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A Tale of Two Cities: Getting Ready for a COVID Winter

It feels like a lifetime ago that I gave a talk about staff wellbeing in paediatrics. It was February 2020 and the talk was titled: “The best of times, the worst of times: finding our words in paediatrics.” The notion (nod to 'A Tale of Two Cities') that when things feel at their worst, they can also be at their best.

How strange it feels now to be writing months on from the first months of the pandemic as our fears about winter just begin to materialise. I am a doctor but also a father, son, husband and a citizen and the global spread of COVID19 has touched every part of my reality. Whilst I am awake and sometimes even when I am asleep. But amongst the fear and social distancing we are also seeing widespread and inspiring examples of coming together, caring for each other and the very best in the human spirit.

As medical professionals we can and must be prepared to purposefully bring out the best in ourselves and those around us at work. We are all getting ready to look after patients and families this winter in the best way that we can but it has never been more important to look after each other and ourselves as staff. If this is a war against a pandemic, then in addition to PPE and a vaccine the weapons in our armoury are small acts of kindness, showing care and consideration and reaching out to those in need. There are wonderful examples of this happening everywhere.

In addition to the way we behave, we also need to consider system and semi-structured approaches to supporting our teams at work in the months to come. Staff sickness, isolation requirements and work intensity are potentially going to demand a great deal from all of us. We need to be ready to try to counter this. There are many people and groups out there doing great work on this. We have by no means done things perfectly, but some of things we found, as a department, worked well in the ‘first wave’ include:

1. Embed a model for a wellbeing ‘check in’ and/or ‘check out’ for staff

Find a way to touch base, even if briefly, every day in the clinical shift. Examples include ‘going home checklists’ and pre-shift wellbeing check-ins.

2. Establish psychology input for staff

See if there is a way to bring in some external psychology help for your team. Many trusts are willing to support this. It is important that not all emotional wellbeing support is delivered peer to peer.

3. Try to manage staff shifts and work intensity

Explore the possibility of (at least temporarily) changing the way we work. Changing shift patterns and hours for example to group days off. Make sure where possible take annual leave and ‘switch off’ for time with family.

4. Provide material support for staff at work

Do real, material things to help staff and boost morale in work. Lots of ideas and options but simple examples include breakfasts for nursing, medical and admin staff; snack and toiletry boxes; pizza deliveries, etc.

5. Create sufficient physical space for staff to rest

Make sure there is space for staff to rest. This may include finding somewhere to fit out a private ‘sanctuary’ room for short periods of isolated rest, reflection and emotional decompression.

It is worth remembering that the double jeopardy of the current situation for healthcare staff continues to involve fragility and fear both at work as well at home in our family lives and this needs careful attention. Although around 8 months into this now, we are all still in uncharted territory in many ways with the COVID19 situation, especially as winter approaches.

But we should all remember that – wherever and whoever we are – the unending riches of the human spirit and the things that make us great have not changed. We have the capacity to care, to be kind and to help each other. And the ingenuity and creative spark to find solutions to problems wherever we can.

Dr Dan Magnus

Clinical Lead & Consultant in Paediatric Emergency Medicine

Bristol Royal Hospital for Children


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