Consultant Simon Holmes applauds the ITU nurse he assisted
Simon Holmes is a Consultant Oral and Maxillofacial Surgeon, with a major interest in complex craniofacial trauma.
Simon recently completed his first nursing support shift at The Royal London Hospital and shares what it was like to work in ITU during the second Coronavirus peak.
“I have been referred to as a reflective surgeon,” said Simon. “Which I take as a compliment, I’d rather that than be called a rubbish one.
“I am very happy with my career at The Royal London Hospital which has been a voyage of discovery and given me spectacular challenges.
“One of the key team members is the anaesthetist and we are greatly fortunate in having a large number of very talented ones that I work with. Our team also provides tracheostomy for ITU and this coupled with joint management of some pretty spectacular cases during the first lockdown, afforded me the opportunity to get a feel of the general situation.
“Where we are now feels very different, I see the way my friends in ITU are and that alone was a big driver for me to help. During the first lockdown we wrote an article for our journal about potentially rationing facial trauma surgery according to Covid status and resource allocation. As we go on, I am now having to ration what I do according to theatre and nursing resource and I felt that I needed to understand ‘how the hospital felt’ in order to legitimise this clinical position.
“As we struggle as a nation, I was aware that we would need to deploy our juniors and whilst I have no leadership role I could not ask anyone to do something if I do not do it myself.
“So I volunteered myself to help, and I will do a night shift, once a week until I am not needed.
“There is also a ripple effect as my junior colleagues, senior trainees, and indeed consultant colleagues see the ‘old man’ have a go and that has been heart-warming. I am lucky that I have an amazing wife Domniki, herself a QMUL dental senior academic, who has been very active professionally throughout the pandemic and entirely understands and supports me in this.
“I have worked in Whitechapel for 20 years, Sierra Leone and Johannesberg, so I am not readily phased by much. But the sheer scale of what is going on, together with the magnificence of our ITU colleagues just cannot be understated.
“I was asked to support an ITU nurse called Andrew from St Bartholomew’s Hospital, this was a truly humbling experience. The guy was a total natural, and rapidly brought me back to 1996-1998 when I was a proper Doctor. The diagnostic and clinical skills, with the ‘sixth sense’ (that in my view cannot be taught) was obvious. I felt very taught and looked after.
“Of course ‘hunting down the drug keys’ brought it all back, and I hope that my blood gas analysis and my resurrected junior doctor drug giving skills were a help. I was able to fiddle with the arterial lines when the patient kept unsettling them, I kept an eye on the machine, and even spotted when an ECG lead went down.
“I washed a patient with Andrew and started to learn the ‘dark arts’ of the red nylon patsheets. It is very fitting that a crusty old professor should give a little back, as I am very aware that all too soon this could be me on the receiving end.”
Simon was asked about the support he received from his new colleagues, he said: “I was supported greatly, there was a lot of learning on the job, for example where exactly is the dexamethasone, the drug keys and even the colour of the bag for packing the used bed sheets. I must however reassure anyone reading this that I do make a mean bed, although my wife would absolutely refute that.”
Simon reflected on anything he would have done differently, he shared: “In the night there was a moment when I should have simply held the hand of one of our patients who was dying, I didn’t and I am sorry for it. I kept them comfortable, moistened their lips, kept them topped up and nicely relaxed, but I did not hold their hand. I think doing that would have been better than the diamorphine.
“I have another shift on Saturday and I have ordered my stethoscope off amazon and a rotring pen, so the people reading my observations will understand them.
“To anyone reading this who has concerns about volunteering or working on ITU, please do not.
"There is nothing to be afraid of, you will be standing on the shoulders of giants.”
If Simon's experience has inspired you to get involved, please register your interest here.