September

65 in ED at 8am
15 waiting for medical beds
further 15 on medical unit waiting for drs
night team hammered
no beds in hospital
I was in ambulatory care seeing patients direct from ambulances to try and keep beds free
Covid - still coming
Upticking again after a bad July, slightly eased in August
ICU half full of covid, very strained on top of their usual patients, managing to offer an elective surgery bed some days
They were intubating another covid when I went over there
Discharging some long stay covid patients who were admitted in early July.
Over a month intubated and more time on the ward.
Young/middleaged, unvaccinated.
They won't be on the death numbers, but they will need months or more of recovery.
Some have died
Respiratory HDU.
Full of covid.
This where patients who are too frail for ICU go.
They mainly die.
The nurses there are angry and tired.
They call me and I try desperate things with frail people, or ease someone's death. It's not been free of covid since October 2020.
There is a lot of staff sickness and I get asked to work extras every shift. I work my shifts but rarely extras because I am totally knackered after 18 months of this, and I feel permanently guilty.

This does not feel like a strong position to enter autumn.

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More from @seahorse4000

2 Aug
If my hospital were a patient, I'd describe it as "critically unwell but stable" right now.

This is better than "peri-arrest", which is where we could have been heading 3 wks ago.

We're admitting as many covid patients as die or we discharge. ICU is half covid. It's holding.
(Almost all of these sick covid patients are unvaccinated. A few are vaccinated and significantly vulnerable in other ways.)
The hospital is also better than "actively being resuscitated", which is what it felt like November through January.

I feel angry and betrayed that that state is now seen as a acceptable benchmark, rather than a never event requiring investigation.
Read 6 tweets

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