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The anesthesiologist-resuscitator teacher of the Vilnius University Hospital Santara Clinics told tv3.lt about daily life and the challenges of working in the department of “combat” on the front line in the fight against coronavirus. Donata Ringaitienė, who faces seriously ill patients every day.
Doctors compare the prevailing situation to wartime: Although the nature of work has not changed much, the daily routine at work is much more difficult and caring for COVID-19 patients requires more planning and strategy. Doctors risk their lives to save others and, over the years, they have had to forget how much time they spend.
Not a single step without a clear plan
The workday begins early in the morning and every day the lives of patients end in the hands of doctors.
“Our work starts at 7 am, the doctors are on call and come together to take over the shift. It begins with moving patients, reports on problems that have arisen, and additional plans for patient examination and treatment. We also decide which patients we can take out, we organize their relocation. A little later we received information from the inpatient departments, whose condition has deteriorated, what needs to be transferred to resuscitation and therefore the endless circle has been turning all year, ”said D. Ringaitienė.
By planning each step of the day and having a clear action plan, comes the most difficult time of the day: visiting patients in the red zone.
“We go to patients long enough, to the red zone: there are procedures, appointment changes, exams are discussed, patients are raised and placed in new beds, exams and treatment plans are re-done.” said the doctor. , adding that such care is continuous 24 hours a day.
Each entrance to the room is planned and has a purpose. If this were not the case, according to the anesthesiologist-resuscitator, the energy would be wasted where it is not needed; just the preparation for the entrance to the room takes several minutes.
“When you go to the patients, to the red zone, you have to be very familiar with the patient, know what you plan to do, because each entry and exit is a specific procedure that must be prepared: put on guards to protect yourself. And others, it takes time. at least 10 minutes. In addition, when leaving the red zone, it is necessary to undress everything correctly so as not to make mistakes. additional the inputs draw a large amount of voltage.
We try to always go with the objective, to have a clear plan. This is different from treating non-covid patients, who can be visited without special preparation. There is more advanced planning in the combat section.
It is also important to give clear instructions to other team members here as the number of staff has remained the same despite the increased workload. There should be very little distraction and every minute should be used correctly. We have to protect each other, ”said D. Ringaitienė about daily life in the department.
Every loss is broken
In COVID-19, the fight against death takes place on a daily basis, and although one would like to save everyone, death often becomes inevitable here.
“Each story is delicate, there is a struggle between death and life; the life of each patient is extremely important. It is very difficult for us to accept the serious diseases of young people. We survive for all and we fight until the last hope,” said the specialist .
One of the most sensitive stories in the doctor’s memory is when pregnant women enter the ward in difficult conditions. Unfortunately, your treatment does not always end happily, sometimes you have to declare the death of the fetus.
“We also treat pregnant women, some of whom unfortunately failed to save the fetus. In situations like this, it is important to save at least our mother’s life and we have been able to do so successfully. Of course, there were happier cases when both the fetus and the mother survived ”, D. Ringaitienė tries to see the bright side.
However, the most difficult thing is to accept the deaths when the room treats the family members and one of them leaves this world; it is a heavy burden for physicians to report a loss.
“There have been situations where family members have been treated at the same time, like husband and wife or mother and child and one of them is dying. It is really difficult to inform a patient who is still being treated in the ward about the death of a loved one ”, the specialist does not stop the tears.
When a patient is lost, according to the doctor, the idea of whether everything he could have done is not always abandoned. However, the confrontation with death is the daily routine of doctors and they have to accept this idea when choosing a specialty.
“Some dissociation should be more focused on treating the patient, the disease, what he can do. It is very calm when you do everything and you have a successful result. But it happens that you do everything that the latest scientific advice dictates, but you do not get a positive effect. These situations are really shocking. “
Provide emotional support to loved ones.
Doctors working in COVID-19 wards not only treat patients, but an important part of their job is communicating with patients’ families.
“The most difficult thing is his relatives who are on the other side of the barricades. Due to the current epidemiological situation, patient care is severely restricted.
Only in exceptional cases, when the patient’s condition is critical and there is no hope that the patient will survive, do we say the last goodbye, ”said D. Ringaitienė.
There are daily telephone conversations with the relatives of the patients treated in resuscitation, the course of the disease is presented to them. This provision of information is currently the only option.
“They only receive basic information by phone and these conversations take place several times a day, we give them brief information about the dynamics of the patient’s condition.”
Telephone conversations sometimes take a few minutes, and sometimes several. When asked how people react to such news, the doctor does not hide the fact that people express various emotions.
“People have a hard time reacting: some are quiet, others express their emotions more, and of course when they hear bad news, those reactions are understandable,” said D. Ringaitienė about the sad daily life in the intensive care unit.
The specialist says that it is not always possible to distance oneself from the thoughts of patients. Patients who are in long-term treatment make contact, so not thinking about their condition is not an easy task.
“At work, you think about the patients, when you return home, the thoughts also revolve around them, about what is happening in the room, how they are … The longer you treat the patient, the more you become attached to him and if the case is unsuccessful, thoughts about whether you did everything right, you don’t give up for a long time, you start thinking about what you could have done differently, “said the doctor.
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