@poppyjuice
.bsky.social
Into safety, bias & human error. Swimming, cycling & running, sometimes mixed. Have been known to pass gas in front of strangers.
My strongest memory of COVID:
I was sat in a respirator. They are horrible to wear. It made my nose stream and I'd gone deaf in one ear from pressure on my temperomandibular joint from the mask straps.
I was tired. So, utterly, dog tired.
I'd just reviewed a man, in his 50s
They do not deserve to even stand side by side with us who followed their rules.
Let alone lead us.
It's time for a swift, aggressively thorough, clean out of the sleaze that somehow hoodwinked us into tossing their crumbs from the table.
I want a change.
Now.
What a betrayal.
What venal, dismissive, entitled, arrogance.
All animals equal, but some laughing at their own special trough that wasn't available for us routine pigs.
It was what we were asked to do.
It was fucking horrible.
But we did it. In the knowledge we were all in it together.
No cake.
No parties.
No mutual soothing.
No party hats and quizzes and cheese and wine.
Just head down, keep moving, for the greater good.
And I moved on to look at the next person dying. Unable to stop it happening.
It was unrelenting.
I went home. I wanted the company of friends. The blissful ignorance of stupid drinks in a pub.
But we couldn't. So we didn't.
I slept, and came back to run the loop again.
home. Unable to come to hospital because there wasn't room for the dying.
She would have to watch him die in her living room.
Whilst she grieved her Mum and now her brother.
She couldn't come
I promised her he wouldn't die alone without caring hands touching.
I hung up.
not good news. He's dying, we can't stop it. Can we organise for you to visit?"
She just sobbed. And sobbed. And sobbed.
She was an Emergency Department sister herself. Working through the pandemic.
Her mum had just died of COVID the morning previously.
Her Dad was dying at
Very little in the way of comorbidity, he was being ventilated, COVID, face down, oxygen saturations terrible, lungs stiff like wood. The regional ECMO centre felt nothing they could offer that would help. There was nothing left I could try either.
He was obviously dying.
I sat down at the phone to call his next of kin.
It's hard enough to have an end of life conversation face to face. Let alone on the phone. Let alone bellowing down the phone through a plastic helmet, unable to hear or talk properly.
His sister answered.
"I'm sorry, but it's
Do I support the Nurses strike?
Things I've watched nurses do:
Hold the hand of a 100% burns victim as they died
Brush the hair of an old man so he'd look smart for his wife when she came to see his body
Take footprints of a dead baby so their parents had something to hold
How I earned my full pay:
Doubled rota intensity
Increased ICU beds from 7 to 26
Walked 20km in one shift
Watched lots of people die
Had a colleague doctor die of COVID
Took no leave for a calender year
Got PTSD
Our reward?
Pensions tax bills
40% pay degradation
Claps
"For he to-day that sheds his blood with me,
Shall be my brother"
And he who flogs his grift off of inducing anxiety, shall expect me to poo in his theatre clogs when left in the changing room.
And I shall have had a lamb phall in anticipation.
So, watching healthcare staff who have refused to take this vaccine, when they knew they would be around vulnerable patients who could be at risk from them, protesting, butters no parsnips for me.
We've ALWAYS had mandatory requirements to work, including vaccination.
Absolute shit bag move Times.
The Junior Doctors have been replaced during the strikes....
By consultants. Our most experienced doctors.
Just done 13 hours overnight in ICU, off the back of 78 hour on call week, including New Years. Back again tonight.
Strike on juniors ✊
No-one gave a toss about that before.
If you'd caught HIV or Hep B from me because I couldn't be arsed to protect against that risk due to a tiny chance of risk to myself, I'd have been drummed out of town, and rightly so.
Every day in clinical work comes with risk
If that's where you're at as a healthcare worker, you don't deserve to stand side by side with us who swallowed our fear and managed our risk, when we didn't know if we'd pay in the hardest way possible.
So for melodramatic flourish:
But patients are being harmed, every single day, in every healthcare setting, by the gradual erosion of healthcare funding.
And that's got nothing to do with the nurses.
If people feel angry about this strike, punch up.
Not down on a nurse who does things that most could never
Shows why we have to have some mandatory conditions to be afforded to privilege to work with the most vulnerable.
It's ok to be frightened, for ourselves, for our kids.
But it's not ok to expect to have risk free professional lives at the expense of risking our patient's safety
About as far as I could throw them when it comes to civil liberties.
But the fact that some healthcare staff have chosen, despite watching what we saw over two years, not to protect their patients from the risk of them being unvaccinated, when they had no clue as to the risk
People argue we don't have long term data on the vaccine.
