Leading heart and lung consultant Dr Joel Dunning is now working as an ICU nurse to help on the NHS front line fighting COVID-19.
The 47-year-old has worked at the James Cook University Hospital in Middlesbrough since 2005, and has been a cardiothoracic consultant there for the last 8 years.
Medscape UK spoke to him about his decision and how he's finding his new role.
Q&A
What prompted your decision to take on your new role?
I felt as a heart and lung surgeon a lot of patients wanted to delay surgery, which freed up a whole lot of beds in our trust but also freed up a whole load of people. So suddenly, I wasn't doing operations.
The great need in the hospital was really two areas, respiratory wards and intensive care. We were all worried about the availability of ventilators but actually you've got to have enough people to run them. The people who do that are intensive care nurses, so I thought I'd go into the intensive care to try to help out.
We'd done some missions, including to Ghana and Pakistan, and when we went out there I brought some of our fantastic intensive care nurses. So I said to them, can you train me up? So I did two 12-hour sessions with one of our fantastic nurses, Jim McDougall. On the third session he said, ‘We're a bit short, so can you just take a patient and I'll be next door.’ And after that I was just chucked on the rota to help out, and it's going really well.
How are you finding it? Challenging? Satisfying? Have you mastered the new skills you need?
It's a very technical job and a totally different job to being a surgeon or even a doctor supervising an ICU.
There's a huge amount you have to do. You have to roll the patient, take care of their personal hygiene, oral hygiene, changing the ventilator tubing, safe infusion, and tube feeding. You are really looking after them 100% for a whole 12-hour shift which is a very different and challenging skill to learn.
It's been brilliant though. There have been loads of other people coming back to the ICU as well. It's been fantastic to see everyone mucking in and filling the roles. It's a challenge working in PPE. It's very difficult and sweaty and horrible but because we've got extra people, we've been able to give each other breaks and support each other really well.
It's been a really fantastic experience. Looking after someone for 12 hours is something you just don't do as a surgeon, you just do their plumbing then deliver them to the ICU and walk away. So to recover and look after them is a very satisfying and different experience.
Has it given you a fresh perspective on the NHS?
Absolutely. The heroes of this pandemic are actually the nurses. They have been so flexible. So many community nurses, outpatient nurses, or nurses who haven’t done ICU for years, have stepped up to the mark and jumped into an ICU, which is a very stressful job for them. It's totally different from working on a ward.
What's the situation like at the hospital now?
Two weeks ago, I'd have said relatively stressful. We weren't sure about ventilators, we were just getting into PPE, and we didn’t know when the peak would be.
Now though we are feeling increasingly confident that we have reached the peak and are actually starting to go over the other side. We've had more discharges than admissions for 7 days. We are coping really well, have enough staff, are supporting each other. We have started thinking about when to restart the normal activities of the hospital, like heart and cancer operations.
We have heard a lot about PPE shortages. Has that been a problem for you?
It's been absolutely fine at our hospital. We have a PPE hotline if anyone is worried about supply. There have never been any problems with visors, masks, and gloves. The gowns have been the national shortage but I think our resourceful hospital has gone and found some big all-in-one coveralls. It feels like I'm off to go and paint a wall! They are actually really comfortable, they zip up really well and then close brilliantly.
What sort of shifts and hours are you doing?
The really important thing about getting lots of ICU staff in and massively increasing our number is that we didn't want people doing huge amounts of overtime. I'm doing a full normal set of shifts, 36 to 39 hours a week, and most other key staff are doing the same as well.
I feel massively lucky that we are in the UK. We go and do work in Ghana, Pakistan, India and we are in contact with all of those teams. It's such a different world in the UK. There are people out there in the world who can't even afford to go and get hospital care never mind ventilation. Here in Britain we are in a minority, we get all of our care for free. We are so very lucky to be in the NHS and have that facility.
