What it’s like being redeployed from psychiatry to A&E during a pandemic

Trainee psychiatrist Dr Alex Beadel describes the whirlwind experience of being deployed to emergency medicine during the initial COVID surge – and why it solidified his decision to choose psychiatry.

Mid-March, I received a seemingly innocuous email from the Director of Medical Education. It was generic, being sent to all junior doctors across all specialities. We had to submit our previous experience in acute, respiratory and emergency medicine, so that if they had to redeploy staff with the expected COVID surge, they would know where to put them.

Amongst my psychiatric trainee colleagues, we thought it was odd that we had been included – what could we offer when treating a patient with COVID? But it turned out we were all able to describe some kind of previous experience in emergency or acute medicine, often outside of our foundation years. I had worked in emergency medicine in Australia a couple of years before starting psychiatry training (and had even toyed with the idea of choosing it as my speciality) but for me it was ancient history.

Such was the shock when myself, a CT2 and a CT1 were selected to begin immediate induction in A&E.

Settling in

For an indefinite number of weeks, we were deployed to a new home and a new team who were extremely welcoming. They recognised that we may be seriously out of practice with various procedures and the variety of presentations that you get in A&E, and so took their time retraining us on key bits of practice and providing us with a lot of reassurance. Senior doctors and consultants were very approachable too, and would happily see patients with you if you wanted.

Having really only visited this A&E to assess emergency psychiatry patients in the middle of the night, it was great to see a patient’s journey before they meet with the psychiatrist – the ambulance, the triage, the waiting, the nursing assessment, the A&E doctor assessment. Plus, it was fun learning how to suture again, examine eyes under the slit lamp and meet patients aged 0 to 100.

Keeping up

However, the A&E rota is intense and unsociable, and had me working evening, nights and on-call. I know some doctors who find this environment exhilarating, and I didn’t really have a problem with it the first time round... but now I had a wife and baby and the job was having a detrimental impact on them.

Plus I was meant to be doing my place in Child and Adolescent Mental Health Services at the time, which I hoped to do for higher training. I felt I was missing out on experience that would help me in ST4.

So, after approximately six weeks, my colleague and I were both able to return to the psychiatric hospital, and I was keen to return.

Choosing the right path

Looking back at my time there, I did learn a huge amount. Working in such an environment boosted my confidence to deal with any medical emergencies that may occur in the psychiatric hospital. I was flattered that my previous experience was recognised and that I could be of help in a time of national crisis.

Yet most of all, it made me all the more certain that I had made the right choice in choosing psychiatry.