A day in the life of a frontline healthcare worker
A fifth-year resident describes an average day in the hospital — whatever that means, during a pandemic.
By Avi Vandersluis as told to Katie Underwood
I’m a fifth-year resident in obstetrics and gynecology at McMaster in Hamilton. We have a clinical role, which includes being on labour and delivery, as well as patient care in the various clinics — cervical cancer screening, endometriosis — depending on what rotation you’re on. We also have administrative duties, and handle triage, which is like emerg for pregnant patients.
I would say the biggest change, during COVID, is the PPE. Prior to the pandemic, we’d only wear it for certain cases, like a c-section, where you have to be completely sterile. The difference is that, now, we’re not allowed to take our masks off post-surgery. At the beginning of every shift, we have to assemble a sort of “emergency case” with PPE, to make sure we have equipment in the event we come into contact with a COVID-positive patient. We don’t want to be running around looking for things.
If I’m doing a day in labour and delivery, I get to work around 6:00 a.m. and do a round on all of my inpatient cases: pregnant ones and antenatal patients who are admitted for various reasons. That can be anything from antepartum hemorrhage or other concerns with the baby. We try to count everybody by 7:00, then the senior residents do teaching for the junior ones, which has switched somewhat to an online format. At 7:30, we do hand-over, where the night team comes and tells you about all the patients that are either still on the board or people that are coming back. Again, only essential people are there. Then we fully start our day. There are usually about three to four C-sections scheduled per day, and then we divide up patients who are labouring already. We get calls from the ward constantly, whether someone needs to get an induction started or there are medication adjustments that need to be done.
Our once-a-week academic half-days, where we would usually have some kind of in-person lecture or event, have all gone virtual. In my year, we’re writing the Royal College exam, so whereas normally, people would get together in small study groups and order dinner, we obviously can’t do that now. Even simple things, like having coffee and doughnuts at the nurse’s station — things that make the environment a bit more positive — you can’t really do anymore.
Emerg can also call us at any time, with patients who are out of their scope — people with postmenopausal bleeding or pregnancy loss. At five o’clock, we hand over to the night team. If I was on-call that night, I’d stay for the full 24 hours.
When you’re stressed all day, if you can get a couple hours of rest, that definitely helps. And having a place that you can go and relax with a proper bed is great. Sometimes, things are so busy that we don’t get to use the call room: there have been lots of shifts in my years of practice where I never saw the call room. But now, during the pandemic, it’s important because I don’t think people are necessarily sleeping as well. So that also increases the value of having a nice Endy mattress to go and relax [on].
Nobody wants to bring COVID home with them, so as soon as I get home, I have to throw everything in the laundry and have a shower before I can even say hi to my wife and kids. After a few months, people kind of got into the groove of things and adapted to the new normal. But with new variants coming up again, now we’re seeing a lot more pregnant patients who are COVID-positive. There are people coming in who are quite sick. One of my co-residents recently had to send a mom-to-be to the hospital on ECMO, which is a heart-and-lung machine. It would be extremely rare for something like that to happen outside of the pandemic. Now we have variants, and younger, healthier people are being affected, and that part is scary. Thankfully, as healthcare workers, most of us have at least gotten one of the two vaccines.
Labour and delivery is a bit different in that it never slowed down. In fact, it’s now very, very busy. Initially, I think people postponed starting a family or having another kid [because of COVID], but as time went on, it looks like they changed their minds.
From a surgical-learning standpoint, lots of people have missed out on opportunities: many of the non-essential patient encounters have been either deferred or switched to a phone call — even gyno patients. Obviously, there’s a huge impact on patients because all of our wait times are way longer for things that are not deemed essential, but they still have significant ramifications for people’s quality of life.
I think it is a good learning experience to be a healthcare provider during a pandemic. Part of the stress was around whether residents would be able to get the necessary competencies we’d need for independent practice, but most people have still been able to, even if things have obviously changed. In Canada, pandemics are not super common, so none of us have ever done this before. There are a lot of big changes that have far-reaching effects, which I don’t think we will really fully grasp until this is all over and a number of years have passed.
Endy has donated over 10,000 mattresses to charity, and with the new Healthcare Heroes initiative, they are doubling down on outfitting Canadian hospitals and frontline medical professionals with comfortable mattresses and bedding, so they can get the rest they deserve. Canadians are encouraged to nominate their local hospital for a call room transformation at endy.com/donations.