Jessica Potter: We must find alternatives to direct human contact for people in ICUs

While people in intensive care are not allowed visitors, it is vital that they are still able to maintain their human connections to the outside world, argues Jessica Potter

I am a registrar currently working in intensive care in a London hospital. One of the most difficult jobs I’ve had since covid-19 began sweeping through the UK is calling relatives to give them updates. They have often already been told that they are not able to come and visit and I apologise, saying I cannot imagine what it must feel like to be prevented from seeing the people they love most in the world at a time when they are critically unwell and may not even survive.

I hear their pain over the phone and I am so sorry that, like many other places, our hospital is on lockdown, with no visitors allowed in at all. I imagine what I would do if it was my young son and conclude I would batter down worlds to get there. I would rage and storm and cry and my heart would break.

Last week, while in full PPE someone came to tell me that my phone had rung 10 times, each time by a different family member. I called my husband, and was unable to hold back tears as I was told that my brother was intubated on another intensive care unit after a car accident. My colleagues helped me slowly and carefully take off all my gear and sent me home. 

That night I repeated the phone calls I’d had the previous evening but this time with my own parents. I tried to talk my mum (in her 60s, a lifelong smoker) out of getting into her car and driving to the hospital. I tell her that they won’t let her in, that we don’t want her at risk, and that we cannot put my brother or anyone else in the hospital at risk. But what if it isn’t him, she asks. I give her rational responses—if that was the case, why would the police have come to her home, we can’t get hold of him so it all makes sense.

The next day my sister drives to the hospital to hand over clothes, cards, and snacks but they will only take the tablet that they can wipe clean. It feels like a punch in the gut but she understands. We are relieved to hear that he will make a full recovery and are grateful to everyone who took care of him.

As this crisis grows, our wounds deepen. I am not the only healthcare worker with a loved one who is unwell, and I am not the only healthcare worker who has to uphold rational rules that I struggle to make emotional sense of. It is right that we ask families to physically stay away at this time, but we need to think of alternatives to direct human contact. Some thought needs to go into how we can ensure that the visits of patients’ relatives don’t become a route of transmission, while at the same time allowing their families to see them in some way. 

I know that this is already happening in some places through virtual resources, but we need national policy and guidance so families understand what they can expect. For example, in my place of work we have bought tablet devices and used online video conferencing facilities such as Zoom to facilitate group prayers or visits to relatives and friends. Other hospitals have set up a ward email address so that relatives can send in letters and photos. Finally, we must do absolutely everything we can to ensure that people can be with their nearest and dearest in their final moments—this may mean full protective gear for families, for example.

Our job is to care for patients but also, by extension, their loved ones. In this fast moving crisis we can and must do this better to help maintain the vital human connections between our patients in hospital and their outside world.

Jessica Potter is a respiratory specialist doctor working in London and an honorary clinical lecturer at Queen Mary University of London. She is a qualitative researcher with expertise in migration and healthcare access. She campaigns with EveryDoctor to improve the working conditions of doctors. She also campaigns for the healthcare rights of migrants with Docs Not Cops and Medact. Twitter @DrJessPotter

Competing interests: None to declare.