Donning & Doffing on the front lines

Mask on, seal over the nose to stop glasses misting up so much. Apron on (always easier with gloves on), feels flimsy especially in the wind, doesn’t feel like it will protect much. Visor on or is the patient low risk? How many more times am I going to put this all on?

The beginning of shift routine is to check if we have enough Personal Protective Equipment (PPE). This involves checking stores, asking managers, raiding dormant ambulances. As relief staff (not on a fixed shift pattern) you go to different stations. Each station has differing policies; some have personal issue PPE, some are ambulance specific. As relief you end up pilfering PPE to protect yourself as you might end up without.

The only certainty is change. Which PPE do I use with which patient with which procedure? What’s the policy at each ambulance station? What’s the procedure and policy with each of the hospitals we go to (anywhere up to 4 different hospitals in a shift)? With each of these a daily change is unsurprising, though things have stabilised.

Where staff haven’t had the right PPE they are put into unreasonable situations, protect yourself or attempt to try save someone else’s life. There have been cases of people refusing to attend jobs. There have been those putting themselves at risk. Either way it’s a failure of the systems. Whether it’s the Government not taking advice to prepare for potential pandemics because its too expensive, they’ll just put a sticker over out of date equipment. To enforced competition between NHS trust’s where we should be working together not separately.

Lockdown begins, doesn’t feel much different as we keep going to work. Keep seeing our regulars, though now they’ve developed a “cough”. Friday / Saturday night in the city centre feeling eerily quiet. Crews seemingly the same as always a mixture of pessimism and humour, even once colleagues started showing symptoms and being hospitalised. “We’ll do what we always do, we’ll make do and adapt”.

The public remark you must be so busy. To be honest the failing system was already failing. All-be-it we can only attend one job at a time the cracks were already showing. 9 hours on the go without a break. Crews have used employer fatigue policies to then “down tools” and leave their 10 or 11 hour shifts early, not without risk of retribution but a standard days work has already been done. How long until the good will during the pandemic starts to push everyone beyond the limit.

Is the virus really that deadly? For some, yes. Walking away from a 49-year-old male, normally fit and well whom we took to the resuscitation bay (whilst the patient was twiddling his thumbs). The consultant glancing at his blood gas results “might as well book him an ICU (Intensive Care Unit) bed” with almost no hope in their voice. You start thinking he’s probably not going to make it. Time for our next patient.

Alcohol gel the gloves, take gloves off, alcohol gel hands, apron off, alcohol gel hands, mask off, wash hands. Wandering if I’ve cross-infected myself, what do I need to clean, what have touched? How long will this go on for? How many donning and doffing will I do? No point counting.