Features
Double pandemic, Dr Forte and the fork in our road Ben Caesar
There are currently not one but two pandemics affecting healthcare workers. COVID-19 was preceded by the pandemic of burnout amongst doctors, nurses and allied health professionals. The coalescence of these two pandemics are compounding the risks to the wellbeing of all healthcare workers, particularly those on the frontline. However, it is possible that these two pandemics occurring simultaneously may offer us an opportunity to create a new working environment as we search for different ways to deliver medical care. Double pandemic
Ben Caesar is a Consultant T&O Surgeon based in Brighton with an interest in major trauma and sports injuries, who joined the Army at the age of 39 as a reservist just as he became a consultant; he changed to a regular commission three years later. Over the past nine years, he has deployed on three operational tours and is currently posted to 16 Medical Regiment in Colchester. He has set up and leads a clinic for Service Personnel and Veterans (the Chavasse Clinic) and has an interest in burnout and wellbeing in healthcare.
Healthcare workers were already teetering on the brink of the burnout Abyss, but nevertheless, everyone rallied to the calls of their governments to help manage this unprecedented crisis. The physical, psychological and emotional strains have been recognised, and emergency measures have been put in place. These, however, have been haphazard and piecemeal crisis management. Any attempts to address the underlying causes of burnout have been relegated to the backburner. The short-term resilience of all members of staff has been exceptional but running on those high levels of adrenaline for many months at a time is unsustainable and takes an additional toll.
In the UK, the public’s initial overwhelming support, often compared to the ‘Blitz spirit’ of the 1940s, is slowly waning as the pandemic becomes part of normal day to day life. The easing of restrictions and the return to a semblance of normality is giving the patients the impression that normal service is resuming within the NHS. This couldn’t be further from the truth. Within orthopaedics, whilst trauma services continue, but in a less efficient manner due to the restrictions required as a result of the COVID-19 virus, elective operating is at a fraction of its previous levels. The public are increasingly frustrated that their planned surgeries are still not happening and may not happen for many months to come. This is adding to the stresses on the clinicians who feel a sense of moral injury that they cannot provide the levels of service expected of them. Originally a military term, moral injury can be defined as the psychological distress that results from actions, or the lack of them, which violate someone’s moral or ethical code. In the COVID-19 pandemic, many of us are having to live with uncomfortable decisions about the allocation of limited resources. >>
JTO | Volume 08 | Issue 04 | December 2020 | boa.ac.uk | 31
