on June 21 in Russia celebrates the Day of medical worker. Since the beginning of the pandemic, doctors are at the forefront of the fight against coronavirus. They go months without seeing their loved ones, sleep four hours a day, forget to eat — and save lives around the clock. About work in conditions of a pandemic, the Russian doctors said Forbes Life.
Ludmila Larionova, head nurse of the medikit in Kommunarka
the Epidemic of the coronavirus fell upon us suddenly, so completely empty clinic, which was opened as a multi-center, we have deployed over night and in the morning opened for the admission of patients with suspected coronavirus. This night, which you can compare with the fighting, divided my life into before and after.
I remember well the first positive patient. I then was intensive care sister and only a month Denis N. Protsenko decided that I should become a senior sister Kommunarka.
Although the first patient and was in intensive care, his story ended well. We were very happy when he was on the mend and strongly encouraged him, because the people who ran with it first, after reading online horror and literally signed his own death warrant.
to Change my schedule had just about everything. I practically lived at work. Were the hard times when I knew that can be dangerous for your loved ones — I have three children 18, 11 and 9 years old, the youngest with my mother isolated countryside, the eldest daughter stayed with my dad in Moscow. When I realized that could be potentially dangerous for them, I didn’t quit my job, Yes especially and there was no time to leave. Today, despite the fact that the intensity subsided, all that is beyond the scope of this clinic, continue for me, it remains far in the background, and the head is fully Packed with current Affairs. When I’m out of this state will happen and I don’t yet understand. Hope it will happen.
I am organizing the nursing activities of the clinic. Yes, I have an administrative position, manipulation of hands, I do not do, but in the first two months is very easy and simple, it happened, and no matter main you’re the sister, the eldest, if patients becomes more and staff there.
I resuscitation nurse to the bone, and was not able to go [home] because he understood that can open a new post intensive care, and nurses not. Then I got up on this post and quietly on duty as a nurse.
We are in Kommunarka very lucky in terms of conditions, the clinic is great and new, “red” and “green” building, between uslyshany, so there are plenty of places to eat, to wash, to rest. Another thing is that the sleep was no more than four hours. I used to live in that dirRome. Perhaps if you give me a day off I more five six hours and not oversleep. To eat is also not always possible, sometimes once a day remember that it is necessary to eat, and once. A lot of work — well, war. We perceive it calmly, no whining, no groaning. Who failed, were afraid, them with us at General no.
My youngest daughter roared Beluga, so she was overwhelmed by emotions. I anyone’s throat — as long as their children I never left. Of course, it’s a challenge for the whole family, and I am grateful to my husband, children, mother, — I never reproached that I am fully immersed in the work.
One weekend I was not forced to come to the clinic, but I just feel the situation, understand what need control, you need to come, to make sure that all you just miss that in the posts order. The clinic is a huge living organism that requires constant participation. And I have a feeling that once I am outside, be sure to something going to happen. This exaggerated sense of responsibility that does not rest. Especially near me are the same people.
Whom drove to her throat every time I see how much your sisters doctors get tired as they work, literally gritting his teeth, but never give up. I’m proud of those moments and understand that force us, we’re a real team, absolutely not random people in the profession. We are willing to sacrifice their “want” or “can not” forget about fatigue, how have not seen children who are afraid we are infected or not. Just go and do their own thing, regardless of misted glasses, how hot in the LPIS (means of individual protection — Forbes) how many hours you slept and how many times over the past day eating, because lives depend on people.
Kovid took something number of lives and not all of them were age, including quite young people. It’s still a failure, but we all understand that we are not magicians. All these cases are heavy on my mind, and I remember about good, when you escorted the patient to be discharged, and everybody’s happy. This is perhaps something worth living for, that is the best reward.
I’m not making any illusions, but now obviously has become easier — less patients, many clinics in the city moving in a regular rhythm, are those, who are working on how infectious, including us. As for me, I’m such a wild tone, which, of course, no vacation is out of the question and I even do not build plans. The only thing I really want is to spend a week with my family in a relaxed mode, enjoying each other’s company.
