Dr Artur Szewczyk: The coronavirus collapses like Tyson, you drop out for at least 10 days, and your shifts remain vacant. The doctor talks about working at the emergency department during the pandemic

Patients with the so-called uncertain status, i.e. without a positive coronavirus test result, but with symptoms. They cannot be admitted to the COVID-19 ward without confirmation of the infection. Meanwhile, you have to wait even 3 – 4 days for the results … During this time, the SOR has his hands tied. He heals in solitary but at the same time the place is blocked. Hence, many hours of queues and taking the sick from hospital to hospital.

1. Some people with a positive test for the presence of coronavirus should not go to the hospital, but go home – says Dr. Szewczyk
2. Dr. Szewczyk believes that as a rule, people who like it work at the SOR, it cannot be done by necessity
3. According to the doctor, the pandemic has proved that there is still a shortage of doctors, nurses and paramedics, and that access to medical services is too small
4. Most of Dr. Szewczyk or their relatives, she was already in quarantine, some had an infection
5. Dr. Szewczyk believes that calmly informing the public about personal protective equipment is ineffective, because most only reach the words: shock, surprise and horror
6. You can find more such stories on the TvoiLokony home page

Monika Zieleniewska, Medonet: Recently, more and more reports about the dramatic situation in SORs, or rather in SORs …

Dr. Artur Szewczyk: I know, you want to know where the problem of ambulances standing for many hours in emergency rooms comes from? I’m already translating. One should look at the matter from different points of view.

Firstly, because of a much larger and growing number of patients and tests performed, even 80 a day! This is a really good result compared to Europe. However, lest it be so sweet, the number of tests performed is not followed by a “follow up”, that is, a specific supervision and guidance of the patient, who is left alone with his positive or non-diagnostic (indication for repeat after 24 hours) test result. Alone, because the regional department of Sanepid is overworked and is not able to provide him with reliable support, because it produces 500 percent. standards.

On the other hand, GPs, often fearing for his health, refer him to a hospital, often infectious, even in the absence of symptoms. However, here I must add that the awareness of family doctors and their involvement, since they have the possibility of ordering tests, and not only passive referral for further diagnostics, has improved dramatically. One could still give them at least basic tools for treating low-symptomatic infections, such as access to some drugs dedicated to hospital wards, and this is basically the second component of ED overload.

The last factor is the patients themselves. Most of them, when they test positive for the presence of, as some say virus-virus-virus, are terrified. Panic anxiety appears: What’s next for me? Will i die Are my loved ones also infected? Where to go for help

It’s natural.

Most often, they end up getting into the car and going to the nearest hospital, as the place where the sick people are supposed to be helped. And then there is a collision with the realities.

It turns out that they find the door closed, no places available, the ward shut down after an accidental infection by someone who, fearing for his own life, concealed some important facts about contact with the patient, because he wanted to have a tomography or X-ray done.

Unfortunately, some patients lie, probably out of fear for themselves, but they put others at risk! Coming back to those with a positive test result, they often spend hours in a queue or spend several hours in a chair in the waiting room. The worst thing, however, is that some of them should not be hospitalized at all, but should go home. Use teleport advice and follow the applicable recommendations.

1. Editors recommend: Have you been in contact with an infected person? The most important thing you need to do

Why don’t they do this?

Well, I don’t know either, but it seems to me that it is about the lack of access to information, despite the efforts of the Ministry of Health and daily entries on many Internet or social networks, people are not able to reach clear, specific recommendations on what to do in their situation.

I think a solution, especially aimed at younger people, could be to increase your reach using social media. They are a contemporary form of Agora and Forum Romanum and often the only source of information and trends for this group.

I know many great doctors, such as prof. Krzysztof Filipiak, doctors Łukasz Durajski and Michał Domaszewski, who tirelessly fight coronasceptics, ignorance and information chaos, educating patients in a simple and understandable way. Based on solid, scientific knowledge, and not on populist reports and pseudo-medical research.

But I deviated from the topic a bit. Continuing, the queues at the SOR are probably the last most difficult obstacle to overcome at the moment. Unfortunately, the walls are not made of rubber, they cannot be stretched, it is impossible to put 10 patients on 20 beds, although hospital maths can surprise you – see: cosmic numbers of available places in Warsaw hospitals, e.g. -27, where each digit below zero means a patient crammed somewhere under a window, by a wall, or on a couch pulled out of the basement. On the one hand, it is nice that these people have ended up in a place where they can benefit from treatment not available at home, but on the other hand, it is disgusting. How uncomfortable and having to endure combination conditions, and it is frustrating.

1. See also: How Is Mild Coronavirus Infection Treated At Home?

A sad diagnosis.

The biggest problem at the moment is patients with the so-called uncertain status, i.e. with symptoms of a typical covid infection, but without a diagnosis confirmed in RT-PCR. For now, this is the only qualification criterion for treatment in the infectious diseases ward for COVID-19 patients.

With the current number of tests performed, you can wait up to 3-4 days for the result! During this time, our hands are tied, of course, we can treat in isolation at HEDs, and we do so, using the same recommendations as in infectious wards, but at the same time these patients take up places for a long time. As a result, the possibility of accepting new ones, of uncertain status, drastically diminishes. In order to be able to accept another patient from the EMS team (medical emergency team), we need to create this place physically. Most often by moving the beds from the so-called green or making extra beds, i.e. adding patients to already occupied 2 or 3-person rooms.

Such combinatorics does not always work, sometimes we have to wait until they reach the target units. Fortunately, most of the patients, their families and colleagues from the EMS know and understand the situation, trying to find compromises, because the last thing we need are arguments and scuffles over places.

I can see that each day of work at the HED is a challenge not only for the medical staff.

