Diary of a (secondline) clinicianAs has been widely reported, SARS-CoV-2, the virus that causes COVID-19, is stable on certain surfaces for up to several days. This is a significant cause for concern when it comes to controlling a virus that already causes an illness with a long asymptomatic transmissible time, making it even more likely to spread amongst individuals. Much attention is paid to cleaning of bed spaces and equipment to prevent cross-contamination between patients. Just as important is frequent hand-washing and changing of the personal protective equipment (PPE) worn by healthcare professionals. "This is a significant cause for concern when it comes to controlling a virus that already causes an illness with a long asymptomatic transmissible time" One thing previously only considered in the context of the operating theatre where scrubs are worn exclusively, or in the intensive care unit where visiting doctors must be bare below the elbows, is what healthcare professionals in other areas wear when not protected by PPE. Given the risk for SARS-CoV-2 to persist in droplets on the surface of one's clothes and be brought back home, potentially exposing one's family, it is now common practice amongst both doctors and nurses to change clothes more times during a day than in a Bollywood movie. Many health services suggest wearing a set of clothes to work, changing into a work set i.e. scrubs, then at the end of the day changing into another set, putting the work set into a plastic bag that you take home and wash immediately. The result of this is much changing and washing to be sure but a curious side-effect is the sudden seeming loss of the ability amongt patients to tell various health professionals apart. Nurses wear scrubs, allied health wear smart casual (pants if you're a physio), pharmacists and doctors wear semi-formal, the former distinguished by prominent purple pens and the latter by stethoscopes, or in the case of consultants, suit jackets. "it is now common practice amongst both doctors and nurses to change clothes more times during a day than in a Bollywood movie." So now that everyone's wearing scrubs, no one knows what anyone else's role is any more. Female doctors have it the worst. Already struggling with septagenarian and octagenarian patients suspicious that non-male doctors even exist, being mistaken for nurses is anecdotally now even more common. More than a few of my female medical colleagues have commented along the lines that they could be wearing a flashing neon sign above their head proclaiming their doctor role and still be asked to replace a bedpan. On the flip side some of my younger female nursing friends have reported occasionally being mistaken for an intern or resident doctor, always by other doctors rather than patients, which has apparently been quite flattering. As a male doctor still semi-formally dressed replet with stethoscope and yet to need to convert to scrub-wearing I'm in no danger for being mistaken as anything other than the secondline 100%-safe-from-COVID-19 clinician I currently am. This puts me firmly at the bottom of the current pandemic-ready hospital moral pecking order, a position I'm more than happy to inhabit for now. If I never need to wear scrubs this year it'll only be because our community has fought COVID-19 and won, and that is something truly worth celebrating.
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May 2020
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