Sergey Petrikov, Director of the Institute of emergency care. N. V. Sklifosovsky
We joined [the treatment COVID-19] on 20 March, some of the feathers��’s and the same evening received its first patients. It was a challenge, because Friday night is always difficult. Remember, I met these patients in the “red” zone himself along with all of the teams, which then worked. To go or not in the “red” zone, I never even thought of. The situation is such that we are one team and should work together. If I don’t go there, why have to go other?
we have Prepared fairly quickly, within a few days. To purchase PPE of steel in early March, then joined the Department of health of Moscow, gave us the equipment, the same ventilators, involved in the provision of Sesami. Had to repurpose two buildings: cardiac surgery and one in which there is one intensive care unit and two operating rooms.
there Were a lot of subtleties that should be considered. First of all, it was necessary to separate dirty and clean areas, because they should not be crossed: in front of the entrance to the dirty area is the sanitary inspection, where wear protective suits, then the person goes through a different changing facility, where he consistently in several rooms all it takes, processed and only then exits into the clean area. In addition, it was necessary to establish it infrastructure. since nothing can be drawn from dirty areas, histories there are in electronic form and then printed out in a clean area.
the staff Problems we had. Some people went to work in kovid, part remained in our main buildings, as we continued to provide emergency assistance.
Plus we have a large training center and is the residency, and there trained up to 600 people, the residents of the first and second years, and only in anesthesiology about 60 people. We taught two years, so we were confident in them.
twice a day we do a bypass, I am present in the morning and evening. Discuss the treatment of each intensive care patient. Plus, complicated cases which are in offices. I know about each patient, which is in the case is the years of practice we accustomed to this.
of Course, kovid made major changes in our schedule. And so we have irregular working day, and now it became very irregular. In something days I haven’t left work, and often went away, but later, sometimes, but not home to the hotel or left in Moscow, because the family out of town.
This is a special month for me, and for all employees Sklife. An emergency situation is usually transient, mobilizueshsya quickly, quickly solve issues and work here long, but I must say that the staff is constantly involved in this assistance, we have problems with burning no special.
These months much has been given, first in terms of awareness of the capabilities of our ��employee in different areas.
some employees took the unusual role, in particular administration. Feature of the device is dirty and clean areas that the negotiations are conducted only on local radios or phones, so inside the green zone shall be the administrator. Just a day after the opening, we have introduced a couple of administrators of the housing in order that if one of them gets in the red zone to resolve the issues, the other remained in the green. This required human resources — 6 pairs, 12 persons. First went there to work as the heads of emergency departments, intensive care, emergency squad, and so forth, that is, those who are accustomed to quickly make a decision. Specific example: one of the heavy resuscitation in Covina body chaired by our head of the anti-shock room. Antishock hall but we also functioning, all this time, there is our employee, she is perfectly fulfilled by the acting head of proteosome, and this is not an isolated case.
And in addition to fighting Kovalam, we have other work to do. Now we have opened a hospitalization is planned, so with the holidays this year will be hard. All cured and then think about the rest.
Oleg Averkov, Deputy chief physician for medical part of the clinical hospital № 15 named. Filatov
the first night I was in the “red” zone, and from outside had to meet the first ambulance, which brought us Vietnamese who test positive, that’s all. And the second day can be described as day in the fog, literally and figuratively, because I, like all who first put on a protective suit, fought mostly with sweaty mask, trying to see not only patients, but also their colleagues.
initially, the hospital was put all with suspicion, at first patients it was not clear how severe the situation is, though, given what was happening in the world, you can assume that we have a pandemic will be sluggish. But the first visit to the filling Department of intensive care gave a definite impression that it is scary and for some some people fatal.
every day I walk around several intensive care units. There is more than 150 people. My responsibilities as Deputy chief physician includes deciding which of these patients to intubate someone to exuberate (IVL may be conducted through a mask without inserting a tube into the trachea, or her. During intubation, the patient is unconscious and not breathing on his own — Forbes Life). These decisions are always important, but here we also have to take them in a strict time frame.
