Covid-secure precautions in the work-place as a locum

RE: Covid-secure precautions in the work-place as a locum

Michael Woodhouse — Mon, 12 Oct 2020 22:28:24 GMT

[quote userid="2457" url="~/001/nonclinical/f/life-in-practice-discussions/29392/covid-secure-precautions-in-the-work-place-as-a-locum/225888#225888"]wasting so much plastic and PPE in simply keeping up appearances[/quote]

Ultimately we are using it so that the practice can stay open in the event of a case. I don't believe by wearing it I'm really protecting anyone from anything. If standards behind the scenes are less thorough then I trust professionals to do what they believe is needed in the circumstances - with all PPE provided.

I don't understand why I can buy a birthday cake from the shop and share it, but it's not ok for me to bake one? Both made by humans. Obviously no candles.

In public I didn't wear a mask until it became a legal requirement. I'm not really convinced the current measures are anything more than lip service, but lets keep jumping through hoops so it looks like we are doing something.......

RE: Covid-secure precautions in the work-place as a locum

Gillian Mostyn — Mon, 12 Oct 2020 21:17:40 GMT

[quote userid="10813" url="~/001/nonclinical/f/life-in-practice-discussions/29392/covid-secure-precautions-in-the-work-place-as-a-locum/225885#225885"]I thought the point many were making about using full PPE was to prevent isolating in-contacts? Doesn’t seem much point in using it otherwise [/quote]

Absolutely. That's why I get annoyed with the current level of PPE use/wastage. The same practices using PPE to avoid test and trace are aware that staff need to sit closely together to eat lunch in the staff room. I'm also still seeing staff bringing in home made goodies for colleagues and being served them by others!

I'm not saying staff shouldn't bake cakes or chat at lunchtime - of course they should, with sensible precautions. But we need to just wear appropriate PPE when working closely but stop wasting so much plastic and PPE in simply keeping up appearances! A paper or cloth mask worn for 3 hours or more isn't doing much....

RE: Covid-secure precautions in the work-place as a locum

David Shepherd — Mon, 12 Oct 2020 18:40:48 GMT

I thought the point many were making about using full PPE was to prevent isolating in-contacts? Doesn’t seem much point in using it otherwise

RE: Covid-secure precautions in the work-place as a locum

Evelyn Barbour-Hill — Mon, 12 Oct 2020 14:32:50 GMT

[quote userid="6550" url="~/001/nonclinical/f/life-in-practice-discussions/29392/covid-secure-precautions-in-the-work-place-as-a-locum/225780#225780"]and we are all being a bit antisocial away from work.[/quote]

Not that I enjoy being pedantic, or anything like that, but I suspect you mean you are keeping away from other people. That's not being antisocial, that's being unsociable. The antisocial thing would be to mix closely with other people, breathe into their faces and so on.

RE: Covid-secure precautions in the work-place as a locum

Anthony Dennison — Mon, 12 Oct 2020 13:56:30 GMT

We have been letting clients into the building since July. Not something I was happy with, but we had one heavily pregnant vet and two vets with bad hips that were really struggling. One client per pet, only 4 clients in the waiting room at a time. Any holding done by nurses, client sits in the corner.

Full PPE (we were initially masks only but have changed). One positive test from a nurse last week who sat with a few people at lunch has taken out 6 staff members due to track and trace.

RE: Covid-secure precautions in the work-place as a locum

Clive Ansell — Tue, 06 Oct 2020 12:53:23 GMT

I'm working in my third practice since returning to work post lockdown.

All are doing very well in complying with covid requirements, despite being not easy at times. Distancing is being maintained where possible, one way systems in place where possible, no clients in consult rooms other than for pts appointments. Full PPE is available and one is expected to use it. One of the practices is small, so clients do not enter the building and have to wait outside or in their cars. Overall they are doing as best as they can in the circumstances.

We have had a small number of clients refusing to wear a mask, but the rules are very simple. no mask = no entry (unless a genuine exemption, and these area assessed on an individual basis)

I would have thought anything other could potentially be a breach of H&S regs?

RE: Covid-secure precautions in the work-place as a locum

Bob Russell — Tue, 06 Oct 2020 12:17:58 GMT

Not much about COVID makes that much sense to me! I am trying to make sure we are doing as much as we can to minimise risk.

Some of the measures are to reassure ourselves and our clients.

