Clapping, reflection, and looking forward

As I joined in with what will by all accounts be the final clap for key workers last night, I was struck by what an emotional rollercoaster we doctors have been on through the past few weeks.

When Covid19 came to the UK, we looked to colleagues with experience of this new illness – particularly from China and Italy – to learn from them. We listened to their experiences and teachings about patient presentations, treatment strategies and so on. Medicine is a global community and at times like this our global networks are incredibly rich places for information gathering, idea generation and strategic thinking.

Whilst we gained all of that, what we also gained was a clear message that this was going to be a global pandemic, the sort of thing that happens once a century and changes our lives and the practice of medicine for ever.

We learned to be fearful of this new virus and what havoc it might wreak on our already over stressed, under resourced, vacancy-ridden NHS.

Fear was something I have never really felt about my workplace or living environment, but suddenly it felt like we were being plunged into a war zone. Inside and outside of work, all we heard about was Covid19. We had to become as expert as possible as quickly as possible. Our families, friends, healthcare teams, and indeed ourselves, expected us to lead and inform as is usual for doctors but we looked around and considered how ill prepared we were, and we felt fear.

As the NHS management structure made their plans, stopped us doing our usual “routine work” and prepared us to face the Covid19 storm, that fear was extended to worrying about not only Covid19 related illness but also what would happen to those whose treatment has been put on hold, to those patients with chronic illnesses or suspected cancers that needed management too.

The fear built.

We learnt to don and doff but then PPE supplies dwindled, and we worried about our own risk and the risk faced by the other members of our healthcare teams-all of them integral parts of this complicated machine we call our NHS.

While efforts to increase PPE supply did take effect, there is no doubt the fear built further.

We went to work and into the danger like an army when many others were able to stay safe at home. We cried a lot and we couldn’t hold each other and give each other the usual comfort. We couldn’t allow our patients’ relatives in to see them and support them through their dark hours. We phoned and explained and updated and we did our best. We looked around us and hoped that none of our loved ones would get ill. All of this was very frightening.

The clap for the NHS began and when it happened on the first Thursday evening at 8pm it was incredibly emotional for us all. Not only did it mark the unprecedented nature of the times, but it was a public expression of gratitude for our work and we really, really needed that.

In recent years those of us working in the NHS have watched as the work gets more intense, the treatments more complex and the resource squeezed so that the mismatch of required work to resource provided has grown beyond reasonable. The NHS has continued to rely on the goodwill of its staff to perform at the level it does whilst the media and UK government seem only to have had criticism for us, particularly with respect to pay deals and pensions. It has been tough, and the weekly clap of thanks has been so cherished by us all during these unprecedented times.

As the first wave recedes and the clap is being stood down along with the Covid19 rotas, we reflect on the past three months and plan for the near future and how the NHS can get up and running again despite the continuing presence of this deadly virus.

We mourn colleagues, friends, family members and patients who have lost their lives or come to harm and we look forward. We cannot just go back – we must do things differently.

The Scottish Government need to have an honest appraisal of what we have the capacity to deliver and have the public conversation about what healthcare we can provide and where and how we can do it.

The time for that conversation is now.

We can’t delay.

Let’s learn the lessons of the past and engage the public and professionals together to plan a brighter, better, adequately funded future of health and social care in Scotland.

Dr Sue Robertson is Deputy Chair of the BMA Scottish Council

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