Moving into management and communications
On the 5 February I rotated to Guy’s and St Thomas’ NHS Foundation Trust, 17 weeks pregnant and vomiting every morning. Taking on the bleep holding role of senior registrar at a large multi-site tertiary trust is daunting: navigating a new building, learning who everyone is and of course dealing with the inevitable swipe card access nightmares; but giving an anaesthetic is still the same, right?
Two months on, and I don’t think I remember what propofol looks like. As the pandemic spread to the UK, pregnancy was included as one of the Government’s ‘high risk’ groups, and it became obvious to me that being responsible for out-of-hours intubations was no longer appropriate. I took the advice in the first Association of Anaesthetists COVID-19 webinar, and signed up to a new role developing communications for the COVID-19 Anaesthetic Strategy Group.
Our department was in the early stages of full reorganisation. Over the course of two weeks, we rewrote the job plans and rotas of our medical workforce, converted recovery areas into critical care, brought our consultants on-site 24 hours a day, and redeployed many of our medical and nursing staff to ICU.
I should admit that I have no specific skills in communication. I read and write in one language, I am organised and aware of human factors, and I am used to taking on a leadership role in a new theatre team. I am on Twitter, Instagram, WhatsApp and Facebook, but I don’t post publicly and I have very few publications to my name. Essentially I’m very similar to most UK anaesthetic trainees. I was acutely aware that in a crisis communication is vital! I felt passionately that you couldn’t expect staff to re-write their working lives without giving them as much information as possible.
It has been a rapid learning curve. Inherent within the role is a need to balance confidentiality with the benefit of sharing information with our colleagues. This balance is made even more challenging when one factors-in press scrutiny and their desire to secure any snippet of information that is potentially damaging to the Government, Public Health England, the NHS or our own trust. Through this role, I have had a rapid induction into my department’s and the Trust’s management structures, alongside the logistical and political inevitabilities. Primarily, I have experienced a shared desire to ensure that the information that clinicians need in a rapidly changing environment is accessible and easily digestible.
We are still on the steep part of the S-curve when it comes to optimising communication in such a large hospital. We have made great strides forward in informing anaesthetists, but must do more to reach out across disciplines, particularly to nursing staff and trainees not working in our department.
I am incredibly glad that I chose to be an anaesthetist. I like going to work each day, feeling skilled and challenged, but ultimately contributing. Like pilots, anaesthetists are trained in human factors, but COVID-19 feels akin to being on a plane that is on fire and potentially about to crash. I feel very privileged to be useful to the public, fortunate that I am not about to lose my job, and very proud to be a healthcare worker.
Jessica Johnston
ST6 in Anaesthesia
Guy’s and St Thomas’ NHS Foundation Trust, London