Upside-down days and the return of the non-Covid patient

IHAVE been eating meals in reverse all week. Pasta or rice before I go to work, a sandwich midway through — so no change there — and a bowl of cereal when I come home.

It used to be the full Irish in my intern days. But after years of trial and error, I’ve discovered the best way of getting through a week on nights is to pretend to my body it’s business as usual. Even if I’m sleeping all day and having my evening meal for breakfast. With a Coke.

Working the 12-hour night shift at Beaumont, you experience a different side of the hospital. The silence on the wards, for one thing. Nurses whisper at the nursing station. The low buzz of the vending machines. The noise of a faroff floor cleaning machine.

There’s no cheery whistling or loud banter you sometimes hear from staff going about their business in the corridors. That’s especially been the case for the last two months as the hospital prepared for a surge of Covid-19 cases that thankfully never materialised.

But I had not expected to be hit by the non-Covid-19 surge when I started my week on nights. I noticed the buzz of activity as I cycled to work to start my evening shift at 7pm. More cars, more pedestrians on the footpath. As I approached the entrance to the hospital, I noticed a group of people standing outside. No great social distancing going on. They were just hanging out, chatting. I found myself eyeing them suspiciously, as though to say: “What are you doing here?”

The last I heard, Beaumont Hospital’s no visitors policy was still firmly in place.

That was unsettling enough. Then, one night last week, I had cause to go to the emergency department. I went down there to meet a patient who was being brought by ambulance from another hospital. I left the relative calm of our neurosurgery ward, walked down corridors and through to the emergency room.

A few weeks ago, this department was often neardeserted. But on that day last week, it was instantly clear we were back to the pre-pandemic volume of patients. The cubicles were full. Every chair around the nurses’ station was occupied. At least everyone in that space — healthcare staff and patients — wore a mask.

I wondered how the doctors and nurses could deal with the increasing numbers of patients in an era of social distancing.

And I wondered if staff in other emergency departments around the country were facing the same conundrum.

I returned to the neurosurgery ward with a rising sense of anxiety. I realised I have become used to all the barriers we have thrown up to keep the virus out.

The health authorities have been pressing home the urgent message to the public that we stop the virus hopping from one person to next by breath or sneeze or contact.

We need to maintain social distancing. We need to stand two metres from the person next to us. I can’t visit my parents in Co Galway. And they can’t visit their grandchildren in Dublin.

All of us have sacrificed normality to one degree or another in order to flatten the curve. And we know that the success we have achieved to date is fragile.

We will have to continue with extraordinary measures to ward off the risk of infection for a long time to come.

We also have an opportunity here. We have seen that the health service is not an immovable beast. We moulded it to fit a pandemic and we can remould it again once it has passed.

This is an opportunity to create more pleasant and safer spaces for patients to be treated in and for staff to work in.

I’m beginning to feel a little uneasy about this easing of restrictions from tomorrow.

But maybe that’s my mood. Sometimes, when it’s quiet, you can end up with too much thinking time working nights.

As the week drew to a close, a heartening gift came in to lift the spirits — a hamper sent in by a kindhearted family to thank us for caring for their mother.

Covid-19 meant they couldn’t be with her when she received her diagnosis, which I had to deliver from a two-metre distance and explain down to her family over a crackling speaker phone.

I thought at the time how hard it was for that family. Their gesture showed they appreciated that it was hard for us, too.

I had my final coffee, finished the shift and cycled home at 8am for “dinner” of Fruit ’n’ Fibre.

And slept.

‘I realised I have become used to all the barriers we have thrown up to keep the virus out’