I have grave concerns about the incoming winter. In ‘normal times’ we usually have patients waiting on trolleys for a bed on a ward. It often gets worse over the winter months as we have more admissions. This results in crowding in the emergency department.

Since March we have tried to maintain some kind of social distancing in the emergency department. This has resulted in prolonged times for patients arriving by ambulance to enter the emergency department.

So, we have a cohort of patients who are in ambulances who have not yet been assessed by a triage nurse or seen by a doctor.

This creates a lot of uncertainty and it is very stressful for our medical and nursing staff. I think it's probably also very stressful for the ambulance crews.

I have seen an increase in Covid cases both young people and the elderly (also in staff). Every morning we have a list of patients waiting to be assessed by the mental health team.

There are people who have taken overdoses, are feeling isolated and anxious, have alcohol or drug problems or an exacerbation of their chronic mental health issues. It doesn’t feel like people are staying away, as they did in the first wave.

It's quite exhausting to work all day in a mask. For confused patients it must be very frightening, and it’s hard to try to reassure them when they can’t see your smile.

I would say morale is low. When you aren’t confident that you will be able to keep patients safe in your department it’s worrying.

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