It wasn’t a surprise that working as a junior doctor in a Melbourne hospital emergency department during a pandemic comes with challenges.
Covid-19 will be one of the biggest challenges of our generation, but despite pleas to politicians and the public to do everything they can to help us get through the pandemic safely, each shift there are new reminders that coronavirus will continue to wreak havoc on our jobs and lives.
I find the hour before going to work the most difficult. Even with time off to go for a walk in the sunshine or phone an interstate friend, the dread that settles into my chest before arriving at the hospital is unshakeable.
Once there, we check in with each other and ask how we’re going, but we know the answer already. Our resilience is wearing thin when lockdown means a lot of the things we do to recover and recharge are off limits. But work gives us a purpose, so we put our grief aside, don our N95 masks and hit the floor.
Waiting times have blown out to unreasonable hours and the list of patients to be seen sometimes exceeds the length of the computer screen. Tensions are high, but because of access block, there is nowhere appropriate to assess or examine patients so we hope that no one still on an ambulance stretcher in the corridor will acutely deteriorate while waiting for a cubicle.
Without the space, we’re temporarily paralysed with 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 nearly as much as they used to.
And still, connecting with patients often means they share how deeply they’ve been affected by the lockdowns with deteriorating mental and physical health. My protective goggles fog up with emotion as there’s not much comfort to be provided – we’re all struggling as well.
Months into this current wave of cases, it is devastating to see the damaging effect that misinformation and ineffective public health communication has had on our vulnerable communities.
I go through the usual checklist questions: “Have you or anyone in your household had any respiratory symptoms, or been at an exposure site?” and “Have you had a Covid vaccination?”
Both these questions are so often answered with “Don’t worry, I never go anywhere.”
But this can’t be true – the virus is spreading and no one is so isolated that they don’t have families, jobs or even just receive grocery deliveries. The mere fact they’re in the emergency department now demonstrates that sometimes you do have to leave home, and the risk of coming across Covid in an unexpected way is rising every week.
It is heartbreaking to have to inform a patient that although they’ve come to emergency seeking help for something unrelated to Covid, unfortunately the patient a few cubicles down the corridor has tested positive so now they are a close contact and need to isolate – a serious inconvenience 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 empathise when this realisation is met with anger and frustration. I also worry that despite long conversations, sometimes with an interpreter, that my patient and I are just not on the same page with understanding the urgency of getting vaccinated, getting tested early and the potential harms of Covid’s spread through our community.
People are looking forward to things opening up again and lives getting back to normal, but I find it hard to feel optimistic when there is no roadmap to regaining safety for our healthcare system.
There is so much strain on emergency doctors who are forced to take on more risk and uncertainty with every shift. There is so much guilt when colleagues have to call in sick, knowing the increased pressure it will put on our peers.
As a team, we’ve made a commitment to keep our doors open and provide the best care we can to those who need it, and we’re no strangers to hard work. But we’re not an endless resource and can only function in survival mode for so long.
The writer is a doctor in a hospital in Melbourne
