This interview is part of the hub's 'Frontline insights during the pandemic' series where Martin Hogan interviews healthcare professionals from various specialties to capture their experience and insight during the coronavirus pandemic. Here Martin interviews an oral surgeon who has been in the post for a year in a trust that covers two sites in the West Country.
Questions & Answers
Martin: What has your experience been like around patient/staff safety during the pandemic?
Oral surgeon: We have been carrying out telephone consultations to prioritise the severity of the injury and prioritising those patients that need to be seen quickly from the non-urgent patients to minimise the risk of transmission of covid. We are using full areosol generating procedure (Agp) personal protective equipment (PPE) whilst reviewing patients as we are working in a high risk area - i.e. in the mouth. Local trust policies have been varied and there is controversy around what is effective protection. Should we be using fluid protective masks for non-aerosol procedures? This has caused disagreements within the trust.
Martin: What resources have been easily available for you to maintain safety from your department/trust?
Oral surgeon: PPE has been readily available in the south-west region of the country and infection control has been present and at the forefront of information and policies. Social distancing has been adhered to when not needing to review patients' mouths. Daily bulletins have been provided by the trust, which updates us on guidelines and new information and cases.
Martin: What have been some of the positives/negatives you have taken away?
Oral surgeon: Negatives – the heat whilst performing procedures in full PPE. It can be extremely hot wearing full PPE and leaning over someone’s mouth. Also cancer diagnostic delays have been noted as patient’s are not presenting to clinicians within the 2 week wait. Positives – staff moral has been high and the general public has been supportive and are aware of the reasons to not treat or to delay treatment.
Martin: How well have you been supported by your seniors? What could have been improved?
Oral surgeon: Communication could have been better. There has been misleading information regarding differing trust policies when working across different trusts. Differences in national and local opinion in what defines best practice. Restrictions in place have influenced the type of clinical treatment given. For example, in one trust I am advised that aerosol generating procedures should be adhered to differently - i.e. use as drilling into tooth is an increasing risk and therefore need to use full PPE and wait an hour to decontaminate room after patient use, but in another it's less PPE and wait 30 minutes post patient care.
Martin: What skills do you have to better enable patient safety and how did you acquire these?
Oral surgeon: I am working in a very productive and dynamic unit. Infection control has been constantly at the forefront and information updated daily. Inter-professional working within the hospital has been key. For example, regular updates from respiratory and microbiology on how to preclude with different care groups during the pandemic.
Martin: How have you coped?
Oral surgeon: A lot of gin and tonics! Support and love from the team. Laughter. Work has been surprisingly easy, more easy than normal due to lack of demand and capacity.
Reflections and final thoughts...
Oral surgery during the pandemic is a high risk area so it's good to hear that PPE has been readily available at the trust. However, as we have heard from many frontline staff, information around the use of PPE can be conflicting and confusing with different trusts working to different policies. Communication at all levels is key to patient and staff safety.
Would you like to feature in one of our interviews? We'd love to hear from other frontline contributors.