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Been speaking to several London frontline doctors working in major hospitals. Picture isn’t great. One: “it’s a bit like a warzone. I’d say not far off where we were at in first wave in terms of capacity. But staff are completely demoralised and exhausted this time round.”
Another: “It’s all pretty grim. Over 50% inpatients are covid cases. But no beds free. Supplies holding up well so far. Staff sickness a risk. Elective [procedures] stopped last week but it’s too late.”
If you’re working at a hospital (anywhere in the country), keen to hear from you- DMs open as ever and in confidence.
Another member of staff from a London hospital: “Things are a mess. Treatment in ambulances, oxygen ran out the other day. It’s horrid. The whole hospital is full of Covid. This is worse than the 1st wave and is going to get worse because the public don’t realise how bad it is.”
The thing I’ve heard repeatedly, from dozens of people working in hospitals, is that the thing making the situation now so much worse is a) severe staff absence which is partly driven itself by Covid but as much by b) profound levels of mental and physical exhaustion.
Hearing about more London trusts cancelling leave well into the New Year, asking people to work extra shifts if they can, redeployments from different parts of the hospital in question.
Similar picture in Wales. This from a nurse in a South Wales hospital: "The nurse to patient ratio is becoming dangerous with nurses often having to look after two level 3 patients. Staff are working tirelessly to keep the wheels turning but they are in danger of falling off..."
"Staff are near burn out with lots of them showing signs of PTSD. I see nurses and doctors crying on the corridors before, during and after shifts.
To anyone who says this is not real they need to be shown the inside of a Covid ITU or acute admissions ward."
To anyone who says this is not real they need to be shown the inside of a Covid ITU or acute admissions ward."
"Nursing staff hold patients hands as they die with their eyes wide open, nurses and doctors holding iPads so families can say their last goodbyes via Zoom as a patient dies."
Consider the psychological toll of that. The word I keep hearing is burnout.
Consider the psychological toll of that. The word I keep hearing is burnout.
I’m told a major London hospital has told its senior medical staff to brace themselves for the peak in admissions which they believe still won’t come for another fortnight.
I’m also told that in one London hospital, psychiatric nurses and other mental health staff have been redeployed to provide support to staff on ICU. One staff member tells me:
“Nurses are walking off the wards in tears, some have resigned. They are dealing with PTSD...”
“Nurses are walking off the wards in tears, some have resigned. They are dealing with PTSD...”
“...from the multiple traumatic deaths they are witnessing and then having to go back for more. We need everyone to be more cautious. People need to avoid mixing and stay at home. We can’t take much more of this.”
From an anaesthetist at a London hospital: “At various points over the Xmas wkend every CPAP machine (assists breathing, often used to see if patient can cope without intubation, sedation and ventilation) was in use across entire trust. This is a very bad situation to be in.”
“ITU is being covered partly by nurses who are NOT trained in ITU nursing. In some instances paediatric nurses. Many of these people are doing a great job under almost impossible circumstances. But they are not trained for this.”
“The wards are completely overloaded with covid patients. Every night was worse, every night trying to work out how many we could take to to ITU and who would have to cope on the ward for longer.”
“Morale is very low. We all feel the government is continually since April about 2-4 weeks behind what is obvious on the ground.
Anaesthesia and intensive care doctors are getting desperate text messages to help with hospitals that are at the epicentre - East London.”
Anaesthesia and intensive care doctors are getting desperate text messages to help with hospitals that are at the epicentre - East London.”
To add some empirical context to these experiences consider a few things 1) NHS had been increasingly struggling in winter before 2) A&E wait times have been getting worse for yrs 3) staff shortages were a problem per-pandemic- eg we went into this with 40,000 nursing vacancies.
This is why the Nightingales aren’t being used. Because there just aren’t enough staff to fill them.
In the spring we rode it out because a) it was spring and b) staff were fresher. 9 months on they are physically and mentally spent and it’s winter. They’re pushing water uphill.
In the spring we rode it out because a) it was spring and b) staff were fresher. 9 months on they are physically and mentally spent and it’s winter. They’re pushing water uphill.
The fact that winter would be so bad for the NHS was predictable and predicted. It’s why people like Andrew Heyward said in Nov that Xmas relaxation would add fuel to the fire. It’s also why some public health experts said that early December return to the tiers was a mistake.
I’ve seen a lot of you say that you want to see all this on TV. Believe me, so would I. I’m trying to negotiate access to hospitals but securing it isn’t easy. Rest assured, am doing my best.
Do not listen to idiots who say this is all fake or exaggerated. There is a real crisis going in some of our hospitals right now.
In meantime am technically still on holiday so returning to that for a few days to gear up for what is going to be a v important few months ahead. NHS staff please do keep getting in touch via DM to tell me what’s happening in your hospital. As ever, always in confidence.
Just after Christmas I was reporting on the grim situation in hospitals from home, via many wonderful NHS staff who shared their stories with me. Certain people claimed the situation wasn’t serious because it wasn’t on TV. Tonight you’ll be able to see for yourself. 
https://twitter.com/bbcnewsnight/status/1350172376500203521
https://twitter.com/bbcnewsnight/status/1350172376500203521
