For the last four years or so my job has been with the ‘managed clinical network for stroke’ with a variety of elements to it including;
· patient treatment
· working with community and acute care staff with their patients
· and education of therapy staff at various levels.
In March this year, in response to the Covid-19 pandemic, NHS Lanarkshire has had to stop home visits and has opened a previously closed community unit as a stroke rehabilitation / orthopaedic rehabilitation unit, freeing up beds in acute care for the anticipated admissions.
Along with other specialist physiotherapists and occupational therapists we were advised that we might be required to work shift patterns, 12-hour shifts, weekends and evenings. Everyone happily agreed to come in as needed.
The first action was getting the unit fit for purpose, new and suitable equipment, upgrades to oxygen and equipment, in preparation for patients with and without Covid-19. We arrived at 7am and got the ward ready for admissions; cleaning the beds, cupboards, floors. You name it! We scrubbed it! I have a new appreciation of why the nurses have a "breakfast break", we were all ready for coffee and food by 8.30am; our usual start time.
There was some time spent on up skilling therapy and nursing staff on moving and handling, as many staff were seconded from areas that did not involve working with patients with neurological conditions. Eventually the patients arrived. The use of PPE took quite a lot of getting used to, but we eventually got the hang of it.
One significant noticeable difference was the lack of visitors, initially this seemed like not such a bad thing as patients were free for rehabilitation all day. However it soon became apparent about the importance of visitors for the patients’ mental health, motivation and general happiness. Watching people interacting with FaceTime/zoom when they could was lovely, and at the same time heart-breaking. It made me consider how I would feel not being able to visit family in hospital for so long.
Considering the positives that occurred, the use of technology was innovative for patients to communicate with family and friends at home, but also changed some aspects of our practise. Instead of environmental home visits family members could send a video of the house or use for example ‘NHS Near Me’ to give a "tour" of the house. When discharging patients home we sent videos of them during treatment and completing exercise programmes with individual instructions for modifications on their own phones or iPads etc. This is a practise which would be good to continue with. The phoning and video-calling of patients instead of home visits and outpatient appointments was more challenging, but it worked.
And now, as we start to be able to visit at home and eventually get back to clinics, I am back in my usual role, with a little more appreciation of the amazing work therapists do at all stages of the patient journey. Much of the technology will remain; carers meetings, hospital treatments watched by community staff to allow carry-over of treatment, individualised home exercise programmes on the patients phone or tablet.
However, it does reiterate that the hands-on treatment, exercise programme and personal interaction is still the most important aspect of Physiotherapy for recovery.
If you would like to develop your ‘hands-on’ treatment skills and development of specific exercise programmes that are meaningful for your patients recovery, consider signing up to our BBTA courses; bringing together the theoretical and practical so you can be a better therapist.