I was one of the first medical students at my university to be recruited to help out in local hospitals as fears rose about the NHS being overwhelmed by Covid-19. The dozen or so other students and I were a little stunned to learn that the job descriptions we had been given by our university were wrong. Instead of the cushy, note-taking roles we had expected, we were there to help with the most severe Covid-19 cases as junior intensive care unit (or ICU) nurses, an area of work we all knew nothing about. In training, a senior nurse told the group, “Normally you would be given 16 weeks to learn how to do this – you get two days”.
With only four months’ total experience in hospital placements, the prospect of this kind of role was daunting. We had all seen reports in the news of the intense, dangerous work going on at the front lines. Great pains have been taken throughout this crisis to “celebrate” the hard work of the NHS and its “heroes”, whether that comes in the form of weekly applause or companies advertising their goods with 20 per cent off burger buns for key workers. But language like this undercuts the realities of frontline work and, if inquisitive friends and family are anything to go by, we are too obsessed with the sensationalist details to see the big picture of what makes frontline work hard.
After each shift, my parents will probe for a fun story that they can relay boastfully to the extended family. Occasionally I will have a good, grisly anecdote about trying to hold down a burly patient whose sedation had worn off and was fighting to yank out the transvenous pacemaker wire that kept him alive. (I was shocked to learn afterwards that this patient was younger than me, but I left that part out for my parents).
But ICU work is mostly startlingly anticlimactic, considering the severity of the situation. That a global pandemic ends with patients needing to be rolled over every four hours to prevent bed sores is simply lame. Really, frontline work is first and foremost work: people still complain about not being paid enough or talk about holidays while inserting distressingly large-bore cannulas into necks, sneak phones into the ICU in the aseptic bags that are used for photos of patients’ loved ones. The threat of infection is reduced to a cheap bogeyman – I overheard one nurse joking that spreading Covid to her diabetic husband would at least save her the effort of a divorce.
In some ways, healthcare work is actually easier than before. With additional hiring and most non-Covid patients sent home, there are far more staff members per patient than normal. There’s a glut of free food available in the break rooms, supplied by various charities and corporate donors. A local taxi company has donated several crates of bottled water emblazoned with their logo and phone number, seemingly unaware that the hospital provides free taxi rides for any employee that might require it. We are paid “unsocial hours” rates for weekends even though the concept of the working week (always tenuous for students) has now all but evaporated.
The real barrier that makes a frontline job hard is the bureaucracy. Getting to the stage of even having the job is tricky enough: our “fast-tracked” recruitment process took over a month of jargon-filled, liability-dodging guidance documents from our university, and countless near-duplicate forms requiring the same personal information (each subtly different enough to prevent copy-pasting). Red tape and inefficiencies plague all healthcare work but the sudden changes to hospital structure have created a perfect storm for a tangle of miscommunication. The swipe cards we are issued don’t provide lift access to the ICU floor, so we have gotten used to taking a lot of stairs. We were all fit tested on rigid N95 masks just before the hospital switched to flexible FFP2 masks, so we all had to be retested before we could go into Covid areas. I lied and said I already had been – they needed help moving beds.
The saving grace, of course, is the people. Consultants and registrars are still keen to teach us, some seemingly unaware that we are now paid workers. But the most useful learning experience hasn’t been academic. When I was first sent to help transport a Covid-19 patient, I asked if the reason we were moving them out of critical care was because they were improving. The junior doctor in charge made an exaggerated throat-slitting gesture and stuck his tongue out the side of his mouth – we were moving them to a side room so their family could come say their goodbyes. This might seem like an odd moment to bring up when celebrating healthcare workers – this isn’t, I’m sure, what people visualise during their 8pm weekly clap – but it is the reality of how people deal with a job that is mostly spent around seriously ill or dying patients. Levity and borderline gallows humour turn the looming prospect of death into something that can be coped with when you go into work each day.
Positioning healthcare workers as put-upon heroes risking their lives out of altruism does a disservice to the people who are struggling to succeed, or often simply make a living, in an underfunded health service that is caked in layers of bureaucratic inefficiency. The urge to celebrate our key workers is well-intentioned but the use of sensationalism and glorification is misguided in a country that all too commonly fails them.
The writer is a medical student now working in the NHS helping to look after patients with severe coronavirus. Jack Gallman is a pseudonym