Swapping STIs for ICU – redeployment and cross-skilling in the era of COVID-19

Dr Ellie Crook is a specialist registrar in genito-urinary medicine and HIV at the Jefferiss Wing at St Mary’s Hospital. In a post originally published as an RCoA blog, she writes about how she felt when she found out she would be redeployed to ICU, and how she felt reassured by the supportive team she found there.

No doctor ever expects to suddenly be asked to work in a different speciality for an undisclosed period of time. Certainly, as a registrar in sexual health and HIV, I did not expect to be spending much time on the wards, let alone going back to work on the front line in the intensive care unit. So, when I received an email from my trust thanking me for “volunteering” to join the intensive care unit (ICU) rota during the Covid-19 outbreak, I felt overwhelmed and quite nauseous.

I wanted to help but I was concerned that the situation in ICU must be worse than I had imagined if they were recruiting community-based doctors with limited ICU experience. My thoughts spiralled and I had visions of being completely out of my depth, looking after the sickest patients and being required to undertake procedures I was not comfortable with. I was also nervous about leaving my team and the speciality I enjoy so much to work in a very different environment.

However, my experience so far has been nothing but positive. Shortly after the initial email, I received communication from the ICU team itself, inviting me to join a series of “cross-skilling” webinars. These were interactive lectures on the basics of ICU, covering topics such as mechanical ventilation and respiratory failure. They were delivered by intensivists that were self-isolating and allowed plenty of time to ask questions. During these webinars I was also reassured that doctors being redeployed to ICU would not be expected to work beyond their capability. Following this I spent the day shadowing the ICU team and received my new rota – I was assigned to the new expanded ICU in what had been theatres recovery.

This new ICU area is mostly staffed by anaesthetic consultants and juniors who have also been redeployed. I was welcomed to the team and overcome by how supportive everyone was. Again, I was reassured that there were plenty of people with much more recent experience than me that would be able to undertake the practical procedures I had been so nervous about.

I have been impressed by the team spirit of everyone I have come into contact with. The consultants at the sexual health clinic check in at least weekly to make sure we are coping and to remind us that even though we are temporarily working elsewhere we are still a team and they encourage us to get in contact anytime. The anaesthetic team have been so welcoming and supportive, they have highlighted the attributes I can bring to the new diverse ICU team and never make me feel out of place.

I have realised now that I initially undersold myself and although I might not be an ICU registrar or airway trained, I do have important skills that I have been able to bring to this ever-changing environment.

I would encourage anyone considering redeployment to embrace it. Not only is it an opportunity to help out the NHS at this critical time, but you might surprise yourself and find that the skills or qualities you have always taken for granted are transferable and truly valuable.