Abstract
Managing uncertainty, balancing risk, safety netting are all well-worn phrases that we hear applied to general practice. We, as GP trainees, will be learning the meaning in our first fledgling months as independent practitioners. However, what do we do when we are thrown into a time of uncertainty, not only for our patients but also for ourselves? As a GP in my first few months of practice, I have found myself uncertain and trying to manage, going from just about getting to grips with 20-minute appointments, to being that voice at the end of the phone for multiple patients a day concerned that their cough is coronavirus. How do we reassure our patients, when we ourselves, are worried? After a long day of telling young patients with cough and fever that they will be ok and do not need to be seen, uncertainty creeps in when the headline in the news is of an 18 year old with no other illnesses who dies after testing positive for COVID-19.
Uncertainty is something we all deal with, both in and out of work. However, what happens when the carpet is whipped from under our feet and we are not sure where solid ground is? We get daily updates, daily algorithms for assessing patients, daily death statistics and chilling stories from our European counterparts. In general practice, we may at times feel guilty that we are not there, on the ‘frontline’, in the hospital with our colleagues. However, then you find yourself seeing patients out of hours, wearing mask and goggles, in a dark car park because there are not enough rooms that have been deep cleaned; you realise, you are on the front line.
This came to a head during an out-of-hours shift. A young woman, unwell with cough and fever for a week, now could barely walk the length of the corridor without fainting. In another world, we would safety net, reassure and send home with reassurance and the knowledge that she is young, has good reserve and likely just to have ‘a viral illness’. In our new world, everything is seen through COVID-19 glasses. We cannot shake it, and we should not, because sadly this is not just the flu, and this young woman may not just be fine.
As a trainee, we probably feel uncertain a lot of the time, but now our senior colleagues are also unsure, probably scared and do not know how this will play out. What we can do is talk, feel lucky we have a job to go to and have the normal chat (socially distanced) around the kettle. We can reassure each other that we are all uncertain, in this very uncertain time. And remember, to keep being that reassuring voice at the end of the phone.
