They say a week is a long time in politics – but right now I think it feels like that for most of us. COVID, lockdowns, social distancing, PPE… there have been so many strange new changes to grapple with over the past few weeks, it sometimes feels hard to keep up.
Being a medic means a few things have changed for us too. If you’d told me six months ago that I’d be suturing toes and bandaging fingers in A&E, I don’t think I would have believed you! But that’s partly what I and my colleagues in the Hampshire Hospitals NHS Foundation Trust have been doing over the past month or two. It’s been a little while since my last update, so I thought you might like to know a bit more about what we’ve been up to.
Business as usual
In some ways, life continues as normal. Here at Chris Bailey Orthopaedics, you can make appointments at our elective clinics at the same times and for the same conditions and issues as normal – it’s just that most are happening by video or phone (I’ll explain how we do that in next week’s blog!). I always enjoy clinics. It’s great to catch up with people, to see how things are going and where we can help – especially right now, when many patients are stuck at home and feeling a bit isolated. Our elective surgery cases are on hold for the time being, but we’re still doing emergency operations. We can also see patients face-to-face in some cases, for instance if your knee is in plaster or if you need an x-ray.
Business quite different
Outside clinic, our rotas look rather different. Recently I have been based in the A&E department at the County hospital in Winchester. As an orthopaedic specialist, I’ve been asked to help on the Minor Injuries Units (MIU). The idea is to free up hospital staff so they can treat other vulnerable patients. This means we’re helping out with the kinds of injuries I encountered in casualty earlier in my career. With most people confined to home, we’re seeing quite a few DIY-related injuries – cut fingers and toes, for example – and sprains, breaks and dislocations from time spent in the garden. All new patients are assessed by a nurse practitioner for signs of Coronavirus infection before they come into the building. From there they either go into the ‘Hot Zone’ if they are displaying any coronavirus symptoms, or into the Cold Zone, which is where the main MIU is based. You can find out more about how that works in this video from our sister hospital, Basingstoke and North Hampshire.
One of the good things about being consultants in this situation is that we can help to speed up the treatment process. We’re able to assess, treat and discharge many patients in MIU, avoiding the need for longer waits. We’re also helping to reduce the need for people to come back to hospital. That means using things like ‘soft cast’ and ‘back slab’ plasters, which can be removed at home. We use dissolving stitches where possible for the same reason. It has been brilliant to see the joined-up thinking that’s happening across departments. And it’s encouraging to think we can do something to take pressure off the staff so they’re able to treat the most vulnerable patients. It has been humbling to see the incredible job that the regular A&E experts alongside us do too.
I’ve also been helping on the Intensive Care Unit (ICU). You may know that ventilator patients with COVID-19 are placed on their stomachs (‘prone positioning’) to improve oxygen flow to the lungs. One of our key jobs is to turn them in their beds. With the tubes and drips involved, timing and technique is important. Because surgeons have to position anaesthetised patients in theatre, this isn’t an unfamiliar role for us. We’re also used to working with gowns, gloves, masks (and sometimes heavy lead aprons) in theatre, so the slightly cumbersome PPE used in ICU isn’t too strange for us either. Everyday skills that we take for granted are suddenly very useful in the current situation.
We also help with the transferring of patients between departments in the hospital. Many patients need to undergo regular CT scans to look at the condition of the lungs, abdominal organs and for blood clots. It requires numerous members of staff to transfer a ventilated patient safely, without putting other patients and staff in the hospital at risk.
I hope that gives you a snapshot of what we’ve been doing. It has been a strange few weeks, but we’ve all been pulling together, sharing our skills and working to get through this difficult situation. Thank you for your patience – and I look forward to catching up with you soon.
You can find out more about how the Trust is tackling coronavirus on their website. You may even be in a position to volunteer to help vulnerable residents across Hampshire; if so, click here to see how to get involved. If you might be interested in donating to the Trust’s charities, you can find out more about them here.
If you’d like to book an appointment with us at the Chris Bailey Orthopaedics clinic, we would love to hear from you. Just head to our Bookings page, or give the team a call on 01962 826107.