COVID-19: lessons for junior doctors redeployed to critical care

Abstract

Approximately 4% of patients with coronavirus disease 2019 (COVID-19) will require admission to an intensive care unit (ICU). Governments have cancelled elective procedures, ordered new ventilators and built new hospitals to meet this unprecedented challenge. However, intensive care ultimately relies on human resources. To enhance surge capacity, many junior doctors have been redeployed to ICU despite a relative lack of training and experience. The COVID-19 pandemic poses additional challenges to new ICU recruits, from the practicalities of using personal protective equipment to higher risks of burnout and moral injury. In this article, we describe lessons for junior doctors responsible for managing patients who are critically ill with COVID-19 based on our experiences at an urban teaching hospital.

Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK

“…Recent publications on staff redeployment to ICUs during the pandemic have highlighted the importance of carrying out detailed skills assessments of redeployed staff to ensure their expertise are used proactively to address patient needs. 31 32 Some publications have also underscored the importance of intensive, yet comprehensive, training programmes for redeployed staff, particularly those that combine classroom and practice-based training and seek to build skillsets in the workforce that will be maintained after the epidemiological peak. 33 34 This last point on the sustainability of a skilled workforce has become particularly relevant as several countries are having to rely on redeployment on a nearly continuous basis to deal with the demand of second and third surges of patients.…”

Factors Impeding Health-Care Professionals to Effectively Treat Coronavirus Disease 2019 Patients in Pakistan: A Qualitative Investigation

“…Undoubtedly, at the start of a medical career, high mortality was seen in patients; sudden deaths and no standard treatment were the most significant challenges that shake their confidence. In addition, with the communication challenges posed by strict limitations on family visits, junior doctors should receive additional training and support in breaking bad news (Coughlan et al, 2020). Well-being is particularly crucial for deployed junior HCPs, and simple measures such as introducing junior doctor forums can provide trainees with a space to reflect on stressful experiences with their peers.…”

Redeployment and training of healthcare professionals to Intensive Care during COVID-19: a systematic review

“…Coughlan et al (2020) described solutions for stressors that Junior Doctors experienced due to working in unfamiliar ICU settings. The interpersonal communication required for intense multidisciplinary teamwork was facilitated by visual aids, anonymised whiteboards and the use of walkie-talkies.…”