Secret Doctor: Entitled patients, fatigued colleagues and inadequate services are all legacies of the covid pandemic

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Finally, the veil of face masks has been lifted within the walls of hospitals, yet the lingering marks of the pandemic endure. The elderly population has borne the brunt of covid-19's devastating effects, the scars of which appear insurmountable. 

Withdrawal from social interactions has dealt a harsh blow to their cognition, resulting in a distressing surge of dementia and functional decline. Additionally, the dearth of exercise and physical activity has taken its toll on their overall wellbeing. Fear and anxiety, like an unyielding grip, have permeated every corner of our nation, seeping into hospitals and searing through the fabric of every home. What should have been a precious time for older individuals tragically became a period overshadowed by apprehension about their own health and uncertain futures.

Healthcare staff, once hailed as heroes during the early stages of the pandemic, now find themselves faced with waning gratitude. The burden placed upon our ailing health system has reached unprecedented levels, as people's expectations soar higher than ever before. I recall a recent visit to my own general practitioner, where in the waiting room, a man who had been granted an emergency appointment erupted into a frenzy of screams, shouts, and profanity hurled at the administrative staff. Oblivious to the fact that his doctor was attending to another sick individual, he exemplified the entitlement that taints the atmosphere in many healthcare settings.

The trauma endured by those working on the frontlines throughout the pandemic is immeasurable. I, too, have vivid memories of tending to patients on numerous covid wards. While I was grateful for the opportunity to come to work and interact with others, what I bore witness to during those trying times will forever leave an indelible mark. Over time, a chilling pattern emerged—a patient would be admitted with seemingly normal oxygen levels, yet their chest X-rays would reveal abnormalities, and their breathlessness would far exceed what one would expect based on their blood oxygen levels. Their desperate gasps for air, coupled with fear-stricken eyes pleading for assistance, were nothing short of heart-wrenching. 

Though we administered appropriate medications and delivered the best care possible, it became distressingly apparent which patients were unlikely to experience an unfavourable outcome. The weight of these deaths reverberated throughout the entire healthcare community, as I recall porters and mortuary staff donning their protective gear to transport bagged bodies to their final resting place in the mortuary. The impact rippled through the ranks of our cleaning, catering, administrative, nursing, and medical staff alike. Just as covid wards would dwindle in size, a sigh of relief would escape our lips, only to be abruptly stifled when new spikes in cases demanded our attention once more.

Among the lasting repercussions of our current hospital existence, one that resonates deeply is the erosion of social engagement beyond the workplace. The customary weekly gatherings at the nearby pub, where camaraderie thrived and an open invitation extended to all, have vanished without a trace. Hospital staff, myself included, have inadvertently become more insular, seeking solace within smaller social circles and partaking in fewer engagements. The resulting impact on morale and the sense of camaraderie within these hospital walls is palpable, evident in the weary grumbles of fatigued healthcare workers.

Unforeseeable as the repercussions of the pandemic were, much of the healthcare landscape operates within predictable parameters. Astute modelling has successfully projected population growth for the forthcoming decades. In Ireland, for instance, the certainty of an aging populace looms large. With this knowledge, we are keenly aware that older individuals represent a significant cohort reliant on healthcare services. It is an imperative to invest in fortifying our primary healthcare resources and reducing the dependency on hospital admission to ensure diagnostics are completed or services in the community are provided.

Our GP colleagues toil ceaselessly at the forefront of patient management in the community. They endeavour to instigate preventive treatments, striving to shield patients from unnecessary hospital admissions that often bear detrimental consequences for the elderly. Alas, the future reveals a sombre forecast: a sizable cohort of experienced GPs will retire in the imminent years, and a dearth of replacements awaits their departure. Digitising our healthcare records and creating a cohesive system for inter hospital information sharing as well as connecting to GPs' electronic systems is imperative. 

Looking forward, it becomes evident that incentivising professionals to work in rural locales is a prerequisite for the sustainability of our health system, be it in primary care or hospital settings. Moreover, empowering and adequately funding home help carers emerges as an indispensable strategy to enable older and dependent adults to retain the comforting embrace of their homes for as long as possible. Recognising the pivotal role of both formal and informal caregivers, we must facilitate their access to services that render life more manageable, including day centres and respite facilities.

In recent times, we have witnessed a glimmer of hope with additional and much-welcomed funding injected into integrated care hubs. These visionary hubs are an excellent example of community care, catering to a spectrum of specialisations such as endocrinology, geriatric medicine, respiratory care, and cardiology. Such innovative ventures aim to enhance the provision of care within the community, ensuring that the right treatment is dispensed in the right place at the right time, for the right person. Plans for further expansions of these hubs stand testament to their success and the vital role they can continue to play in our healthcare landscape.