Stories from the point of care: Juliette
24 March 2021 Story
A genetic counsellor who was reassigned to the proning team at her hospital’s ICU shares her reflections on time spent working with Covid patients.
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“I am a specialist Genetic Counsellor at the Ehlers Danlos National Diagnostic Service based at Northwick Park Hospital. However, from January to March I was re-deployed to the Northwick Park Hospital COVID-19 Intensive Care Unit (ICU) proning team.
“The proning team consists of six people under the guidance of an anaesthetist. The role of the proning team is to turn a patient who is on a ventilator onto their stomach which helps increase the amount of oxygen that gets into the blood. It is a long and complicated process of gently unravelling and disconnecting tubes and ECG wires, followed by careful positioning of the patient, and then reconnecting and testing of all the equipment. This process can take up to 45 minutes to complete. Hours later, the patient is then turned back onto their back, and so on and so forth.
“I would like the families of people in the ICU at Northwick Park Hospital to know how well their loved ones have been looked after, and that they have received a great deal of care and individual attention which is imparted with respect and dignity. After proning a patient, we were often called back to a patient’s bedside to help the nurse straighten the bed sheets or adjust the pillow. And this is not done in silence, but the nurses can be found talking to the (unconscious) patient about the mundane things they are doing like making the bed or changing a tube.
“I was struck by how quiet the ICU is, with the occasional notes of gentle music rising above the humming of the ventilators and beeping of the machines. Each patient has their own unique management plan, with hundreds of items of data analysed every few hours to create the best possible and bespoke care. The dedication of the nurses, doctors, physiotherapists and other health care professionals is hard to describe, and despite the huge pressure the ICU staff are under, they are kind and patient, and were always so grateful for the support that the proning team provides.
“When I started proning it was with some trepidation. However, I now feel gratitude that I was able to witness such humanity and dedication during such a deep dark winter. I have seen first-hand how, with this exceptional care, some of the patients have started to make their first tentative steps of recovery as winter turns to spring.”
Juliette Harris, March 2021
Acknowledgements: The proning team is organised by Dr Robert Reichert, a consultant breast surgeon, who has worked tirelessly since the beginning of the pandemic to help his beleaguered colleagues in ICU with support from Dr. Aynkaran Dharmarajah, Consultant Anaesthetist, and proning training provided by Deeptika Chauhan, Principal Respiratory Physiotherapist and Critical Care Lead under the leadership of Dr Ganesh Suntharalingam as Clinical Director of Intensive Care. Of course none of this would happen without the proning team anaesthetists and my resolute fellow proners.