‘It is desperately sad taking patients to hospital alone, heartbreaking in some circumstances’
Irish paramedic in Wales Phillip Cahill on working during Covid-19 pandemic
‘I have had many people ask me if their loved is going to die, whether they will ever see them again?’ Phillip Cahill, who works as a paramedic in Wales
Phillip Cahill from Salthill, Co Galway works as a paramedic in Wales. He spoke to Irish Times Abroad last Christmas about his job (which became one of the most-read Abroad articles of 2019), but we caught up with him again this week to find out what it has been like working as a paramedic during the coronavirus pandemic.
To recap, why did you go to work in Wales?
My partner Susie and I moved to Wales because we have the great outdoors on our doorstep, so it was a lifestyle decision as opposed to a work-related decision. I moved from Galway to Essex in 2008 to start my career as a paramedic, which is where I met Susie. We travelled regularly to the west coast of England for the surf and the hills. In 2016 we took a year out, travelled the world and when we returned, we took the opportunity to relocate. Wales is where we decided upon.
What places do you cover in the area you work now?
I mostly cover the county of Bridgend in South Wales, however if demand dictates I can be sent to neighbouring counties. More often than not this means we are called westwards towards Swansea.
How had Covid-19 affected people there?
Quite badly I would say. The incidence of Covid-19-positive patients has been quite high in southeast Wales. There is a prevalence of lung disease in this area, which stems from working in heavy industry, particularly the mining industry. This leaves these people in the high-risk category.
In many cases, I have left the patient’s loved one at home alone, where they don’t have anyone else there for support. I can’t imagine what it is like
What changes have you seen?
Broadly similar to in Ireland. Lockdown was quite well-observed in Wales, certainly until recently anyway. The vulnerable have been shielding, with support from their families and friends. Everyone has just been getting on with it as best they can. As talk of reducing restrictions began though, people have begun to reduce their compliance.
Have you taken people with coronavirus to hospital?
In the majority of instances, I would not know whether a patient had Covid-19 when attending to them in the community. I would look at the patient’s clinical condition and history and from this would have a reasonable idea whether they were likely to be suffering from Covid-19. There is no official feedback mechanism in place, so If I did bring a positive patient to hospital I wouldn’t be informed.
I have followed up on some patients with the staff in the emergency department, and some have turned out to be Covid-19 positive. This included one particular patient I attended to who worked in her local area as a nurse. Sadly she passed away a short time after being admitted to hospital.
Is it sad that you take patients to hospital alone?
It is desperately sad taking patients to hospital alone, heartbreaking in some circumstances. It has often been in the back of my mind that this may be the last time the patient is going to see their wife, husband or partner, children or loved ones. Having to tell people that they cannot come to hospital with their loved one has been very difficult; many were unaware this would be the case.
I have had many people ask me if I think their loved is going to die, whether they will ever see them again. In many cases, I have left the patient’s loved one at home alone, where they don’t have anyone else there for support. I can’t imagine what it is like for these people. Also, when the patient needs support the most, they can’t get it from their nearest and dearest. I try not to think about it too much, because it is just so desperately sad.
What is your day like now?
When I’m not at work, I busy myself with jobs and projects in the house or garden. I find it tough enough to spend the whole day just relaxing around the house, I feel much better if I have had a productive day in some way or other. On the rare day Susie and I are off together we try and get out of the house for a while. There are plenty of local walks from our doorstep. We were more than five miles from the coast, so we weren’t able to go to the beach initially and it was great to have that restriction lifted.
How have things changed for you at work?
Things have changed drastically at work on a number of fronts. At the start of my shift, I check to see if there have been any procedural or clinical updates in relation to the Covid-19 response. At the start of the pandemic, the advice could change a number of times in one day and it was a job to keep up with it.
I wear PPE for every patient encounter, this includes apron, gloves, mask, and eye protection. If a patient is particularly unwell, we may upgrade our PPE to a full body suit
Then I check my Covid-19 personal protective equipment (PPE). This includes a powered respirator hood to protect me while I work. I wear PPE for every patient encounter, this includes apron, gloves, mask, and eye protection. If a patient is particularly unwell, we may upgrade our PPE to a full body suit, with gloves and respirator hood.
The cleaning regimes have been overhauled and are much more robust. The British military were assisting with this in South Wales. They were based at the local hospital and would clean the ambulances while the ambulance crews brought the patient into the emergency department.
Since the start of the pandemic the hospital has been quieter, which means that we have a quick turn-around when we bring patients to the emergency department. I think the risk of coming into contact with a contagious virus has made people think very seriously about whether they want to go to hospital or not.
This is a double-edged sword. There has been a reduction in patients who should have gone to the pharmacy or should have seen their GP instead of ringing 999 or going to the emergency department, however there is also a reduction in the number of referrals for diseases such as cancer, as people are putting off seeing their GP or the hospital when they really need to.
We have had great support from the local community here, between the clapping on Thursday nights, to people delivering all sorts of food and drinks to the ambulance station. I also thank those who have raised money for the ambulance stations in Bridgend. This has been so humbling and very much appreciated. Sometimes a little chocolate pick-me-up does a world of good when you’re having a tough day.
How are you looking after yourself?
There are a couple of things that have helped me through this time. Firstly, the support from Susie, family, friends and colleagues. Everyone’s world has been thrown upside down, but we are in this together. Secondly, and I don’t think I’m overstating this one, the weather has helped. It has been fantastic here in Wales up until a few days ago. This has allowed our garden to be a sanctuary for us. All I have to do is sit out and look out over the valley and I feel instantly more relaxed. Having the good weather has also let me crack on with some garden projects, which I find puts me in a good mood (most of the time).We’ve had lots of barbecues. Also, our local walks are that much nicer in the sun.
Is there anything you miss about Ireland at the moment?
Yes, I would love to catch up with and actually see my family and friends. This is always the case, but it is now even more acute. In terms of the response to Covid-19, I think Ireland did a much better job than Britain. I feel it has been a disaster here and we are looking down the barrel of having this Westminster government for years to come. I find that prospect very worrying.
If you live abroad and would like to share your experience of how Covid-19 is affecting you there, email Irish Times Abroad at email@example.com