One of the characteristics of this new infection provoked by the Coronavirus is the possibility of triggering morbimortality in health professionals. Many fell in combat, with a previous ritual of passing through the ventilators, as happened in Italy, Spain, France and the United Kingdom.
In this unique period of Global Pandemic, National Emergency, Public Calamity and other devastating epithets, it became imperative, even by law, to use Personal Protective Equipment, the so-called PPE.
The Gastroenterology and Hepatology Service is a vital service, like many others, being responsible for carrying out 25,000 outpatient consultations and 25,000 exams at the Gastroenterology Techniques Unit, including the ill-fated colonoscopy. Some call it the 25/25 Service. Yes, we work 25 hours a day. If you are 45 years old, have you had your colonoscopy?
TAP generously donated 200 full protection suits to the Service, those that transform us into modern astronauts.
I myself, and our (only) male nurse at the Gastroenterology Techniques Unit, Pedro Pires, were welcomed into a TAP aircraft maintenance hangar (TAP - Maintenance & Engineering), a place where safety is the key element, defending and ensuring one of TAP's values: "Safety - So that nothing is more important than the life of our customers and employees. Achieving this goal is only possible through excellent care totally focused on quality and safety. Following the example of aviation philosophy of no flaws, this is what we health professionals want to apply in our daily practice as a multidisciplinary team. The value of defending life, which is and has always been our banner, has made the Gastroenterology Technical Unit develop standards and operating circuits in the context of COVID-19; defending users, respecting their needs and ensuring above all the safety of all those involved”.
For two hours, we had the opportunity to see all the effort and team work towards total safety, where there can be no flaws. The safety rules, the invisible work placed on risk management, are translated into a process called CRM (Crew Resource Management), the foundations of which were published in an article by the Portuguese Medical Act by Captain Armindo Martins, who also gave a Conference at the Aula Magna in October 2019.
CRM is not the technology of the 22nd century, it is human resource management, teamwork, working on concepts such as humility, arrogance, stress management, unforeseen situations management, example to follow, fatigue and alertness, surprise and fear factor, risk analysis, etc.
The COVID-19 infection brought us doctors, once again, close to the concept of aviation safety. If we fail, we are also at risk of dying. The risk of dying as a result of the health professional activity is not very present in our mindset.
There are many points in common between a surgeon, a gastroenterologist, a pilot, a Supreme Court judge, a general. Many of them have been practicing their profession for over 30 years, with thousands of tried cases, thousands of flight hours, thousands of hours of emergency service. Rui Tato Marinho worked 25,000 hours in the Emergency Unit, Head Pilot Armindo Martins worked 22,500 hours in both plane and simulator.
The concepts of how to deal with the human factor, teamwork, etc. were found in TAP’s garages that deal with reactors and cockpit. All are important, such as electricians, mechanics, upholsterers, engineers, etc.
We were welcomed by Engineer José Moreira (Long Distance Fleet Coordinator | Wide Body Fleet Coordinator), who is passionate about the Medical World and Professor João Lobo Antunes: “Being able to participate, as a facilitator, in the donation of PPE by TAP to Santa Maria Hospital, in this very peculiar context, was a great source of pride for me! As Professor João Lobo Antunes once said, the founding thought of medicine is altruism. In these difficult times, we must keep this thought in mind in our actions, thus helping to complete the dignity of others.”
In the end, as a take-home message, the Dirty-Dozen.