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We are talking to L. Darginavičius, the head of the Emergency Department, about the changed “front and rear doors” of the patient’s path and how they will “get out” of the situation caused by the COVID-19 virus and quarantine.
– Emergency care is necessary not only for patients affected by a pandemic, but also for patients with other illnesses or injuries. How is the work of your department these days?
– Now the situation is twofold. On the one hand, we are outside the conditional comfort zone, a little uncertain envelopes every day, but on the other hand, we feel good, we are fully prepared for a large influx of patients, we just do not receive it. Of course, it is good that the number of patients does not increase by hundreds or thousands, but the feeling is ambiguous, as in standby mode. You could compare that prevailing feeling to a sports competition when you stand in line and wait for them to cover you to start getting excited. When you start working, you are already calming down. And while you wait, it is so “good, already”, either on the bench or in the plaza.
And when it comes to the routine of the workday, this is the changed beginning and end of the patient’s journey, from arrival to departure. Or as we call it: the front and rear doors. On arrival of the patient, for our safety and that of patients in other rooms, we assess whether the visitor can contact others and in what part of the room we can inspect and accept him. Regardless of what part of the room the patient is in, they are examined, consulted, their indicators are measured, tests are carried out and, based on the results of the examination, we decide which will be the back door: to the house, to us or another hospital. If a patient undergoes a COVID-19 test, it is sometimes necessary for the person to wait longer to be absolutely sure that it is safe to travel and be with other people. Therefore, that time until the back door is extended.
– How have patient flows in the country changed since the introduction of quarantine?
– I would like to highlight some moments in which we feel the difference. We found that the people themselves are often confused and anxious when considering whether or not they should have come. Furthermore, we see that more sick patients often arrive. In the past, before quarantine, up to a quarter of patients may have gone somewhere other than emergency care, but now they no longer know where to go, feel bad, think the worst, and turn to us. In general, the total number of patients is lower than usual, but we work more with each patient, paying more attention to them. The variety of injuries and illnesses, so to speak, remains during quarantine: these are eye injuries, heart ailments, brain problems, and other injuries. The distribution is similar.
In the past, before quarantine, up to a quarter of patients may have gone somewhere other than emergency care, but now they no longer know where to go, feel bad, think the worst, and turn to us.
– In what situations have you been caught as unexpected or surprised?
– I couldn’t identify cases of patients and their diseases, but it was unexpected that some colleagues who decided to stop working in the Emergency Department when the fight against the COVID-19 virus began. I am not talking about doctors. In contrast, when someone fell ill or retired to self-isolation, the doctors themselves asked them to fake a colleague. But at the same time, the sacrifice of the unity of the other people who went to work surprised me. It is gratifying that we go together and see the importance of not leaving others in trouble.
– How do you feel the intensified emotions?
– The team’s mood is good enough, I didn’t hear any complaints that it was a bad psychological feeling. It is true that at the beginning of the pandemic there was more anxiety. Some have said out loud that they are afraid of getting sick or of carrying the infection to their loved ones. But now we’ve really gotten used to it. We are already used to the need to use a lot of protective equipment. It does not provide comfort, but we understand that it is part of the job and is necessary for the safety of all of us, so we have adapted.
We really fight for the patient’s health all the time at work. That fight is not just with the disease, but also with colleagues: sometimes we have to argue more fiercely, discuss who has to treat that person, if we can take them home or if we still need to be hospitalized. It’s natural to be frustrating and frustrating when it comes to helping a patient become more persuasive. But I did not notice an outbreak of emotions, and even if there are more acute situations, we talk, we listen so that emotions do not accumulate.
If there are major fears, a psychologist works at Kaunas clinics, and there are phone numbers for psychological help available, where you can go.
– Why did you choose emergency medicine over some other specialization?
– I was already talking about being a doctor when I didn’t go to school. This is how those around him valued it as children’s languages. But over time, everyone became convinced that the wishes did not change. There were doctors in my family, in the family, so, as I like to say, it is a characteristic of the family.
And emergency medicine because I really like this specialty. The timing of decisions is very important in the emergency department. Therefore, this area requires a quick response to an emergency, a plan A and B, the ability to cope with stress and learn to do it.
Also, here is a part of all medicine, each area. For example, I can help a patient with nasopharyngeal and pediatric diseases, as well as trauma or surgical problems. Regardless of the field of medicine that we advance, I have knowledge everywhere. For the vast majority of patients who come to us, I have enough knowledge and skills to help and spend at home. It motivates me, as does the feeling of freedom and independence that I can do myself and I don’t have to ask someone to do it. The man came, I solved the problem here and now.
– What leisure activities distract from the work routine? I have seen your name in the swimming minutes, what is the relationship with this sport?
– Anyway, I’ve been swimming since I was 8 years old, I’m an amateur. After having tried all the competition formats, I participated in swimming marathons in Lithuania. I was training for triathlon lately. Swimming is both a sport and a way to relax. Being in the water is a form of meditation in which you remain in a state of weightlessness with your thoughts.
Now the pools don’t work, the open waters don’t reach 10 degrees, I can’t go out and do it with the additional equipment I have. During the winter, in the afternoons, when there are no people on the streets, I run or extract a bicycle, I put it on a special trainer. The total amount of time I can spend on that now is less. You have to do more forgeries, you also want to spend time with your family. I will resume my swimming activities in the summer.
– What would you like colleagues who also work on the front line?
– I don’t want to lose my good humor, let’s remember what we work for. Let’s learn to enjoy the little things because looking a little bit in that moment can make a big difference. I would also like us to learn the lessons that we have been able to learn during this time. The pandemic and quarantine have taught us useful lessons, and I hope that we learn from them, and not just that we run in the wind, so that there is no laughter in the nation about doctors, and that a virus comes unexpectedly.
Draft On the front It seeks to bring together Lithuanian medical personnel in all fields and at the same time create a quarantine yearbook during the global pandemic COVID-19. We invite all medical staff to share their own captured moments: videos, photos, personal stories, reveal their emotions, behind the scenes, everyday joys, create a strong sense of unity and leave authentic content for future generations. We are waiting for information by email. [email protected].
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