I am the administrator, if you wish, could stay in the green zone every day, but it would hurt to make an objective decision, because most frequentü decisions are taken there, at the bedside, looking at him. In the “red” zone have to be in order not to be the chief who remained at home, sending their employees to work and take risks.
some day I felt a mild ache, light fever, light cough and also sore throat. In principle, the common cold, but two days later, the witnesses began to say that it looks bad, so I went to CT (computed tomography — Forbes). The defeat was not easy. On the CT it looked impressive, I feel everything was normal. I have not experienced any problems with breathing, and only once I have registered the saturation is less than the desired performance. Six days I spent in the hospital in some moment there was a sense of threat to life, but it was short. Probably helped that I didn’t have the dramatic deterioration of shortness of breath, breathlessness, fever until he lost consciousness. So on the second day in the evening I felt almost healthy person, and then waited as the indicators will return to normal. During this time I at least managed to partially liquidate the debt by e-mail. Then I have 14 days spent in isolation at home, working remotely. In General, I believe that I got off easy.
so that’s once flatters vanity, and it seems like now most of the population is engaged in the glorification of doctors, but reason remember the old parable about Stalin — who are the five million who wrote denunciations? According to his service, I am responsible for the complaints of citizens and remember who and how we were called at another time, so I know roughly what will happen in a few months after the cessation of the pandemic. Complaint come now.
the Clinic at the worst time too it failed in logistics, document management. People find it difficult to explain that the statement he had made man on duty 12 in 12 in steamy glasses, two gloves printed it on the computer and there somewhere peed, put the two together three. A man writes to the President, Roszdravnadzor, Rospotrebnadzor in that it is a disgrace that taxpayers ‘ money goes to the wrong place. These people also left, they are also a kind of heroes of our time.
Talking about the burnout of physicians was always, now, probably, they are particularly relevant. But I see people who work in the “red” zone, I know them for a long time, they have changed little in terms of a reflection of stress on their behavior, relationships. Maybe they tempered previous burn-in “time of peace”. Although the minimum number of people in my environment do was forced to leave the hospital because it was difficult and to go to the “red” zone, and stay “green”, when colleagues come to covenin patients. I don’t blame them.
About the rest I don’t think. I have long paid vacation for the second half of July at Valdai, but now it is not clear, will it take place at all.
Nikolai Karpun, Deputy chief physician of the medical unit of the clinical hospital named. VP Demikhova
the Disease is new, but we’ve encountered similar infections, for example, in 2009, when was the swine flu. In fact, the coronavirus that causes respiratory infection, a more severe and contagious, in this regard received a large number of patients, and almost at once all the beds were filled.
the Schedule was tight, one big duty, and sometimes they had to spend nights at work.
fortunately, all the doctors anyway faced with respiratory infections, so they all coped with this task, including neurosurgeons, traumatologists, obstetricians just worked fine.
March 28 we have attached a branch of the Moscow clinical center of infectious diseases “Raven”. This is a hospital on 42 acres, over 50 buildings, all were built during a month. Together with the builders we have taken an active part in the creation of the hospital, I thought over the logistics on the technical and medical decisions. On 20 April, the center received its first patients. Despite the fact that the hospital was built and assembled here different people who must work in the same way, we have a decent performance.
in the past I have a military doctor and have experience of working in difficult conditions. Now the difficult conditions, nothing more. Therefore, to start working with the coronavirus to me was not a big problem. I myself, despite the administrative position of the practicing doctor, the anaesthetist, spend anesthesia, patients are in intensive care as possible. Now I’m running rounds, I’m not sick, there is a special doctor, but nevertheless control the action of the doctors discuss the most seriously ill patients for making specific clinical decisions.
That is, the situation has stabilized, and it is certainly more favorable than it was in March or April. But of course, we will work to the end, it has become quite routine story.
Natalia Kostareva
