I felt so let down…

I was the clinical lead for my team and having seen the severity of covid in Italy, it was difficult to understand the approach taken by our leaders in UK The hospital leadership team got all the leads together to plan for the worst-case scenario- I was proud to be part of this group, who went out of their way to help/contribute to the rota/eventuality planning and the camaraderie shown.

Personally, not sure how I managed during the first wave. I was leading my team locally, implementing national policies, supporting patients and their families, all within new restricted operating procedures. It was extremely difficult to support our cancer patients, some of whom sadly lost their lives or had treatment delayed/changed to palliative approach due to restrictions due to the pandemic.

Some decisions had to be made, as local and national teams did not have specific advice Two-way communication with the leadership team was extremely challenging at this time and all decisions appeared to be top-down as opposed to collectively as previously.

I had trouble accessing adequate protection to scope patients (Aerosol Generating Procedurehigh risk of spreading covid) Fit testing was not fully implemented with no structure, and when I asked the tester what I should do as I had failed - shrug was the answer, they were unsure as to what to suggest due to lack of national/local policy

During all of this, the national leaders I felt did not appear to have a handle on the seriousness of the situation until the later stages of the pandemic.

Some of the positives during this surreal time were - colleagues, who had not done acute medicine, pitching in to help. Junior doctors and final year medical students stepping up, having difficult conversations and being so flexible and doing their best whichever ward they were posted to The nursing staff, who were probably the most exposed / vulnerable to catching covid, ensuring the compassionate care and spending time with them when they had no contact with family members. Consultant colleagues setting up WhatsApp groups with junior doctors to keep up the morale and providing pastoral support The IT and ITU support to enable decision making/escalation decisions.

The effect on my family has been disastrous – our whole routine changed, I and my wife are both doctors. So we had to prepare for the worst- we used to shower as soon as we entered the house, place our clothes in the washing machine, feed the children, and then move into individual rooms to prevent transmission One of the children was being bullied at school and did not feel able to open up and discuss with us as they felt that we were doing far more important things in a life/death scenario. Our other child was diagnosed with osteomyelitis, as both myself and my wife kept administering paracetamol (and heading in to work) thinking it was covid related even though they continued to have a temperature after 1 week. We have experienced a long inpatient stay with the child during the covid pandemic and the worries and anxieties of severe illness and the long-term outcomes. So, as parents, we struggle to forgive ourselves for failing our children.

Post covid first wave, trying to support the team, patients as well as planning for further outbreaks as well as having to come to terms with losing colleagues/close family members. Observing the effect on the BAME community, the realisation that although I was taking precautions

The BAME risk tool that was being used by our organisation at that time was sent out over a weekend – unfortunately this tool failed to request specific information relating to race, sex or age of the person. When I enquired why the organisation at that time did not want to appear discriminatory in any way Until this time, I had never felt discriminated at our Trust, but afterwards I felt for a period of time our organisation did not respect nor cater for diversity/ethnicity. The positive to come out of this situation was I became involved in the trust BAME network and this made me realise how naïve I was and that implicit and systematic racism still prevails. The Trust response to acknowledging junior doctor/teaching fellow contribution was inadequate including financially.

I did liaise with both regional ERCP centres and our organisation to ensure protection of our ERCP service as I was a lone operator and needed to ensure our organisation leadership team were aware of this and its implications if this service stopped. I felt disappointed at this time as whilst wanting to ensure the ERCP service continued to ensure it was as productive as it could be for our patients my request to be removed from other services to focus on maintaining this service were not adhered to, so after gaining regional network formal agreement I trained another colleague to cross cover for eventualities to ensure the service would continue

Following the second covid wave, there was discord within our team, I was supporting colleagues in tears – team ethics were not being adhered to, there was some disagreement within the team regarding some of my decision making as lead, I felt that I no longer had the support within the service so I resigned from my position as clinical lead.

I had requested help regarding personal issues, but I felt a lack of compassionate leadership at this time.

Having worked in a Trust that I had looked forward to coming to work, felt that it had changed completely, I felt let down so I resigned from my post I worked with a brilliant colleague as colead as well as having a coach/counsellor to navigate me through the turbulence- I had taken up a post elsewhere but reconsidered and felt that I still had a core group of colleagues who I could work with to change/influence change to make QE the place it used to be, where people strove to do their best for the patients - so I rescinded my resignation.