Tales from way behind the front line. A retired anaesthetist in the vaccination clinic tells all
Jabber and his colleague, the Queen Bee, having
finished the last jigsaw and been comprehensively
blocked by Boris from visiting their respective
grandchildren, have decided to throw in their lot with
the ever-expanding COVID vaccine force. If nothing
else, it’s an excuse to get out of the house that doesn’t
involve Waitrose and a sudden and inexplicable
shortage of quinoa.
Despite the media fuss, the online training package was a
breeze. Without this essential preparation, we could easily
have finished up administering vaccines without knowing, for
example, that a wet floor is a hazard that can cause harm, or that
someone clenching their fists might be exhibiting warning signs
of impending conflict. The potential consequences of such
ignorance cannot be lightly dismissed.
The only bright light was that, NHS bureaucracy being what it was, nobody had yet got round to cancelling my hospital parking permit.
No, it was the form-filling that nearly did us in. Although I had
left only four months earlier after more than 30 years at the
coal face, Occy Health at my old employing Trust did not have
any record of my existence, and the Other Trust, managing the
community hubs, wanted my bank account number actually
spelled out in words (yes, as in ‘one, nine, eight’ etc). I had to
take my passport and a gas bill to the hospital to show what
appeared to be a 10-year old from Human Resources that I
was actually me as part of my DBS check, and submit a cheek
swab for DNA confirmation (one of these may be untrue). The
only bright light was that, NHS bureaucracy being what it was,
nobody had yet got round to cancelling my hospital parking
permit.
Since then, it’s been all hands to the pumps. Our hospital Trust
has two or three doctors on duty at any time, largely involved
in helping the ‘assessors’ who are doing the screening, or in
signing prescriptions for the vaccine. In the community hubs,
prescriptions are not needed at all, for some reason relating
to PGDs which I learned on line and then instantly forgot. I say
not needed at all, but in the first two weeks we had to prescribe
every sixth dose of Pfizer, since only five doses from each vial
are licensed - amazingly this is not the most pettifogging rule
we have encountered, as will become apparent.
There are, of course, few more important tasks than helping with the vaccination drive.
Each community hub has at least one GP ‘lead’, who does
exactly the same job as me and the Queen Bee but gets paid
twice as much for doing it. The actual task of jabbing is, quite
reasonably, regarded as easy to learn and teach and is often
performed by medical or nursing students, and we are left
with the vital and skilled task of saying “Yes, she’s good to go
despite the apixaban”, a phrase which we should really have
emblazoned on our foreheads to save time. As anaesthetists,
we tend to get a bit busy checking the emergency equipment;
this led me to search out a bloke with a hacksaw the day before
one of our hubs opened, when it became apparent that the
legs on the examination couch were so long that you’d have
to be Richard Osman on a step-ladder to have any chance of
performing effective CPR.
There are, of course, few more important tasks than helping
with the vaccination drive. The multidisciplinary teams are
highly motivated and great fun, the customers almost entirely
happy, and the atmosphere as positive as a proton blessed with
incurable optimism. But, for those of us accustomed to a patient
bleeding out in a trauma room or a rapidly-deteriorating CTG in
a BMI 60 primigravida, it’s not the most exciting place to be. The
biggest thrill in the last fortnight was when a vaccinator, faced
with a morbidly obese patient, whispered to me, in a manner
reminiscent of Roy Scheider in Jaws, “I think I’m going to need a
bigger needle”. Clinic nearly went into meltdown as I replaced
the standard blue needle with a whopping 21-gauge green,
and I had to justify myself to none other than a pharmacist. But
more of pharmacists next time…
Jabber the Nut