That's true. But we don't have long term data on sequelae of natural infection either.
There's some early data though that it's not innocuous. The link with children and diabetes particularly worries me for my kids
Everything we do comes with risk. The world is not risk free.
But a tiny risk to me, to protect my patients, is a no brainer.
I'm not hugely comfortable that we have had to mandate this vaccine, because it smells a bit authoritarian, and God knows I trust this government
I was never a great researcher. I don't have the right mindset for it. But I've worked alongside some amazing research scientists and doctors along my career.
I have faith in the scientific community, and they pulled an absolute blinder that year.
To have vaccines on the
Pick maggots out of flyblown wounds
Talk down scared psychotic patients holding a blades
Break apart gang fights in waiting rooms
So many memories of love, care and attention in situations where most of us wouldn't even know where to start.
And now we want them to do it for
The reason we've got such a terrible brain drain of British doctors abroad is because they're fucking good
Well trained, capable, effective
Other countries pay multiples of what we do to secure that talent
What sort of fuckwit thinks the answer is to make our own doctors shit
Less reward than 10 years ago.
Food banks and missed bills and fretting about the heating.
I couldn't do what they do, and I don't begrudge them for fighting to have a decent living wage for doing it.
None of them want patients to be harmed by striking.
Writer to try to tell my experience, many have told their stories better of what it was like to watch the dying and their loved ones, sometimes only on a screen.
It was, not to mince words, fucking brutal.
Some things we will bury deep, faces of dead mothers and babies, sobs
When on the 8th December, the first vaccine was given in the UK, we clamoured to find out when we could get ours. I'd seen too many patients, younger than me with minimal medical history, get sick, stuck for weeks on a ventilator, sometimes dying.
Get that needle into me ASAP
I've been punched, had blood spat in my eyes, bitten, intimidated by gangs trying to stab each other in clinical areas.
I've had to take PEP after needle sticks, take antibiotics after exposure to infected patients.
Colleagues have had teeth knocked loose, bones broken
Been hospitalised, left the profession burnt out. One lost vision in an eye from an infection caught from a patient.
One colleague crashed his motorcycle fatigued and died.
I'm into double figures for healthcare staff I've worked with who took their own lives. Also one murdered
I wasn't the first ICU Consultant in my hospital to intubate a COVID patient, but I was close to the front of the first wave, some time in March 2020.
Me and
@DaveJMelia
went in, in tandem, sweating in unfamiliar PPE.
We'd heard stories of doctors and nurses dying already.
Market in under a year within the normal study framework for a novel therapeutic shows the power of innovation and science, particularly when red tape is stripped out and cash thrown at a problem.
As time went past, the vaccine didn't stop spread as we hoped it might do, but
The vaccine hub in our hospital did a wet run to trial process, I was lucky enough to be asked to be in the trial, and got my first dose just before Christmas 2020.
Same for second dose, same for booster.
As soon as I could, I was in the chair, with my pasty arms out and ready
I was frightened, although I'm too much of a fragile ego to have admitted it to anyone.
Working in full PPE is hard, your manual dexterity is compromised, it's hard to see properly through a respirator, and it's really difficult to hear.
The patients needing to be intubated
we expected of them.
One doctor in our hospital died of COVID. Other staff too.
One of my colleagues came out of retirement, despite being at risk, to rejoin the team. He got really sick. We were desperately worried.
An ED reg ended up on CPAP on high oxygen requirements.
As a consultant in intensive care medicine, the staff in my father's local ICU were likely very nervous having me watch them tend to his final moments as he was removed from a ventilator and made comfortable.
They gave him peace, respect and dignity as his death came, gentle
That's why they've all been vaccinated too.
Plus watching them struggle with missing school, particularly one battling through GCSEs largely rudderless, was heartbreaking, and I don't want that to ever happen to them if possible.
I checked on him multiple times a day, watching like a hawk.
Thankfully they both fully recovered.
Many others got sick too, although thankfully not as bad.
It was a a hard brutal year. Many people have shared stories of what critical care was like, I'm not a good enough
flow oxygen on a CPAP system clamped on the patient's face.
We made sure though that it was two consultants going into the dangerzone of aerosols first, standing at the patients airway.
We wanted to lead by example, to show the whole team that we would take the same risks
Drop their oxygen levels frighteningly quickly when you anaesthetise them.
So I was scared for myself, for the team, and scared that my patient might die whilst I hamfistedly tried to function, double gloved and shouting to be heard through masks and above the noise of high
I was on strike today.
