An Cosantóir

18 changes to their condition are highlighted and new admissions discussed. Plans are made for the coming day at this morning meeting. Patients are assigned to each clinician and the day's duties are divided. Oftentimes, COVID-19 patients are already inpatients in the hospital who deteriorate and need urgent admission to the ICU for assisted ventilation. Sometimes they are emergency admissions that present in extremis via the Emergency Department. In all cases they have proven to be clinically complex and you can never be sure just what the next moment holds. The day ends when the work is done, unless I have on-call duties in which case I spend the night in the hospital. Long hours invariably come with the job I do. The ICU is the area of the hospital where the sickest patients are cared for. The level of support needed by a critically ill patient varies and it is usual to have patients who require multiple organ support in the ICU. They may need a ventilator if their lungs cannot work sufficiently, they usually need medication infusions to maintain their blood pressure and heart function and they may need dialysis in the event of renal failure. COVID-19 has made the tough job of keeping these critically ill patients alive even tougher. The level of PPE we now wear in the ICU makes practical procedures difficult. On a more human level, it can be hard to communicate with patients when both are wearing masks in a noisy environment. Visitors to the ICU are forbidden due to the risks of virus transmission which is particularly hard on patients. Unfortunately, I have had colleagues who have contracted COVID-19 in the course of their work and it is an ever-present worry for those of us who treat these patients. Similar to the military, the intensive care unit relies on teams of staff all working seamlessly together to function well. The Intensive Care Unit is analogous to a chain of care, where doctors make up only a single link. The other links in the chain are nursing staff, physiotherapists, dieticians, microbiologists, healthcare assistants, clinical engineers, right through to cleaners. It is quite humbling to realise the sheer number of essential workers that I work alongside. Aside from my civilian duties, I am the CO of 2 Brigade Medical Detachment (Reserve). We have been deploying alongside PDF colleagues testing for COVID-19 in residential institutions. It has been particularly gratifying to see the Army Reserve used in support of the PDF during a national emergency. I have been both hugely impressed by, and deeply appreciative of the readiness of unit personnel to volunteer their time to fill duties despite the demands of their civilian jobs. I have spent the last few years trying to expand the medical capability of the Army Reserve, in the wake of the reorganisation of the RDF in 2012. There remains a lot more work to be done on that front but progress is being made with interviews due to take place soon to induct new RDF Medical Officers. At the time of writing, we have been extremely lucky that we haven't experienced the surge of patients as in other Cpl Colm Kerr (AR) My name is Colm Kerr. I've been a member of the Reserve Defence Forces since 2002, having joined what was then the 1st Field Medical Company in County Cork, soon to be followed by my brother Maurice and later my brother Brian. My father had recently retired from the army and it was through him that I developed my interest in medicine and the military from an early age. Joining the Reserve Defence Forces helped me pursue this interest further, as well as giving me the opportunity to learn new skills, meet new people and forge great friendships too. Being a member of the RDF gave me the opportunity from an early age to learn the basics of first aid right up to pre-hospital medicine skills such as CPR and defibrillation use. Providing medical cover for RDF Summer Camps and field exercises in the wilds of Bere Island and further afield gave me my countries. Instead we are receiving a steady number of Covid-19 patients. Work in the ICU during the pandemic is busy, sometimes hectic, but not as yet overwhelming. As we wait to see what the future holds, it is a source of pride knowing that the Defence Forces are playing a crucial part in stamping out the pandemic. RESERVE SUPPORT TO «OPERATION FORTITUDE»

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