SOR is a kaleidoscope of events. It is impossible to predict possible scenarios, because when you think you have already seen or know everything, suddenly something appears prompting you to verify the knowledge. HED is also a lesson in humility and patience, which is often lacking, especially in patients’ families. The duty begins with the receipt of a report on the state of patients from his predecessor, and ends with the submission of the same report by the successor. Sometimes in the morning you know where you are standing, because all the seats that are occupied do not bode well.

Most often, the duty looks like this: I go to the hospital – report, then patients, orders, some quick shame, patients, time for coffee, patients, work, at 16 p.m. ?! And more work, then some work again, and phew 18. People came back from work, ate, so welcome the second wave. And again the robot patients, some food, because your hands are already shaking. I see! And you were supposed to visit the toilet at 12 … then you go, and here’s some work again. After all, when around 23 pm you think you are a guest, because you have covered most of the things and you are going to let your body go to the ward, that last ambulance comes in. The last one in this hour … But it is also looser, there is nothing to complain about, usually those who like it work at SOR, you cannot do it out of need or for other values, because it will not work, it will burn out the rest of your strength.

So, has the pandemic changed anything about your work in the emergency department?

What changed is that I put on the suit faster than the suit, and my ears and skin of my face are already starting to develop a natural thickening for the mask. And my surgical knowledge has been enriched with a number of issues in the field of pulmonology, internal medicine and infectious diseases.

Seriously, this pandemic is a difficult period for everyone, especially for hospital staff. There are definitely more robots and it is burdened with a higher risk. A risk that each of us, somewhere subconsciously in the back of our head, grapple with throughout the entire shift. Nobody wants to catch the virus and pass it on to their loved ones, so we watch out at every step. There is no place to let your guard down here, because COVID-19 is pounding like Tyson, you drop out for at least 10 days and your shifts remain vacant.

And this is the biggest problem of the pandemic, she exposed what the Agreement of Residents and the Medical Chambers in consultation with the NRL have been talking for a long time – that despite the constant investment in the health care system in Poland, there is still a shortage of doctors, nurses and paramedics, and access to medical services is too low. small. But it’s not something that can be dealt with in a year or two. Human education lasts for years, and until then some temporary ad hoc measure is needed.

What?

I have no idea.

Is there anything you would change in the procedures and organization that could improve your work with the sick?

There are many things to be sorry for, and probably many people are looking for an opportunity in a pandemic to point out mistakes or an opportunity to show what I would have done better, but not the time and place for it. We have an exceptional period, exceptional in every respect, and the priority should be to work to tackle this problem as quickly as possible, so that in a month or two you can breathe.

It is known that there is a shortage of equipment, people, places, procedures for every eventuality, but we have what we have and we have to deal with. It would surely be better to organize the routing of ambulances and patients between hospitals. At the moment, there are areas where poviat hospitals are bursting at the seams and those with reserves. It would be nice if there was one central, efficient system for informing and referring patients to hospitals. It would certainly take some responsibility off the already overloaded EMR teams and hospitals.

Clear top-down guidelines for patients would be welcome when they should stay home to recover, and when to receive hospital treatment.

And you healthcare professionals aren’t you afraid of a pandemic?

Only the stupid is not afraid. However, fear makes us think even more. The only thing we have no influence on are accidental infections, unexpected in situations completely beyond our control. Most of my colleagues or their relatives were already in quarantine, some had an infection. It’s a bit like a palace of fear – you know that everything is set up, but being inside, it’s impossible not to scare for once.

Do you expect something from officials and decision makers?

Like every human being, regardless of social status and origin, we expect: respect for our civil rights, dignity and equality. We expect a fair judgment of us on the basis of our actions, and not the opinions expressed by others. We expect someone to ask for our opinion when making decisions at the administrative level. We also expect you to understand that we are just human beings and like we all have our fears, limits and values. Our physical and mental health is not made of bronze and we cannot be exploited to the limit.

Therefore, let us remember that the relocation of staff is a very delicate matter, because the number of doctors, nurses and rescuers is constant and all kinds of transfers must be made wisely, with agreement, because a nurse shifted from one ward to another is often depriving one patient of care at the expense of another. It is similar with doctors, but I wanted to give an example of nurses here, because they do a great job, which often gets overshadowed by other activities.

And society? How should it support your effort?

Society can do so much to help us, I don’t even know where to start! Best of all, it’s free. It is enough for us to smoke one less cigarette, put aside one chocolate cube, or replace one burger with a juicy tomato, go for a walk twice a week and measure our blood pressure every other day. It is enough that we do not postpone the visit to the family, and in the era of a pandemic, that we put a mask over the face to cover the nose and mouth. Also, don’t stand on your back in line and wash your hands more often, but for at least 20 seconds with soap. I would not like to scare people and appeal to people all the time, but the last few months have shown that when people are informed gently and calmly, the reaction is small, because most people get the words: shock, surprise, horror.

See also:

1. COVID-19 has more serious complications than the flu
2. New research proves: the coronavirus can be caught in a minute if the sum of such contacts a day exceeds a quarter of an hour
3. There will be no ventilators for COVID-19 patients? We already use almost 70 percent. of them
4. “All we can do to prevent the spread of the coronavirus is to have our own minds” [LETTER TO MEDTvoiLokony]

The content of the medTvoiLokony website is intended to improve, not replace, the contact between the Website User and their doctor. The website is intended for informational and educational purposes only. Before following the specialist knowledge, in particular medical advice, contained on our Website, you must consult a doctor. The Administrator does not bear any consequences resulting from the use of information contained on the Website. Do you need a medical consultation or an e-prescription? Go to halodoctor.pl, where you will get online help – quickly, safely and without leaving your home.