Lots of people have posted saying that they did so reluctantly, and found it a hard choice.
For me it wasn't.
I'm sick and tired of talking to patients who haven't been able to access care in a timely manner because we don't have the staff, the time
Not linking in the current news story, although my heart goes out to all involved, family and staff, for what be an extraordinarily hard set of circumstances to be navigating.
But it might be a good time to talk about brain stem death and how confusing it can be as a concept.
@ElstoneGutters
Lolz, only just saw this since this tweet blew up again.
Took a lot of foresight to set this account up 14 years ago and masquerade as a sleeper cell agent within the NHS awaiting my activation trigger, but it's all come to fruition 💪
@MikeClarkeSnr
@gibbie46
Masks worn for oxygen supplementation at altitude can tolerate a leak as they're positively pressurised by oxygen inflow, so don't need to be worn as tightly.
Ours needed complete seal as they have negative pressure at points through the respiratory cycle so musn't entrain air
@LozzaFox
It's not rejection though, is it Loz?
Some cultures show respect by not touching the opposite gender outside of their own family, but bring their hand to their heart instead.
Personally, I wouldn't shake your hand either.
But for a completely different reason.
You'll thereby understand why we consider your "journalistic" opinion poorly informed, poorly researched, ignorant and offensive.
Kindly go give your head a wobble.
You're embarrassing.
An "interesting" 48 hours in politics.
So much so that I nearly didn't clock the date today.
17 years ago I was running a teaching course just across the road from the Leman St police station, and heard siren upon siren heading out at pace.
It quickly became apparent that
It's weird, because I've worked in a critical care unit over the whole three years since COVID landed, and I've seen untold misery to those who weren't vaccinated, but still haven't seen a single case of critical illness related to a vaccine 🤔
@i_iratus
Used to live off Rotherhithe St on Swan Rd
Photo looks like late 60s from the clothes and cars
Just round the corner was St Mary's Church, where Jack "The Hat" McVitie's body was dumped overnight having been murdered by the Krays
Funny how that's not mentioned by Mr Nostalgia
"Check your conscience"
23000 excess deaths from ED waits
46,828 nurse posts unfilled
10,582 doctor vacancies
Hospital roofs being held up by props
37.7% doctors leave before entering specialty training
72% senior doctors planning to retire early because of unfixed pensions tax
I urge
@BMA_JuniorDocs
to come to the negotiating table.
We owe it to junior doctors and patients to agree a fair settlement which recognises the hard work & vital role of junior doctors and wider economic pressures.
Read my article
@Telegraph
👇🏻
@thecoastguy
It's weird because I've watched loads of people die of COVID, unvaccinated, but yet to meet even a single one, yet alone a single one critically ill, from a vaccine.
And neither have any of my colleagues.
In close to two years.
Fuck my boots.
Gone to the cinema with my eldest and out of nowhere got sideswiped by this ad.
Huge flashback response.
Sat here trying very hard not to let him see that I've teared up.
Bloody cinema.
@SteveBarclay
Know what else we need to successfully treat aortic dissection?
Good GPs to treat underlying risk factors.
Good ED doctors who start emergency treatment.
Good radiologists to spot it on scans.
Good anesthetists to provide stable operating conditions.
Good surgeons to operate
I know these little irritations can be frustrating for staff, but I suspect they're probably extremely stressful for patients, and it becomes their take home memory of that day, regardless of how smoothly clinical care was delivered.
I have utmost trust in the specialty in the UK, to care for both the living and the dying, with professionalism and dignity.
Regardless of what sells copy or makes good clickbait.
@FICMNews
@RCoANews
and pain free.
Whilst still surrounded by machines and in a hospital environment rather than a dedicated hospice, it was expertly done, with grace and sensitivity, with my father and our family cared for and cradled.
Intensive Care is a specialty that, by its nature, can see as
much death as it does survival.
Intensive Care doctors, nurses and AHPs, whilst not palliative care specialists, have a profound understanding of delivering palliative care in the ICU environment, and will often work hand in hand with palliative care teams to give good deaths
@HarrietSergeant
Furlough?
As doctors we doubled our rate of critical care shifts.
Colleagues on the anaesthetic rota joined us and were sleeping in the hospital instead of at home.
I didn't take any annual leave for the first year.
One doctor in my hospital died.
Journalist?
Embarrassing.
@Triquertrum
@untypicalboro
Not a race to the bottom, we should all stand in solidarity, doctors, nurses, HCSWs, AHCPs, MLSOs, healthcare managers, paramedics, admin staff, ambulance techs, etc etc
All shoulder to shoulder, one
#NHS
together
Maybe going forward this opens the opportunity to talk about what role professional mediation has in critical care medicine for the very rare cases when relationships become strained.
