You clapped for carers, but now people spit in our faces. I don’t want to go back to this normal
As A&Es get busy again, one doctor’s anguish...
WE don’t want to carry on living the rest of our lives with a deadly virus but I’m going to be a bit controversial and say I, as an emergency medicine consultant, don’t want things to go back to normal.
Three weeks ago, I thought we’d struck the right balance and people were being thoughtful and considerate and only coming to the emergency departments if they had a serious problem. We were happy with the care we were giving.
Unfortunately, a combination of good weather and some very mixed messages, especially coming from south of the Border about the state of play with regards to coronavirus and the easing of lockdown, led to some big problems.
Some people thought everything was suddenly fine, so they could just go back to normal.
As a result, we’ve been back to almost our usual levels of alcohol and drug-related behaviour and violence and that has included three episodes in different emergency departments where there have been assaults and abusive behaviour on NHS staff.
It is very disappointing to see the re-emergence of a pattern of behaviour that is typically linked to Scotland when the sun shines.
Of course, it’s natural to want things to go back to the way they were but, actually, some of the things that were there before were bad. Coronavirus made us break the cycle of alcohol, drug and violence-related behaviour.
Can we not go back to that sort of ‘normal’, please?
When lockdown eased, there was always going to be a section of the population that went berserk, getting drunk and coming to emergency departments.
BUT this is very hard for us to bear, having worked as hard as we can to try to do our best, knowing there is a degree of personal risk, to go from ‘clap for carers’ to being spat at, punched or abused and called all sorts of things because some people decided we’re there to pick up the pieces, rather than try to behave a bit more responsibly.
One female colleague in Glasgow has been pretty vocal on social media about how she was assaulted twice during one shift.
That shows how awful the ‘old normal’ is and, in a civilised society, the fact there’s even three such incidents should be appalling.
Emergency departments are often used as a safety net for the system and I’ve seen in the past three months totally different ways of working, co-operating and team work between people which I hadn’t seen in 20 years in the NHS and I don’t want to see that go. That includes my fellow professionals whom I’ve been working with a lot more closely, but also patients and the public of Scotland.
Previously, lots of people would come to emergency departments because it was the most convenient or the easiest option, because another part of the NHS couldn’t provide their needs.
But we’ve just performed a very large-scale natural experiment with this outbreak and it showed us what the future could look like.
We’ve proved that we can reduce the numbers of people coming to emergency departments by finding more appropriate places for their care and infection control measures in place have meant we didn’t have patients waiting on trolleys for hours on end.
We have to find the resources to make this better model of urgent care sustainable. It was forced on us through necessity but it worked and it would be good to try to preserve it for the future.
However, we cannot have a system where the emergency department is more dangerous from the point of view of infection control than a local supermarket.
I know it’s very difficult for people to accept that we are operating at reduced capacity because of measures aimed at keeping everyone safe. We are going to have to continue to be honest with the public and say the vast majority of you have been great up until now, with a few disgusting exceptions, but everyone needs to understand that ‘normal’ has gone for the foreseeable future.
We’ve got a limited service, which means we still need to ask you to work with us – even though that might mean we work in different ways and you might not be able to just rock up somewhere and get seen, and we might have to say there are certain behaviours that we can’t tolerate.
The bottom line is that the virus is still with us. In my department, every day we are having around 20 patients booking in who are possible Covid-19.
If you look at how many people are infected and how many die in a day, we’re sort of where we were in early March, and hopefully this is a downward trend.
But we don’t want it to suddenly spiral out of control again.
It might be a blip, of course, and these do happen, but data in one of the UK Government’s most recent weekly surveillance reports shows the number of people admitted to hospital in London two weeks ago with possible coronavirus had increased. With this virus, let’s see where we are in three weeks, one way or another.
Finally, it has meant an awful lot to NHS staff across Scotland just to know that the public care about us.
Sometimes we’ve felt underappreciated or under attack, so hearing the public’s appreciation has made a massive difference to our morale.