Covid-19 “flicked a switch” for Gisborne doctor called to ED
When called to the emergency department (ED) during the Covid-19 lockdown to help a man with respiratory failure, Gisborne Hospital anaesthetist Dr Leigh Willoughby considered the possibility she was at risk.
“This was the first time I've ever felt like that,” she said.
“Covid had flicked a switch and being at risk as a practitioner was a whole different ball game.”
Along with medical registrar Dr Elliot Green and the ED's Dr Tom Palfi and nurse Ryan Thompson, Dr Willoughby worked through the night to help the man whose lungs were potentially under attack.
He was having a lot of trouble breathing and the results of his Covid-19 test weren't back.
“There was a sense of enormity to it and it wasn't just about me.
“It was about the safety of our small pool of staff in Gisborne,” said Dr Willoughby.
The team worked in full Personal Protective Equipment (PPE) to stabilise the patient.
Later, as Dr Willoughby and the team took stock, their overriding thought was “thank goodness we'd been prepared”.
“While it was a jolt to the system, we all knew that we'd practised for this,” says Dr Willoughby.
“We felt confident in our supplies, confident that we had the protocols in place.
“It was a significant team effort in difficult circumstances but we were ready.”
Dr Willoughby is Hauora Tairawhiti's head of the anaesthesia department.
Like anaesthetists around the country, she was at the forefront of the planning and preparation required at Gisborne Hospital as it readied itself for Covid-19 patients.
Earlier this year Dr Willoughby watched with growing apprehension as Covid-19 cut a devastating swathe through China and Europe.
“I and many others spent every hour awake consuming every piece of information we could physically read coming in from China, the UK, our advisories and our own Australasian colleges.”
In preparation for the potential influx of patients with respiratory illness at Gisborne Hospital, one activity carried out by Dr Willoughby and colleagues from throughout the hospital was real-time simulations to prepare and improve the local response.
It was those real-time dummy runs that provided reassurance to the team in ED that night.
“The simulations were practice runs of many different kinds of patient situations.”
Staff did them in full PPE and incorporated all the relevant processes to find areas of weakness and impracticality when dealing with unwell patients during a pandemic.
Around 10 simulations were carried out between February and April in maternity, the emergency department, the intensive care unit, the operating theatre, the radiology department and more.
Dr Willoughby said the multi-disciplinary simulations played a vital role in coordinating action across many areas of the patient pathway, from staffing, equipment and bed management to treatment and hygiene skills.
Dr Willoughby said after each simulation her colleague, anaethetist Dr Deon Stoltz, created acute care plans, checklists, and guides for staff.
Hauora Tairawhiti chief medical officer Dr Anne Kolbe says most of the public and even some health workers probably didn't quite understand what anaesthetists did, before the Covid-19 response.
As well as being specialist doctors responsible for providing anaesthesia to patients for operations and procedures, they also have a range of practice that includes pain management and intensive care.
“As airway experts, anaesthetists are at the forefront of managing patients with Covid-19,” said Dr Kolbe.
“They were essential for managing the expansion of intensive care areas and the theatre environment and the simulations they ran were fundamental to ongoing hospital operations during the crisis.
“Anaesthetists are, by the nature of their job, calm in a crisis and supportive of colleagues.
“These attributes are critical in managing teams in a stressful dynamic environment and supporting organisational changes.”
Dr Kolbe says this story is just one of the many examples of the amazing work done by all Gisborne Hospital staff to ensure the hospital was well prepared to deliver safe, high-quality care to the community during the Covid-19 pandemic.
“On behalf of the Tairawhiti community, thank you for your courage, dedication and hard work to keep us all safe.
“The simulations created conversations at nearly every point.
“Every environment is different, every patient is different, and so by doing the real-time simulations we were able to readjust, improve and calibrate what we were doing to protect staff and patients with the valuable insight of everyone there.”
Dr Willoughby says they did as much as they could under urgency “but of course it's always different when you are ripped from your bed when fast asleep and called to full alert level.”
Six hours after that high-tension night in the emergency department Dr Willoughby was tired, dehydrated, and still bore marks on her face left by the mask she wore.