And maybe another day we also need to talk about the damage external lobby groups can cause
In 1996, horrifically, Dunblane saw a mass shooting in a school. Two new firearms bills were quickly passed regulating the ownership of handguns.
That has consequently been the only school shooting we've ever had here in the UK.
@HowardCCox
@SadiqKhan
If only there was some form of larger vehicle that could drive through communities, stopping frequently, moving people short distances within London.
It would be even better if the more elderly were allowed to use them for free.
They really should give this some thought.
@DrAseemMalhotra
How utterly irresponsible to post this in a manner that you know will stir up anxiety for the vaccine hesitant, and reinforce the beliefs of vaccine deniers.
The reason we have vaccine injury reporting systems is to properly scrutinise deaths temporally associated, so we 1/2
Outside of palliative care units.
Recent news has the potential to have dented the reputation of critical care, but words spoken in the depth of grief don't reflect my experience of dying in ICU, as a practitioner or as a relative having been through it in the closest way.
FFS, I love the NHS but sometimes it boils my piss.
Was just on my way home and a frail, elderly outpatient who was an amputee stopped me for help.
Had got lost in the corridors and didn't know how he was getting home.
Ascertained that they'd come in by hospital transport...
One last thought.
Even when you've decided you would like to become an organ donor if the situation arose, your family can still over rule that decision, so please, talk to each other about what you would want to happen. 🙏
My mum just phoned late, she's elderly so always makes me twitch in case it's bad news.
Wasn't bad, but she'd watched
#breathtaking
and was in bits. Delayed trauma reaction, I hadn't really shared with her what it was like at the sharp end.
I haven't watched, not sure if I can.
My strongest memory of COVID:
I was sat in a respirator. They are horrible to wear. It made my nose stream and I'd gone deaf in one ear from pressure on my temperomandibular joint from the mask straps.
I was tired. So, utterly, dog tired.
I'd just reviewed a man, in his 50s
will be afforded all possible dignity in the UK, of that I am sure, and want everyone who might be a little bit more anxious after recent news to also be assured
And also to let all ICU staff know how much it is appreciated that they can safeguard a good death, if it has to come
government, I will try hard to remember the people who lost their lives on the 7th July, 17 years ago, and the amazing people who did everything they could to save many more.
@JasonRadley1
That's a nice thought, but the phrase “The standard you walk past is the standard you accept” keeps going round my head.
I think I'll seek someone out to give some feedback tomorrow.
If I found out someone spoke to an elderly relative of mine like that I'd be seething.
I am an ICU and Anaesthetic consultant, and have been for 15 years after 14 years of training. I've done little except be in ICU for two years looking after COVID patients. I am fully jabbed and boosted, as are all my family and kids. Please
#GetVaccinatedNow
With a cherry on top
Very sadly lost our first patient of the third wave yesterday.
Confidentiality precludes details, but young, fit and unvaccinated.
Please, please, please, get your vaccine if you possibly can 🙏
COVID sitrep: We are definitely now entering another wave of hospital admissions in the UK. In the NHS Trust where I work, we are admitting more COVID-19 patients to hospital and more to intensive care, although the pattern seems different to the winter.... 1/8
One day, I'll be able to take this pinned tweet down and move on.
But not today.
Couldn't get a COVID test for your family? Rees Mogg could
Worried about your Nan having a 1:20 chance of dying? Boris wasn't
Didn't want to bring COVID into a care home. Hancock wasn't bothered
My strongest memory of COVID:
I was sat in a respirator. They are horrible to wear. It made my nose stream and I'd gone deaf in one ear from pressure on my temperomandibular joint from the mask straps.
I was tired. So, utterly, dog tired.
I'd just reviewed a man, in his 50s
@SteveBarclay
@BMA_JuniorDocs
An utter joke.
We've been sorting out rotas, cancelling elective activity, doing top up training.
It's a huge price of work to keep patients safe.
10 at night on a Friday before the strike starts Monday morning?
You easily could have stopped this by negotiating
Utter joke 🤬
@ABridgen
He died from a gun shot wound.
You truly are a suppurative boil on the anal verge of all that is wrong with British politics Bridgen.
A proven liar. A grifter. An embarrassment.
Can't wait for you to be in the bin of history and we never have to hear your lies again.
If you hadn't blocked everyone who starts to unmask you, we could all have a good session ripping this nonsense into tiny pieces
@CartlandDavid
You clearly never stepped foot into a COVID ICU
Coward.