ESRA Residents and Trainees Representative, Greece
The Covid-19 pandemic has impacted significantly on speciality training. This was reflected across all specialties. Although most anaesthetic trainees retained their customary role, a significant number were redeployed to Covid-19 units. The trainees had to step up their role by making decisions on critically ill infectious patients, ethical issues collided with budgetary constraints and allocation of scarce resources.
Does true altruism exist?
Those having to deal with work related anxiety due to provision of personal protective equipment, had a direct effect on their mental wellbeing, which superimposed on family and led to domestic disruption. The impact on the trainees mental health and all healthcare professionals, emphasised and refocused our attention towards our wellbeing.
Trainees are also still enduring the major challenge of comprehending the new educational needs, posed by the new healthcare environment, while maintaining a high standard of care, along with training. Across the world we saw educational activities being cancelled, postponed examinations and rotations, vital to our progress through training. Education had to evolve radically by adopting modern teaching modalities, such as e-learning and webinars.
There are numerous stories across the world by trainees having to step up their roles, inspiring stories with resourcefulness of caring for Covid-19 patients, during a time of uncertainty and despite personal risk. We should be proud of the empathy and profound dedication exhibited by trainees during these strange times.
ESRA Trainee Representative, Romania
Thank you to all trainees!
My name is Theodor Boț and I am an Anesthesia and Intensive care trainee, in the final year of the programme, in Cluj-Napoca, Transylvania, Romania.
My country was a little more “protected” at the beginning of this pandemic, so the inevitable phone call came only on March the 22nd. The phone call through which we, myself and 7 other trainee colleagues, were summoned to the Intensive Care unit which, beginning with that week-end, received the first 3 critical cases of Covid-19 patients.
We already knew from our European colleagues that the situation was, to say the least, difficult, we had talked to them beforehand. We had seen it in the media how high-performance medical systems couldn’t handle the huge wave of patients.
We spent there the next 3 months, in the so-called “first line”,covering shifts after shifts and caring for patients after patients.
Slowly, the hospitals filled up and more and more trainees were called in this “first line”, which most of the times felt like the only line.
Was it difficult? At the beginning, yes, overwhelming. It was something completely new, we didn’t know what we are fighting against and had very little information about this new virus, which creates lung damage up to 90%. But we didn’t give up, trying ventilation mode after ventilation mode, spending days trying to improve all the affected organs.
It’s been definitely a few stressful months. The work in Covid-dedicated hospital was exhausting, because of both intellectual involvement in giving the patients the best treatment, as well the psychological discomfort that there is a chance that a mistake of dressing or undressing the equipment will lead to our infection, as well as our intense physical exertion. But none of us pulled back.
That’s why I bow in front of all my resident colleagues in Anesthesia and Intensive Care, Infectious Diseases, General Medicine, which helped save the lives of thousands or tens of thousands of patients. Resident colleagues who spent hundreds or thousands of hours next to the Covid-19 patients. Resident colleagues from wherever they are because the pandemic has hit hard all over the world.
The second phone call, probably inevitable as well, came on the first of October – the one through which I had been informed that I am confirmed as being positive with the infection with Sars-Cov-2. For other colleagues of mine, the second phone call had been made months or weeks before. For others, the phone rings just now. After the mandatory isolation period, everyone returns to work. Back in the “first line”, back next to the Covid-19 patients, grateful for our health restored.
That’s why I bow in front of them once more.
Sending a good thought to everyone and stay safe wherever you are!
ESRA Trainee Representative, Portugal
Being an anesthesiology resident during the COVID-19 Pandemic
I understand being a doctor is much more than a specialty, it is a way of life that prepares us to deal with joy and health, but also with suffering, pain and death. A way of life that prepares us for the hard scenario in which a hospital can become.
I started and embraced my journey in anesthesiology training with this idea very present, but I was far from imagining living pandemic times like the one we are living nowadays… Times when I had to assume more responsibilities in order to be possible to guarantee medical care to all the patients, times of change in hospital dynamics, times when it is at the same time important to strive so that our training does not fall second. These are difficult times! It was necessary to overcome insecurities to be able to correspond to the new responsibilities and face this challenge with so much of unknown, the COVID 19.
We all grew up, we all dressed up of strong ones, we all became different!
Anesthesiology, as a specialty of great versatility and with a wide area of activity, has become central to adjustments in hospital dynamics in Portugal. Many anesthesiology residents were fundamental to implement contingency plans and were called to take their position on the
front line. We did not hesitate to demonstrate why anesthesiology is a central specialty in hospitals, we showed our adaptation capabilities even in extraordinary times, when there is no time to tune weapons. Beyond the tasks of everyday anesthesiology resident, we stood tall on the COVID-19 triage tents, on the emergency room, on the intubation teams and on the ICU.
Our training is based on pillars of monitoring, organization and safety. The new reality imposes multiple risks for the anesthesiologist, due to the daily procedures that generate aerosols. Once again, the use of regional anesthesia has proven to be fundamental, allowing alternatives to aerosol-generating techniques, maintaining the safety of the patient and health professionals, allowing for a higher turnover between cases and assuring a better post-operative recovery. Thus, in my practice, regional anesthesia showed to be a good way to optimize the safety of the entire team, an aspect that I consider fundamental for us to be able to continue to perform our functions and contribute towards victory against SARS-Cov 2.
In these difficult moments, I would like to end by recalling a sentence by Maya Angelou:
“Courage is the most important of all the virtues because without courage, you can’t practice
any other virtue consistently”.
Anesthesiology Trainee, Croatia
I am a resident in the Department of Anesthesiology and Intesive Care and for the last two months I have been working in the Respiratory Center for COVID 19 patients.
I’m used to work in stressful situations and with criticaly ill patients so I didn’t think this was going to be difficult for me. During the time spent in the personal protective equipment, sometimes for hours, I realized this was much more of a challenge that I thought it was going to be. I never felt scared for my own health because I was wearing all the necessary equipment all the time, but I was afraid of making a mistake during some invasive procedures or that I was going to overlook something on the ultrasound when wearing blurred glasses.
When I would become more sweaty under the suit I would try to finish my job faster and I know that there would be room for mistake then. So in time I’ve learned to calm myself.
I also feel sorry for awake patients because it must be hard not only not to be able to see your family but the only people you are in contact are medical workers in some white suits. I would talk to them much more then I usually do with patients because I wanted them to feel safe and not alone and after a while all of them where so grateful for the job that we were doing, and many of them told us how much they appreciate what we are doing because they saw it was not easy for us.
Now I’m glad that I am a part of the team in a Respiratoy Center because it offers a new challenge and great experience for me to become a better doctor.
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