Reflections on returning to clinical practice during the COVID pandemic

Janice O’Connell is a retired Consultant Stroke Physician and Co-Chair of the BGS Retired Members Group.

I took early retirement from my post as a consultant stroke physician at the end of 2017 but have continued to work in undergraduate medical education on a part-time basis. I am based in the Education Centre of the Trust where I have worked since 1997, so my return to clinical duties at the height of the pandemic was a temporary redeployment. My experiences will therefore be different from those of others who have returned to work in the NHS after being fully retired.

I was asked to support the stroke service whilst colleagues were on COVID-related sickness absence. The stroke unit was classed as “COVID-free”, with any patients testing positive transferred immediately to one of the designated COVID wards elsewhere in the hospital.  Thus, I would describe my role as behind, rather than on the NHS front line. Nevertheless, due attention had to be paid to the wearing of PPE for any clinical contact, in line with the current guidance at the time.

Many people have asked me what it was like to return to clinical work. There was the novelty of going into the hospital wearing jeans rather than professional attire, as scrubs were mandatory in ward areas. Since I’d been teaching geriatric medicine and stroke management to medical students for years, my knowledge was up to date. I found that I still enjoyed the interaction with trainees on the ward, particularly the FiY1 doctors who had been our final year students a few weeks previously and now appreciated some pastoral support from one of their teachers.  Any rustiness with the hospital’s clinical IT systems disappeared rapidly after accessing a few patient records. I spent much of my time undertaking telephone consultations in a virtual TIA clinic. This was a new way of working for me, as my entire previous experience had been of face-to-face encounters in the OP department.  It was challenging to rely only on verbal communication, without the additional benefits of observing the patient’s facial expressions, body language or gait. However, most of the diagnosis of TIA depends on appropriate history-taking and this proved to be quite straightforward for a “veteran” of many TIA clinics! I came away from these new clinic experiences with some very valuable insights into the pros and cons of remote consultation, all of which will be extremely useful in preparing students for their future clinical practice.

I have worked for the NHS since 1985 and returning to clinical work during a global pandemic was one of the most challenging but rewarding things I have done in my career.  Looking back now, I am pleased that I was able to play my small part in providing care to patients and support to colleagues at a difficult time.