Silver Linings Handbook: Tips for the Covid Cohort - Chapter 1
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Dear Covid Cohort,



 

In the space of three months everything has changed. The rulebook for starting work as a foundation doctor has been torn up and thrown out of the window. You were preparing for exams and planning electives in sunny Belize. But instead of revising and dreaming of sipping mojitos on the beach, you’re being drafted onto the frontlines of a health service in the midst of an epoch-defining global health crisis. I think it’s safe to say that for everyone working in the NHS, these are slightly unsettling times. Especially for those who are yet to work their first ever shift.

 


But oddly enough, a pandemic of Hollywood proportions might just be a good time for junior doctors to enter the NHS. No one has ever been 100% prepared to make the difficult transition from student to professional. But right now, there has never been more love and support from the public for healthcare workers. Trundling off to a nightshift on Thursday night to a chorus of pots and pans, whoops and cheers was something I won’t forget in a hurry.

 


And this nationwide sense of goodwill can also be seen on the wards: in the comradery between colleagues. To beat the new virus, everyone has to learn new skills– from students to consultants – and this a great leveller. Overnight, coronavirus has shown that we can move away from an antiquated hierarchical structure that I often feel stifles training in hospital.  Yesterday, I found myself learning how to run a ventilator with a group of Orthopaedic consultants who hadn’t given respiratory physiology a thought in twenty years. A matter of months before, I was namelessly handing instruments to them in theatre. Although we were all out of our depth trying to set up this vent, as the youngest and most recently graduated, it was my vague recollections of lectures on expiratory pressures and tidal volumes that came in handy.



 

To prepare for the worst-case scenario, as well as calling on you, the NHS is drafting in every doctor in the country to fulfil clinical roles. Popular non-fiction book lists are awash with horror stories of F1s having the realisation that they’re suddenly responsible for an entire ward of sick patients overnight. But from the ITU rota that I’ve just got, I’ve never seen more senior doctors on shift at once. So even though you’re hitting the ground running earlier than expected, you’ll be surrounded by people to turn to for advice and support.



 

This is a time to practice and learn real acute medicine. Quite rightly, people aren’t turning up to A and E with stubbed toes or following months of mild non-specific abdominal pain who couldn’t get a GP appointment. Those that do are presenting with COVID-19 and genuinely need our help. There’s nothing like a pandemic to keep the worried well away from hospital doors, and as such I have never had a more enjoyable or educationally valuable set of shifts as those in the last fortnight.



 

As members of the Covid Cohort, you are being fast-tracked into a health service which is changing every day. You will have been rapidly escalated to a public health expert in your household and will have been appointed virologist-in-residence in your Zoom parties, all without a medical licence.



 

Over the next few weeks I will be posting regular blogs with practical pointers to get you ready to step up. Unlike you, I had three months of shadowing an F1 before taking in a position of responsibility. With guidance and knowledge of COVID-19 evolving as fast as the virus is spreading, I’ll also be sifting through the research to offer some tips for the best way to manage the care of the deluge of patients who will soon be filling up the nation’s hospitals. This series will be supported by current consultants on the front line to make sure you’re best equipped.



 

It will be a challenging few months, but I think there are some silver linings for those starting on the wards earlier than planned. And fear not, the beaches of Belize aren’t going anywhere.



 

Please feel free to comment and ask if you need help or advice. If you have your own cases to share let me know. Look after each other and yourselves.



All the best and welcome aboard,

 



Silas (@Silas_Webb)

 

 

 

 

 

 

 

 

Originally published 12 April 2020 , updated 10/06/2020

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