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RDGH Junior Doctor Network

Zoom meeting 29/03/20

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Sunday, 29 March 2020

Zoom meeting 29/03/20

Zoom meeting 29/03/20

Introduction:

B5 our current COVID-19 ward, AMU is increasing in COVID-19 capacity

We are 2nd highest for severity and number of cases in the area

Current NIV capacity 8

 

Projection:

70,000 cases likely in next few months; 15-20% admitted

Will need 70-80 ITU beds (4000% increase needed-this will be difficult, still waiting on ventilators)

30-40 deaths per day at peak in April; 30-40% staff sickness rate

ITU will have nurse 1 to 6 care, doctors will follow

We need to look after ourselves and our patients!

 

Rotas:

Green (currently), Amber (within a week or so) and Red (after that)

Amber- doubling up (Team A- on call, Team B- on standby)

Red- 1 in 4 work days, 1 in 4 work nights -> 3 days on, 3 days off

There is no fair way to do this, we will all be working a lot of shifts, they may not be fairly distributed because of how it all works, they will be remunerated as per new contract

Annual leave will be honoured where able, but may need to discuss that individually- this is not ideal of course but the situation is difficult

F1 and SHO will be seen the same.

Reg and F1/SHO will be divided into zones. Consultants same but not yet defined

ACPs will support, SDECC will reduce and likely close eventually

If annual leave not booked, may be a case of holding fire for now, but this is not a recommendation, will still try to honour leave. Any unused leave should be carried over

We can be pragmatic amongst ourselves, we can co-ordinate extra rest as able

Rob will chase F3 annual leave policy

Rota updates will be dynamic, will publish through NHS website

 

PPE:

(Changed from today)

Initially we were using PPE incorrectly due to having high stocks of items soon to expire

Low level          Surgical face mask (fluid resistant), apron & gloves

Low level: All clinical areas need low risk protection

                        Cubicles with confirmed COVID (low burden)

High level         Under gloves, long apron, over gloves, FFP3 mask (if tight seal no need to tape), visor if coughing, (ENT and A&E have been advised to always wear visor)

Cohort bays on AMU- FFP3 mask due to higher viral burden likely as lots of new patients with ?COVID

                        ED, Resus, critical care areas where suspected/confirmed

High level PPE if aerosolising (non rebreathe 100% O2, BPAP, CPAP, high flow O2) not nasal cannula

When seeing each patient will need to change gloves

Surgical mask goes under oxygen mask

 

Welfare

They key is for us all to work together

Fudoodle- please do get involved https://www.doodle.com/poll/cimc6bmbg8tktq4p/

Car parking free from 1st April

Anyone can contact Sunny if they would like to

Please also remember Nhs.unmind.com/signup if you would like somewhere a little removed

Bereavements: You should not be pressured to come back to work before you are ready, if you would rather, please message Sunny and he will liaise with the Trust so you don’t have to

M&S will remain open and have more basics range (general groceries)

Boots may close

Costa may close

Staff canteen- free staff meals while open

Banter group will also be set up

 

Training & Education:

Upskilling in e.g. LPs may not be what is required at this point and takes time to develop competence

Targeted training on COVID-19 specific issues such as Venturis, conscious proning, ARDS etc

Rob will disseminate the latest guidance through the website & is in touch with ITU to make sure we are on the same page

Andie, Lucy & Priya have been working on a COVID handbook

Concerns raised:

Not being up to date- Rob S will work on disseminating this through the website

Removing duplication/ unnecessary exposure (e.g. ABG) - Rob S will work on clarifying this

            All the information will be on the website

            Will still need to be aware of non-COVID conditions:

Rob P to provide Sengstaken-Blakemore tube training for SpRs

Will to complete thrombolysis training- please contact Will if able to support (whsapwell@doctors.org.uk)

            Should only work within your competencies- regardless of role

            Rich Eddery to look into CPAP & BPAP training from Melissa

            Anaesthetists will now not attend non-COVID cardiac arrests

            You must still wear full PPE before you start

            Anaesthetists can still attend if fast bleeped if you believe escalation appropriate

            Further information will be disseminated as we get it

 

Communication:

Dedicated website with everything would be better, please sign up! https://www.networks.nhs.uk/nhs-networks/rotherham-coronavirus

 

Consultant contact:

A letter has been drafted, it will be edited in the next day or 2, once this is complete if you agree, please sign