As coronavirus cases continue to increase in the UK, hospitals are facing an ever-increasing demand for their resources.
Dr Jenny Abthorpe, ICU registrar who works at a large teaching hospital in London.
She wrote a journal for Sky News about what’s going on on the front lines.
Today I went to work, cycling the country roads to the train station and stopping briefly to enjoy the chorus of dawn.
The station is deserted. I feel like a lone warrior as I get on the train.
It was a difficult week in our intensive care unit.
We have killed a number of patients – I don’t remember losing as many in a week.
I can’t stop thinking about the parent of one of the deceased patients – an 81-year-old mother, who called daily to find out about her son.
She had that frail, trembling voice and she seemed relieved when I told her that her son was fine.
But now I feel physical pain when I think about the phone call made to her the day before – that her son was dead.
And the fact that she couldn’t get to the hospital on time.
As I approach the hospital, I join the army of NHS workers at the start of the day and feel a sense of pride and belonging.
I pass the warning signs at the entrance to the hospital and then on the doors of the ICU. I’m used to them now.
The ICU is incredibly busy, and the number of COVID-19 the number of patients requiring intensive care is increasing rapidly.
Our unit is refilled with 30 patients, having received six new overnight admissions.
I change into a scrub, put on my mask and receive an update on each patient.
The transfer is fast and efficient. The night shift of two doctors seems exhausted.
We send them a round of applause to send them home. Hero.
COVID-19 patients have now completed a second intensive care unit on site, and a new unit, created in a former highly dependent unit, is also full.
There are now a significant number of beds in theater rehabilitation that fill slowly.
The pediatric intensive care units receive non-COVID adult patients.
Two other intensive care units are increasing their bed capacity in anticipation of the surge.
Staff are redeployed from across the hospital to join the ranks of critical care staff. And we are very grateful to them.
Department morale is high with support from each department and staff level.
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We are getting to know this silent enemy – the virus.
Patterns emerge, but it’s frustrating and slow.
And these patients who are doing worse, we feel lost knowing how to stop their decline.
The day is spent in a blur.
Some patients are at the beginning of their illness and need stabilizing and vital care.
Last week, a new patient arrived at intensive care at 6 p.m. after deteriorating in the ward. He needed an intubation, but the intensive care extension team was too busy to do it, so he was brought to us.
He sat trembling in fear, eyes wide as he looked around.
I had put on my PPE and went to reassure him. He was exhausted.
I managed to put him to sleep, reassuring him that I would see him soon, that he would be fine, that we would take good care of him and that he would never be alone, a nurse always watching over him.
He held my hand and said, “See you tomorrow morning … thank you doctor. “
My heart broke a little.
Half an hour later, it was stable and installed. I placed my hand on her forehead and whispered “Please do well. “
A quiet plea.
Others are static in their progress and we analyze their number and their clinical image, trying to move them forward.
Some are improving and approaching their exit. We have had great successes.
A colleague and I perform a tracheostomy on a patient who has recovered but is weak and requires slow weaning from the ventilator. But we’re glad he’s gone that far.
End of shift.
One hour by train, then return by bike. Two hours later, I’m at home and I took a shower.
Just in time to cuddle my little one and read her favorite bedtime story, Spot Says Goodnight. Precious moments.
It is becoming more and more difficult to stop working. Sleep is slow in coming and the nights are restless as COVID-19 fills my thoughts.
But a little stupid TV and a debriefing with my husband put those thoughts aside for now.
Bedtime. Ready for my night shift on call tomorrow.