing this for a few days on full capacity now and I don't know how long we're going to be able to do it or how much more they are going to push us. Because we've done it before and we know how much it takes. Because we've done it before and this time is worst. Worst because there are more admissions than the first wave. Worst because we were caught out of the blue and the hospital was not at all prepared. Worst because the people outside don't seem to care. I see people having parties indoors with people that do not live with them and shouldn't be there without any mask or social distance. I know we are tired and are all craving human contact and the reality from before. We are admitting younger people every day. We have people on their 30's and 40's being admitted to us. This past week, we admitted a teenager. When they come to the respiratory ward, they're way past using a nasal cannula. They're on Venturi mask 60% at 15L of oxygen or on a non-rebreather mask. And we'll change them to Airvo or to CPAP as soon as they arrive.
And they normally stay with us for about a week. Some more, some less. And they have three possible outcomes: they get better and are transferred to a medical ward, they get worse and the team decides to transfer them to ICU or they get worse and we actively treat but the patient is now NFR (not for resuscitation) and has a EOL package (end of life) pending, waiting further deterioration to be initiated. And, as much as we are struggling now, we haven't received yet the patients that got contaminated during Christmas time.
We were told that this will be a marathon and not a sprint, but we are running on our feet every day, admitting more patients, transferring to make space for the ones who need the most, attending to bells and alarms to increase oxygen on the ones that are already there. Every week day shift and weekend day shift is the same, every day and night shift is the same now, apart from the light outside telling us the difference. It's a marathon but we are running around like it's a sprint and I wonder until when can we keep this rhythm going.
This is the reality that did not end with the 31st of December. So to everyone wishing a different 2021, remember that you can make the difference by staying at home and wearing a mask when we have to go outside. Please follow the rules.
On the 11th of December, the respiratory ward on the hospital had 12 patients, some COVID-19 positive, some with other illnesses. During the following week, the cases started to increase until the whole 12 beds available became full with COVID-19 positive patients.
On the 21st December, the decision to increase the number of beds to 16 was made. Somewhere around Christmas time, can't remember the day, that number increased to 20.
A few days ago, we were told about the plan to increase the number of beds to 25, meaning we'd open 5 more beds for patients with COVID-19.
Yesterday those beds were open and we were told that no more than 5 would be opened because it would be unsafe for the respiratory staff. We ended the day opening 5 more beds, increasing our total capacity from 25 to 30 beds. 30 beds distributed across two wards on two different floors.
The patients keep on coming and they are on CPAP, Airvo or wall CPAP. If you don't know what those things are, I suggest you look on Google images. Two of these treatments require a mask on you face that is worst than the normal surgical mask that we are required to use. Patients come and we put that mask on them, and they refuse and don't tolerate it. Which is ironic, considering that's the same treatment that can save their lives. Wall CPAP on 15cmH2O, 100% of oxygen with 70L of flow rate are the max settings and the last treatment before being transferred to ICU, if you get there. Because ICU is so full that we are selecting the patients with the most capability of surviving it. It's very sad having to escalate a patient because he's deteriorating, and hearing the doctor on the other side of the phone asking me the age of the patient and saying that someone will come to review, but there are no beds in ICU, so if the patient is already on max treatment, that's all we can do for them. And I can't imagine the doctor's role in this, having to go inside the rooms and explaining to the patient or to their families on the phone why ICU thinks they're not a very good candidate for surviving.
For me, this sounds like the nightmare I hoped I wouldn't go through again, and the news say that some hospitals are worst than we are at the moment.
We've been doing this for a few days on full capacity now and I don't know how long we're going to be able to do it or how much more they are going to push us. Because we've done it before and we know how much it takes. Because we've done it before and this time is worst. Worst because there are more admissions than the first wave. Worst because we were caught out of the blue and the hospital was not at all prepared. Worst because the people outside don't seem to care. I see people having parties indoors with people that do not live with them and shouldn't be there without any mask or social distance. I know we are tired and are all craving human contact and the reality from before. We are admitting younger people every day. We have people on their 30's and 40's being admitted to us. This past week, we admitted a teenager. When they come to the respiratory ward, they're way past using a nasal cannula. They're on Venturi mask 60% at 15L of oxygen or on a non-rebreather mask. And we'll change them to Airvo or to CPAP as soon as they arrive.
And they normally stay with us for about a week. Some more, some less. And they have three possible outcomes: they get better and are transferred to a medical ward, they get worse and the team decides to transfer them to ICU or they get worse and we actively treat but the patient is now NFR (not for resuscitation) and has a EOL package (end of life) pending, waiting further deterioration to be initiated. And, as much as we are struggling now, we haven't received yet the patients that got contaminated during Christmas time.
We were told that this will be a marathon and not a sprint, but we are running on our feet every day, admitting more patients, transferring to make space for the ones who need the most, attending to bells and alarms to increase oxygen on the ones that are already there. Every week day shift and weekend day shift is the same, every day and night shift is the same now, apart from the light outside telling us the difference. It's a marathon but we are running around like it's a sprint and I wonder until when can we keep this rhythm going.
This is the reality that did not end with the 31st of December. So to everyone wishing a different 2021, remember that you can make the difference by staying at home and wearing a mask when we have to go outside. Please follow the rules.
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