If we are all wearing PPE all day then the authorities should allow us to stay open rather than self-isolate. At least that is the idea.

Who knows what is right or wrong?

RE: Covid-secure precautions in the work-place as a locum

Andreas Ege — Tue, 06 Oct 2020 11:30:50 GMT

Read that as well, though in the Guardian and they said it offers some protection for the wearers eyes.

What I find tricky is that it seems increasingly difficult to judge what makes sense, what is a lot of effort for little effect and what is just hyperbole/ pointless.

RE: Covid-secure precautions in the work-place as a locum

David Shepherd — Tue, 06 Oct 2020 11:12:59 GMT

According to this source https://www.sciencedaily.com/releases/2020/09/200901112231.htm face shields don’t help. I’ve no idea of the quality of this paper but it makes sense.

RE: Covid-secure precautions in the work-place as a locum

Bob Russell — Tue, 06 Oct 2020 10:36:36 GMT

The idea is that they are changed every time. As I read it we need to be taking similar precautions to medical staff to prevent the whole practice going into self-isolation should a member of staff test positive.

Clients here are staying in the waiting room. One admitted at a time. 2m distancing except for brief hand over (face coverings).

A client in the consulting room for a PTS is acceptable but we do put on face shield, mask gloves and apron.

The face shields we have ordered from eBay (143701067484) are brilliant. Almost don't know you are wearing them and they don't steam up!!

RE: Covid-secure precautions in the work-place as a locum

Andreas Ege — Tue, 06 Oct 2020 09:53:04 GMT

Last two practices locumed for only let clients in to reception one at a time and into consult only as an exception. The one for pts for example, placing iv catheter and elongation in prep, then giving the animal to owner with vet able to inject in a meters distance.

[quote userid="5083" url="~/001/nonclinical/f/life-in-practice-discussions/29392/covid-secure-precautions-in-the-work-place-as-a-locum"]apron, visor, gloves[/quote]

Could anybody enlighten me, what aprons and particularly gloves are supposed to do? Unless you disinfect or change them after every contact, I can't see it making a difference compared to without gloves. And I haven't seen anybody doing either (changing or disinfecting regularly).

Besides, it seems an increasing number of epidemiologists considers fomites more or less negligible as a route of transmission.

RE: Covid-secure precautions in the work-place as a locum

Utlendigur — Mon, 05 Oct 2020 20:05:17 GMT

Each of the practices I work in is still keeping clients out of the consult room. Reception areas are usually bigger, allowing distancing (especially if clients phone on arrival and wait in car until there is room) and can be better ventilated than a consulting room. Before full lockdown one practice was asking clients to stay seated on a chair in a corner of consult room but 70-80% of them got up and came over to hold their pet so that didn't work. One practice was considering letting clients back in but the set-up in the consult room seemed designed to invite them to stand directly across the table - I said I wouldn't continue working there but they decided against it anyway. Most are also using face coverings either when staff are working close together, or all the time. I just don't understand why practices would not take precautions to reduce obvious risks. The factors for increased risk of transmission are all present in a typical consult - indoors, small space, lack of ventilation, extended time, close proximity, talking - and the potential outcomes eg staff illness (even death), staff passing it to possibly vulnerable family members, staff quarantining, and practice shut downs (has already been one round here) are pretty severe economically and in terms of disruption to clients even if you don't care about staff welfare.

This is an oldish article but quite a good one

https://www.docjon.org/post/its-not-only-about-social-distancing-the-importance-of-aerosol-spread-of-covid-19

Also just leaving this here

RE: Covid-secure precautions in the work-place as a locum

Bob Russell — Mon, 05 Oct 2020 16:18:59 GMT

I cannot see how 15 minutes in a small room with a client with a simple face covering can be adequate. More acceptable if staff are wearing full PPE. This would be in line with NHS guidelines for front line staff. Changed between clients to prevent cross infection.

It is far simpler and better to ensure distance is maintained. We have a single client in the waiting room in a small chained off area. This area can be cleaned between each client.

Works well but a bit slower.

The full PPE, all day with staff distancing or sitting side by side might allow a practice to keep open should a staff member test positive or a client tests positive and lead to forced self isolation.

We have chosen to stick with client distancing unless tighter regulations are enforced locally.

I would allow nothing that would put me or my staff at unacceptable risk at work and we are all being a bit antisocial away from work.