Coronavirus: On shift in intensive care – BBC Newsnight

hand over and the incoming team will work 12 hours trying to save the desperately ill 12 2 patient again on a lot of oxygen on a lot of cpap and needs to do more pruning today to fear sophia's patient not an old man by any means has been in intensive care on a ventilator for a month hello my name is sophia i'm your nurse for today how are you doing can see candy complete vigilance is required because even this battery of equipment can't save him from respiratory failure that noise they call it bubbling is caused by a buildup of fluid in the lungs sophia draws it out to keep him alive and with the bubbling you were drawing fluid off his chest is that off his lungs exactly yeah so this is the secretions that they've got in the lungs as a result of the inflammation that the covate has triggered across the ward the trajectory is better nick is making great strides how long have you been in intensive care were you admitted straight into intensive care or were you on a ward first no no straight in here uh i think it was friday evening um and i'll be honest i didn't think i was going to make the night either i was that ill and then it's been all slowly up here afterwards so i say this morning was the first time i've got our bed and had a walk in that so i'm very happy at the moment nick's hoping that this shift might see him released from icu they're managing people here on widely differing trajectories some getting better some getting worse and all you can really hope for on a shift in this ward is that at the end the score is in your favor more patients improved and discharged to other wards from getting worse or possibly passing away consultant phil donason has gone to talk to a patient who's going downhill it's time to persuade mike as we'll call him that to survive he needs to enter the coved netherworld heavy sedation and a breathing tube yeah is that because he's so short of breath yeah would you like us to phone your wife yeah of course themselves mike agrees to general anaesthetic and intubation a state from which a significant minority never awaken it's clearly a very difficult conversation because at that moment where the person goes under they don't know if they're going to come out of it do they no they don't and we don't either dealing with covid has meant more than doubling the size of salisbury's intensive care unit they've done it by taking over neighbouring operating theatres and while kit can be put into place the usual ratio of one intensive care nurse per patient has been lost intensive care nurse sue crocumb came back from retirement eight months ago and is dealing with these new realities this patient we'll call him jim is being readied for exubation having sedation dialed back and a breathing tube removed sue's overseeing him and another patient in this operating theater and how has it been this second wave how tough has it been it's much tougher um the patients are younger as well we're seeing yeah it's much tougher we haven't had we are getting the the support deployed nurses but not the same in the first wave i don't know whether that's because theater's shut everything shut down so there were more nurses clinical psychologist kate jenkins works with hospital staff the current crisis she believes is taking a heavy toll as of january our staff referrals to clinical psychology were up 1400 on the year previously that gives you some indication i'd say that everybody is feeling it to some degree probably 10 to 20 are requiring some sort of formal intervention we're just doing a ward round we'll chat about everyone we'll just have a look at all your tests and things and then see the plan from there all right the consultant begins his round of the ward trailed by staff assessing who's getting worse and who's on the mend for nick it's good news i feel really brilliant today like i found desperately hoping to get onto i think that's what we're trying to do for you that would be very nice 10 hours into the shift sue's patient who we're calling jim has had his breathing tube removed i'm close to tears actually because i'm just so tired um it's been really busy um it's been good that we've been able to take the tube out we're not at the woods yet um so he's been uh he's been a bit challenging in the period since we've taken the tube the outlook should be positive but jim is distressed um the uncertainties of this disease are all too clear a good day can be followed by a rapid decline it's necessary for the icu team to keep an eagle eye all the time john is another patient there watching closely he'd been awake throughout the shift and really wanted to talk to us when did you come down with this i mean how long have you been sick about ten days i think but i've only been here about uh three or four so yeah tried holding on and then it just hits you going sorry don't i don't think we can chat at the moment your stats are a bit late okay sorry sorry boys at the moment it's where he's not prone uh where he's not face down um his breathing really suffers but he can't he can't stay on his front 24 hours a day um and both for his his sake and things like eating drinking that kind of thing and it is much easier if he's not on his front but i'm just hoping we can keep it as short as possible which is why he's having some food at the moment and then prone again and then yeah as soon as i can really back on his front and on oxygen john's a fighter and he wants to chat again there's no pain there's nothing you know it's just this silly little thing inside you know that apart from that i'm all good get told to slow down on me speaking but concentrate more on my breathing but yeah i like this it's it's fine i think that's probably a good moment for us to stop asking your questions then good luck the shift is coming towards its end there have been a couple more admissions and that's meant shuttling beds around as for discharges they're waiting for beds to become available two people have died in the hospital this day neither though in the intensive care unit it's not been a bad shift plenty went on today but it felt okay actually and what of the people who work in here taking the strain day after day what are you most looking forward to being able to do again well being able to get closer to my patients and not wearing these foods at least the masks and being able to hug my colleagues just before the end of the shift a bed opens up for nick he's off thank you taking with him a sense of overwhelming gratitude to those who saved him absolutely unbelievable they've got the hardest job in the world and they're just so dedicated it's unreal as the evening handover begins mike and jim are both back in the suspended animation of general anaesthetic for days or weeks nobody knows the next shift takes on the struggle to keep them alive 12 hours at a time

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