GWH intensive care consultant describes gruelling 11 months on Covid frontline

Dr Mark Juniper, who works at the Great Western Hospital, opened up about the challenges staff have faced throughout the past year.

The respiratory specialist said: “People are tired, people are emotional. It is hard dealing with patients who are themselves frightened when they are awake, to deal with families who are also frightened.

“And deal with human interaction with people, whether it be patients or their relatives and where you have to wear protective equipment. It is not a simple mask; people are wearing the full protective equipment.

“So actually, delivering compassionate care and caring for the patients and the relatives is more difficult because you’re distanced by a mask and a visor. People can’t hear you properly.

“When I stop to think about what we’re doing, it’s quite an emotional thing. The thing you would normally rely on – your human interaction with another person – is taken away because of having to wear PPE.”

ICU at GWH

Dr Juniper said the interactions medics have with families are hard because they are often to do with bad news and death.

He added: “We actually don’t see the families when we have somebody who is getting better.

“We do speak to them over the phone but we don’t actually have the positive of the successes to celebrate and so it can all feel quite negative.”

Dr Juniper has been working between the respiratory ward and ICU since the pandemic began.

He recalled the first time he treated a Covid patient at the hospital.

“One of the things that happened in the first wave was that people were frightened to come into the hospital, so they tended to come to the hospital after they had deteriorated at home,” he said.

“So, we saw quite a few people coming into hospital who were profoundly unwell when they first arrived.

“The first experience I had was when we had to sprint along the corridor to get the patient as quickly as we could to a place where we could safely put them on a ventilator.”

Dr Juniper wearing his mask and visor

When asked about the hardest thing he faces, Dr Juniper said: “For 20 years I have used the ventilators in ICU to keep people safe but the difficult thing that we face is that they are not as effective with Covid.”

Dr Juniper works three 13-hour shifts in a row, followed by two days off and then two night shifts.

He said: “I’m slightly older, I don’t do the whole night shift but some of my colleagues do.The nurses are doing really long shifts and are stretched to a level where it is both fatiguing, hard work and it is very emotionally challenging.

“I have seen plenty of tears because people find it hard to deal with difficult situations. We often deal with difficult situations, including dying people. But the frequency with which we had to deal with some of the hard stuff has been more in the last few months.”

Dr Juniper's colleagues also working in ICU

There have been moments he will never forget. “It’s the emotional link with a patient who is lying in a bed with severe Covid, who we’re about to put on a ventilator who is still conscious and able to talk to us,” he said.

“Then they have a phone call and ring their family and they are on a speaker phone, and I am there, and the nurses are there, and the patient is there and the family is on the other end of the phone. The patient is saying to their family ‘I’m going to go on a ventilator, and I am okay with that’.

“We tell the patient we’re doing it because we think it’s the safest thing to do and the one thing that we think we can do to save their life and yet you hear the patient having the conversation with their family and the patient is saying ‘I love you’ and the family on the other end of the phone are saying ‘we love you’ and we just hear the emotion.

“It feels like they are having a final conversation, as if this is the last thing, they would say to each other.

“Sometimes it is, and you witnessed the last conversation those people have with each other. That feels hard because it is a very emotional, personal place to be – overhearing those conversations and actually being part of the conversations.”

Staff moving a patient

Having a chance to relax away from work and think about other things was important, but so was being part of an amazing and supportive team, he said. “We have more than one consultant on each shift, so there’s always somebody else who is senior who you can discuss difficult cases with so you don’t feel isolated and your own so you will make decision as a team.

 “The team is the thing that really keeps you going.”