I sat back on New Year’s Eve 2021 reflecting the worst was over and we would all begin afresh. Little did we know how hard this year was going to be. Covid has not gone away and the economic crisis has hit hard. We have started to live ‘normally’ again, whatever that means. The triumph of vaccination has stopped the need for restrictions but Covid is now embedded in our DNA. It has hurtled us into a new age of digital and social interaction but has thrusted an imprint on all of us, whether we recognise it or not.
The images of the faces of healthcare workers after wearing masks 24/7 are hard to forget. The smiles were gone, skin furrowed where the masks had cut into cheeks and foreheads. I still wear a mask in theatre and clinical spaces, now with annoyance rather than the fear when it was mandatory. I know it makes a difference, when we gather together and one turns positive, we are not all sent home to twiddle thumbs, feeling alright and wondering if we going to get the dreaded virus.
Masks make us feel safe but do we really take them off? We spend time with people and get on with our jobs. We interact in shops and restaurants but it all feels superficial now. I see and talk to people every day. I talk to colleagues and patients, the hello in the corridor, the invitation to share symptoms and progress in outpatient clinics. Moreover, in these important contacts, we only just scratch the surface rather than invest in a deep conversation.
When you stop and consider what is being said and follow up with interest, curiosity and compassion, incredible experiences are disclosed. People come to work everyday and do not readily reveal the enormous changes that have occurred in the last two years. The havoc that has ensued losing loved ones or caring for those with long Covid. The fact that family members have lost jobs and that living on the breadline is not a statistic but an everyday lived nightmare. The emotional assault of being locked away in lockdown, isolating people, taking away the normality and safety of human interaction, and leaving mental turbulence unleashing mental health needs.
And this is playing out when pressures at work, especially in the NHS, at an unimaginable high. The drum beats the NHS battle rhythm, day after day. Who can go home, who needs to be admitted, trying to make the numbers add up but they do not. How do we find safe ways of managing the tsunami of need presenting to the emergency department. The novel ways of stemming demand failing, senior decision makers at the front door, diversions to other providers of care and streaming to same day emergency care. The media suggest that primary care has ceased but colleagues are working equally as hard but failing to manage demand.
Funding is needed to make a difference. Virtual wards and investment into social care will make a difference but the investment needs to be immediate into the workforce. They are emotionally burnt out, altruists balancing professional and personal lives, where both need increased attention. Staff went all out to support Covid care with little knowledge of the risks to themselves nor whether the PPE they wore made a difference. This merged seamlessly into the desire to treat those patients who were waiting in the ‘backlog’ for elective care and an increasing public behaviour change where the emergency department was the easiest way of getting care. Mental health services are overwhelmed, underfunded for many years, and emergency departments have morphed into mental health wards without the supportive services that people with mental health needs, at their most vulnerable, require.
I am proud to work with my colleagues, not just clinical, Allied Healthcare Professionals, Nurses and Doctors. So many jobs in the NHS are still unrecognised. Those in ‘backroom’ jobs that make the NHS work. The administrative staff, our bookers and schedulers, our cleaners and porters, the volunteers and our HCAs. They continue to work in the most difficult circumstances and have ensured that the NHS has continued to deliver elective and emergency care.
When I visit centres, the pride of those who are achieving innovation and exceptional care cannot be underestimated. It is breathtaking and all consuming as it envelopes you, and entices you to do more. It is wonderful, and should be rewarded, so that the moral injury that is hides is mitigated. We need to create an NHS that we are all proud of working in with an environment that is clean and fit for purpose. That teams have appropriate rest and on call rooms. Free parking and bike racks are a minimum with a desire to understand and support our NHS staff. This is for Provider Chief Execs, NHSE and Government to decide, as individuals we can support in a much simpler way.
Each of us is exhausted; we are looking forward to planning holidays this year. We have worked out how taking days around bank holidays will stretch our annual leave out as much as possible. It is important that we do look after our families and ourselves. It is also important that we look out for our colleagues. Take time to ask how people are and listen to responses. Only recently, I said hello to someone I had not seen for a few weeks. I asked how they were and whether they were okay. They had taken a few weeks off as their partner had died suddenly. They had to come back to work as they have young children and do not have family to support. We sat and chatted, and even though I had nothing new to offer, the fact that someone cared made a difference. It is now so easy to hide our true emotions behind masks, and because we are all so busy, to accept the masks on colleagues. We use social media and WhatsApp that allows us to be positive and present a facade of golden normality. WhatsApp allows us to talk without picking up the phone and listening to the catch in a voice that betrays the fact that everything is not right.
This year, I will try to talk to people more often rather than dropping social media messages and to meet up with people rather than spend an extra hour at work. I will try more than ever before to be compassionate and curious at work, to support colleagues and I ask you all to do the same.