These last days the situation in Medellin or Antioquia has being very complicated, having to take the decision of an obligatory quarantine, departure times and days depending on the number of your identity document. In order to understand this situation I talked with three friends that are close to the medical and health system to share with me their experiences during the pandemic. there are interns, doctors or close to be doctors and with lots of feelings share with me their experiences and their own opinions regarding the population behavior.
Their names are Natalia Mejia, Johan Vergara Pérez and Pablo Jimenez Marín and answering 5 questions they shared with me their experience and how is being to work while clinics and hospitals declare state of emergency.
1. Tell me about your professional profile, semester you are studying, if you are an intern, in which university do you study? where do you work? ...
Natalia:
I am Natalia Mejia, senior intern (13 semester) at the Universidad Pontificia Bolivariana, I have 3 months left to graduate as a general practitioner and I find myself rotating through the Neurology service and I have had the opportunity to rotate through different services during this pandemic.
Pablo:
I am a Doctor from the CES University, and I graduated about 9 months ago and I am working in a private first level medical unit called "UMI" (Unidad Médica Integral) in Marinilla, Antioquia.
Jhoan:
I am Jhoan Vergara Perez, I study at CES University and I work in the CES clinic (emergency room). I’m a Nursing assistant with an experience of 8 years in the emergency room and currently I’m in the seventh semester of nursing.
2. Tell me about your experience in ICUs
Natalia:
I have little access to the ICU, perhaps because I am a resident inmate because my access is very limited due to the current situation. I have had some opportunities to visit the ICU, with regarding to my patients they are more than all those from psychiatry who are in "Delirium" for COVID, and they are patients who need a permanent accompaniment and to be locating them (tell them where they are or date ...). The "Delirium" is a confusional syndrome, is generated because the patients are not in their usual environment and they begin to present changes such as being disoriented, sleeping more than necessary, they are sleepy, they are agitated … although it depends on if it is Delirium hyperactive or hypoactive.
There is a very stressful environment because the ICUs are very full because they do not give vast and even the medical personnel sometimes overlook some things about the patients. At the Bolivariana Clinic a patient arrived with Obesity grade 3 and has Quadriparesis (which means that she cannot move any of her joints) and the Interns no longer give enough and say that she is a fat patient, which is why she does not move when Before she had mobility, they no longer want to attend to her either because she has Covid or because she is fat.
Pablo:
In the ICU I have not had much experience, the truth is because during the degree we visited the Intensive Care Unit little, unless you requested a rotation there and now I work with primary care.
Jhoan:
I have been working in the emergency room for 8 years, I have had very little opportunity to be in the ICU, but I am in constant contact with the initial critical patient, this type of patient leaves many lessons, both in the ICU and in the emergency room, you live daily with life and with death, in ICU the patient who arrives we do not know if he will leave again, but humanly, the impossible is done to achieve recovery and adequate evolution of patients.
3. What is your position on the vaccination plan, do you think it has been effective? logistics? Applications?
Natalia:
I think that vaccination is very important to make herd immunity and especially for vulnerable populations and older adults who are the ones who have suffered the most from the consequences of the Covid. I think that it should be done in a more responsible way and not in a massive way because it can have consequences in the short and long term. The logistics have not been correct, contact is being promoted and everything has been on a massive scale, the vaccines arrived late and compared to other countries since there is already herd immunity because most of the population is vaccinated and we are very far from being vaccinated, only the population over 70 years of age, vulnerable populations and health personnel are, and the rest are not ... we are really far away and ICUs are already full of these populations, in short the government has not handled the situation well!
Pablo:
At the departmental level, I think it has been well managed, but here in Marinilla the state has handled it very regularly. The few doses that arrived were for the medical staff of the local hospital, but for the other IPS who are also treating respiratory patients, priority has not been given. However, the vaccination days lend themselves to disorder, despite the fact that the resource is there, it is not being distributed in the best way because it is facilitating sources of contagion by making people stand in very long lines instead of improving displacement and making it more organized, vaccinators are really few ... and putting a vaccine is not complicated.
