Stressed, scared and ‘put in a closed box for six hours’ with Covid patients

Paramedic tells ‘The National’ of intense daily pressures and moral injury facing Britain’s health workers

London Ambulance staff stretcher a patient from the ambulance into The Royal London Hospital in east London, on January 2, 2021. Health Services are under increasing pressure after record levels of daily lab-confirmed cases of Covid-19 has led to more patients being treated in hospital in England than during the initial peak of the outbreak in April. / AFP / DANIEL LEAL-OLIVAS

The level of demand on the NHS has been huge and the impact is that there are less resources available every following day.

Our vehicles are waiting for five, six or seven hours at the hospital doors to transfer patients. It’s ripples in the pond. If you stack us on the hospital, we’re not on the ground and that means people could face delayed treatment – or worse.

As the system gets more and more stressed, the patients are being held in ambulances, which is something that we’ve not done before because we’ve always put them in corridors. The two-metre distancing rules means people can't be put in those spaces any more.

We’re getting into a whole different world where we’re having to accept something which the NHS hasn’t done before, all the way from frontline operational staff to people in control rooms, admin staff, strategic managers and up to the directors.

The terms which the military have used around ‘moral injury’ are becoming very applicable. That is that medical staff make very difficult decisions that are unfamiliar, and have a potentially harmful long-term impact on the individual involved.

We’ve only got a finite number of ambulances and finite number of resources and we know that we’ve got people that are suffering injuries and getting more unwell. If a vulnerable, elderly person falls, we need to get them up off the floor within 30 to 60 minutes before they start suffering from other injuries and we’re not getting to those people in a timely manner. It's scary to look at the queue of yet-to-respond ‘plus calls’ and then work out who needs the ambulance the most.

Then when you are in the ambulance with Covid-19 patients there is an ever-present danger. That takes a toll on the medic.

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We have two levels of Personal Protective Equipment (PPE). Level Two is mask, goggles, gloves and an apron. Level Three is the full Tyvek protective suit and when you have to do your resuscitations it’s hot and horribly debilitating. We’re putting people into a closed box to wait six hours with a patient.

Staff are pushing back because they don’t want to be with a Covid-positive patient in confinement for six hours. Rest time between shifts has to be extended.

The average paramedic doesn’t manage a patient for such prolonged periods. All our training is around a couple of hours one-on-one. It’s very difficult and it’s very scary for us as well, because paramedics don’t have the training that other healthcare professionals do.

Despite this, the idea of the NHS being overwhelmed is not accurate. We are able to adapt and overcome. The system will do its best for the most number of people. The problem arises when people don’t understand that comes with making some really difficult decisions.

By prioritising the Covid response service, the elective care element has suffered.

We are starting to vaccinate our staff and have a programme in place. We’re going to do it as quick as we can. This is priority one for us after patient care.

Health workers wearing full personal protective equipment (PPE) tend to a patient on the intensive care unit (ICU) at Whiston Hospital in Merseyside as they continue deal with the increasing number of coronavirus patients. (Photo by Peter Byrne/PA Images via Getty Images)

The new strain of the virus is very difficult to control and anecdotally it’s hitting younger people.

Everybody’s just waiting and watching to see what’s going to happen. We all knew from working on the first wave, that was bad, and things could get worse. What you see now is that it’s a very delicate position. At this stage every incident on top of the last puts us into massive pressures.

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