Alumnus profile: Jamie Croker

What year did you graduate?

I graduated in 2014 from BSc Biomedical Science

What is your current role?

I currently work as an anaesthetic nurse in Evelina London Children’s Hospital, which is part of Guy’s and St Thomas’ NHS Trust

How did you get into your current role?

I worked within another department (Interventional Radiology) working as a multi-skilled practitioner (doing anaesthetics/scrub/recovery) and did an internal transfer to work as an anaesthetic nurse within our paediatric hospital’s main theatre complex.

What do you enjoy about your role? 

I enjoy the diversity of patients working within paediatric anaesthesia and surgery. I get to work with many different professionals, all of whom are experts within paediatrics. Also, I get to work in different areas such as congenital cardiac cath lab and MRI as well as attending resuscitation/crash calls in the hospital and in A&E when needed. I work with a great team of anaesthetic nurses, operating department practitioners, consultant and trainee anaesthetists as well.

How has the COVID-19 outbreak changed the way you work?

COVID-19 has fundamentally changed the way that we work in anaesthesia. Giving someone an anaesthetic requires the intubation of the patient, which is considered aerosol generating procedures (AGP). An AGP is considered a high-risk procedure with COVID-19 as it is transmitted through droplets, which are aerosolised during these procedures. We now conduct all anaesthetics using full personal protective equipment for the entire surgery. We have new protocols about flow through theatre, how to clean the theatres as well as which patients are to be prioritised for surgery. We no longer use our anaesthetic rooms in order to keep them clean from COVID-19 and all patients are anaesthetised inside theatre. We have had to change the equipment used to undertake tracheal intubation and which types of airway devices we can and cannot use. For all cases we need to have staff in the theatre and runners that stay outside and bring equipment to the theatre if needed as our theatres are clear of all non-essential equipment and in order to reduce cross contamination. This requires more staff in order to undertake one surgery.

What is the biggest challenge about this new way of working, and what has helped overcome this?

Having to work within the full personal protective equipment when anaesthetising children is difficult. As we are wearing the masks and visors it makes the experience more frightening for children coming to theatres. Also, the PPE makes communication more difficult as the masks muffles the voice and reduces the non-verbal communication that everyone relies on for effective communication.

How are you working to tackle the outbreak in your role? 

In my role, it is less about tackling the outbreak but rather trying to ensure children that need operations are able to have them. Children are affected by COVID-19 in a different way to adults. In general, they present with milder and often atypical symptoms of COVID-19. However, children can present with a delayed inflammatory response weeks after being infected with COVID-19. This hyperinflammatory response syndrome (also referred to Kawasaki-like syndrome) is presenting a new aspect to the outbreak in my role.

How did the experience and skills gained at St George’s help prepare you for the current situation? 

I think the knowledge I gained in my Biomedical Science degree has helped. It has given me the knowledge to understand the disease mechanisms of COVID-19, the pharmacological treatments, physiological changes that we are seeing to name a few. I did the Infection and Immunity module in my final year, which has helped in understanding both the infection as well as the immune (and hyperimmune) responses we are seeing.

What helps you stay positive during this challenging time? 

It is sometimes hard to stay positive during this crisis, especially when you are unsure if you will be redeployed to support intensive care services or continuing to work in a service that

is in high demand like paediatric anaesthesia/surgery. However, I am lucky that I work with a good team and we have pulled together to support each other during this. All the nurses, operating department practitioners, anaesthetists and surgeons in my department are working to keep our service running for the children all across the South East can have access to specialist surgical services. Also, I have found keeping in contact with friends and family as they provide an outlet from the clinical environment, which can be physically, mentally and emotionally demanding.

Do you have any advice or a message to others working on the front line to keep the public safe?

Just keep doing what we are doing. Following the guidelines, sharing knowledge, keeping up to date with the evidence base as we learn more about COVID-19 will in turn keep the public safe.