Jhoan:
I think that the brightest minds on the planet worked to invent the vaccine, and even more so when there was a previous antecedent such as Sars-Cov 1 in 2003, so this is not something from now and has been working for a long time. In this, the vaccine is effective, of course it is, but I think the population was not adequately educated so its logistics failed, the vaccine is effective after a week administered the second dose, but people thought that with the first vaccine I was already immune and it is not like that, as for the vaccination phases, I think they were adequate, but due to the evolution that this disease has shown us is that it does not respect age, gender or race, the application in recent days has been something chaotic and in particular cases where the vaccine has not been administered and people are deceived, it becomes a vulnerable population that affects vaccination statistics and that loses not only effectiveness, but also credibility.
4. Tell me about an experience that has moved you too much from all this experience, including the most difficult decision you have had to make, for example disconnecting a patient, administering a medicine, etc.
Natalia:
I am not a doctor yet, therefore there are decisions regarding patients that I cannot make yet, but I have had the opportunity to see situations that emotionally impact not only the patients but also the staff. Many times, the staff is already exhausted, the health center is full of patients and it is already working by inertia, it is thought that patients are machines, and we are losing our human side, deciding between "which machine works more and which machine works less". We have to see that we are working with human beings, that these patients are very lonely, they are very afraid of having to find themselves between life and death (because they need intubation) and they are generally neglected; Anyway, it is very sad and there is no support from relatives or someone you trust because the situation does not allow it.
Something that makes me even sadder is like the attitude of the general population against doctors ... in acute moments or crisis, the doctor is the hero or the savior but when they see you walking in the street in uniform or anywhere else, they avoid you, they try to keep their distance, they look at an ugly one. It is evil because one is the one who has to go to hospitals and there are doctors who are risking even their own lives in this pandemic and live many situations of rejection.
Pablo:
One in particular, I do not know ... day by day it is hard to refer patients who are ill or who are desaturated with indications of being hospitalized and that due to the current situation they do not receive the patient then it is that impotence to see how the patient is getting worse in front of you and you can't do much.
Jhoan:
I think the experiences are incalculable, but personally it seemed very difficult at the beginning of the pandemic to see people die who suddenly did not say goodbye to their loved ones and whom they would never see again, the last memory of their relatives was seeing them enter a emergency room.
See how through a cell phone they experienced the pain of saying goodbye to their loved one.
5. Do you think that our health system is really prepared to face a situation like this?
Natalia:
The truth is that I am very grateful for something to our health system and that is that all citizens have access to the health system. In developed countries, work is done differently and many of the patients do not have the right to health, and that is a fundamental right that should be available throughout the world, not just in our country. Obviously, we lack many resources such as ventilators, the ICUs do not have the availability to attend a certain number of patients because they are already fully occupied, so alternative ICUs have had to be set up and, obviously, at this moment the health system is collapsed, and the hospitals and major clinics have already declared a state of emergency.
Another problem is the education of the population because they are not aware of what is happening right now, they are irresponsibly going to common places to agglomerate and there is no control whatsoever.
Pablo:
I think that the personnel we have at the national level is too good, with regard to infrastructure there are some better than others, however due to the little awareness that there is in society it may be the best health system, but it is very difficult for it to endure the situation. The health system is well but not excellent (from a score of 1-5) I give it a 4 to face all this despite the fact that the EPS and everything is very regular, but I think more than everything has collapsed due to the lack of education and awareness Social.
Jhoan:
Noooo, it has never been prepared, neither the health system, nor the people, nor the country, nor the world, we never imagine facing a pandemic, but you know something, I think that more than the health system is the ignorant mentality of the majority of the population, if the population became aware of self-care, the health system would not collapse and perhaps there would be more scope for action.
In conclusion, the is needed that the population will be more aware of the current situation, where really the clinics do not give vast and we need to understand that our medical staff is tired and they have to make drastic and difficult decisions every day, where they try as much as possible to attend and save to the patients. Let's value our medical staff more and consider if your social outing and gathering is really worth it ;) 😉
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