'We're being asked to do too much': NHS staff on fighting the second wave

By Molly Blackall

With the UK reaching record levels of coronavirus cases in January, pressure on those working in frontline health services has never been greater.

From paramedics to intensive care nurses, the Guardian speaks to six healthcare workers about how they’re coping during the second wave of the coronavirus pandemic, and how it compares with the first.

The intensive care nurse, London

Sometimes, we can’t even provide hygiene and wash patients’

In intensive care, you’re supposed to have one nurse for each patient, but for the past few weeks with rising Covid rates, there have been about three or four patients to one nurse. This is having a massive impact on the standard of care we’re able to give. Normally we rotate all patients every three or four hours to avoid pressure damage or infection, but we don’t have the staff, so we’re having to leave them for six hours. Sometimes, we can’t even provide hygiene and wash them.

Everyone I’m talking to that works in this setting is exhausted and really angry and frustrated. It’s worse than during the first wave as the lack of staff has increased massively and we’re not receiving any financial compensation for nearly one year of hard work and excessive commitment. We’re being asked to do too much and I am worried that the system will break soon if it stays like this. Most of us can’t cope any more.

The GP, the Isle of Wight

You want to do your best, but your best isn’t good enough’

Last week we had 25% of all coronavirus cases so far diagnosed in one day. It makes me want to cry. I am busier than this time last year, and there is no end in sight. On a typical duty day I have 45 e-consults to wade through, at least 30 phone calls, face-to-face appointments and copious visit requests, as well as all the paperwork. Add to this a vaccination programme and you can see why we’re struggling to keep up with demand.

During the first wave, patients would not contact us for minor ailments, but now they have waited too long and want it sorted. Patients are taking to social media to vent their frustration that we are not up and running normally. There is a lot of anger towards the GP surgery and my staff have been in tears.

In the Isle of Wight, we went from tier 1 to 4 in a week. I never thought I would tell mainlanders to stop coming, but I am now: our rates were fine, but look what’s happened three weeks later. Our only hospital has limited capacity and cannot cope, and transferring patients is not simple and involves helicopters or hovercraft. The ferries have also made it difficult to obtain vaccines and the fridges needed to store them as they cut their timetable.

I worry about the cancer cases that are being picked up later, and my biggest concern is the high number of mental health issues in young people caused by lockdown. I also have lots of patients with hip operations and I’m trying to keep going with pain relief, but I know that what they need is a hip operation. Walking to the corner shop kept a lot of my patients mobilised, and now they’re in lockdown, I see them fall over and lose their independence. It hurts, because as a doctor you want to do your best for your patients, but our best isn’t good enough.

The cardiac physiologist, Birmingham

Most patients have Covid-19. We have no beds’

It’s bad again on the wards and in intensive care. By bad I mean that most patients have Covid-19. We have no beds. Ambulances are queueing up outside. During the first wave we cancelled most elective appointments and diagnostics, but this time we are trying to keep those services open. This means we are stretched to the absolute limit. A lot of appointments are going to waste because people are scared to turn up to hospitals, out of fear they’ll get Covid.

I was told yesterday that the matron is considering making the cardiology ward a Covid ward, which would mean admitting more coronavirus patients. I hope it isn’t true, because most of our cardiology patients are extremely vulnerable. During the first wave, quite a few colleagues were redeployed to intensive care and they’re talking about redeployment again. I think it’s fair that I go, as I didn’t last time, but I’m worrying about it.

The thing I’m finding hardest this time is discussions outside of work. I have family members who claim that hospitals are empty and the death rates are lies. I feel like saying: are you calling me a liar?

The paramedic, east of England

Patients are dying or having life-changing complications just by waiting so long for an ambulance’

The NHS is at breaking point. I have worked on the frontline for six years now and have never seen such a severe situation. In my ambulance trust, patients are dying or having life-changing complications just by waiting so long for an ambulance. As a solo responder, I get sent to sick patients to make an initial assessment, and if they need to go to hospital via ambulance, I have to request one. I now often wait for hours, meaning I cannot respond to any other patients. Ambulance crews are stuck waiting with their patients, often on the back of the ambulance, as there are just no beds in the hospitals.

Paramedics are in a confined space with Covid-positive patients for hours with poor ventilation and cheap PPE, and the impact on the mental health of ambulance staff is staggering. On a personal level, I haven’t seen my family since August. I know others who’ve not seen them for more than a year. Everyone is petrified of taking the virus home.

The continuous exposure to the very worst situations that families find themselves in is heartbreaking. Taking a patient to hospital, who is critically unwell, knowing their loved ones may not see them again day after day is soul-destroying. All this, and then attending patient after patient who says: ‘Oh, I know I shouldn’t have but I did meet up with my group of friends on New Year’s Eve’ or: ‘I don’t think the virus even exists’. There’s only so long we can go on hearing this.

The midwife, Greater Manchester

The number of pregnant women with Covid seems to be increasing’

Even though I don’t work the areas deemed as high-risk, we still have women with Covid symptoms awaiting test results, Covid-positive women, and women who are contacts of Covid-positive people. Despite this, we are only given surgical masks to wear unless we’re doing aerosol-generating procedures like general anaesthetic, but we have women huffing and puffing in labour all the time.

We now also have longer visiting hours and, since September, two birth partners are allowed instead of one. Partners have become much more lax in distancing measures and mask-wearing and increasing numbers of them insist on telling you that Covid isn’t real or arguing when visiting finishes at 6pm. They are not supposed to leave the birthing room once inside but frequently do to go to the shops or see relatives waiting outside the unit. We can PCR swab [standard test for Covid] the mum-to-be, but we have to wait 24 hours for a result, and only swab partners in advance of planned caesareans.

The number of pregnant women with Covid seems to be increasing. During my last five shifts we have had three Covid-positive women and two close contacts of positive people. In summer I saw about four over a couple of months. My daughter, who I live with, has asthma and my dad, who lives close by, is over 80, I am his only support and I am scared that I will catch Covid at work and pass it to one of them.

The junior doctor, Wales

I spend a lot of time on the phone to family members, and it’s pretty much never good news’

In the middle of December, our hospital had some of the highest rates of coronavirus per population in Wales. The ITU was full, and we got a lot of staff illness as well.

I only had about six months of normal work before Covid hit last year, and the work changed a lot. Now, I spend a lot of time on the phone to family members, and it’s pretty much never good news. It’s emotionally draining having to tell family members again and again that their loved one is unlikely to survive the weekend.

I’ve felt a bit out of my depth. I’ve cried on the way home from work a few times over the past few months – and I didn’t during the first wave – because of the strains on the healthcare system. You find yourself making decisions you probably would have had more support for during previous years, and doing ward rounds alone rather than being guided by somebody else. It sounds selfish, but our learning opportunities are completely diminished because of Covid, and I do worry a lot of junior doctors will be deskilled as a result.