Occupational Therapist, Naomi Lean has shared her experience of being part of a new multidisciplinary team in the face of COVID-19. 

My name is Naomi, I have worked as an Occupational Therapist (OT) at University Hospitals Plymouth (UHP) within Emergency Care (EC) since 2004, during this time I have seen many changes and the therapy team has grown hugely.  I am now lucky to be one of the OT team leads for this area and I love the work that I do.  I have often thought that I could not work anywhere else, but I was about to be proven wrong.

At the beginning of March the hospital started to prepare for receiving and caring for COVID patients.  I have never seen so much change in such a short space of time with everyone working so hard to make it all happen.  We started to see patients arriving at UHP who tested positive for COVID and anxieties become heightened about the challenges ahead, however staff constantly amazed me with their focus and determination to do their best for their patients.

Once my team seemed settled in its new COVID routines I turned to the main OT department to ask if they needed any additional support.  This is when I started to work as part of the COVID Rehab Team.

From the very first day it soon became clear that the team I had joined was one of passion and inclusion with bundles of support.  They were a team led by the desire to get their patients stronger, more independent and more able so they could leave hospital and enjoy life again.  No one was afraid to think outside the box and try different approaches to provide the best outcomes possible.

It very soon became clear that more staff were needed.  Seeing patients took longer, their needs were different, the community services to support patients upon returning home were not available. There was little to no rehabilitation available in the community and in a roundabout way this helped to alter and shape a new and different way or working – a way in which we would not normally have had the capacity to try.

It is at times like this that you start to realise the value in working in different roles throughout your career.  I may not have worked on the wards for 16 years but working in Emergency Care meant that I was used to seeing a wide range of patients with a huge variety of conditions.  I also started to pull on skills I learned through working in Health Care of the Elderly, Orthopaedics, Vascular, Amputees, Palliative Care and Hand Trauma.  I was seeing patient’s young and old, some delirious, some highly anxious, some bed bound, the list goes on…

Within the team were highly skilled physiotherapists who were amazing to work alongside.  It was with the confidence of working in this team that I starting working in ICU.  On my first day I met two patients and I was nervous, if you could have seen my eyes under the PPE they were wide open – trying to absorb this strange environment.  The machines, the tubes, the patients – so depleted, so dependant.  It could have all been too much, but oh my, the staff! Their skills, their calmness, their openness to the provision of therapy for patients was amazing.  The patients – the trust they put in everyone, having everything done for them, allowing us to move them, tilt them, stand them and trusting that they would still be able to breathe.  It was within this team that we were able to identify ways of working to compliment the environment, start upper limb rehab through basic functional tasks, help reduce the effects of delirium, start cognitive rehab, enable patients to go out into the fresh air in the therapy garden.  From ICU I was able to see patients step down onto the wards and continue to work with them to regain strength, confidence, independence and achieve goals. The next step for our patients was the biggest milestone of all – to be able to go home!  The feeling of seeing patients who were so ill, who had needed so much care walking out of the hospital, to be greeted by loved ones and head home is one that I will never forget.  My feelings were mixed with huge pride for the patient in what they had achieved through hard work and determination, and huge admiration for the team of skilled professionals that surrounded me.

I started to wonder, what if we could do this normally, without COVID.  What if we had the staff to provide acute rehab in the hospital to give patients the best opportunity to recover and remain strong and independent? Having a rehab ethos from the moment they enter the hospital – whether they stay four hours or four weeks, the impact could only be positive for the patients and the Trust.  I appreciate that not all patients have had a success story.  It has not been the case for all of them, some of our patients were so frail and so depleted by the virus that it has been too much for them to recover and they now need more care despite theirs and our best efforts.

So this is where I now find myself.  With a new passion for rehabilitation! I will always remember the words said to me on one of my first days in the COVID Therapy team. Two of the physios Jude and Susie “We’ll make a rehab OT out of you yet” and by hook and by crook they did! Don’t get me wrong, I still love EC but I would also love to be able to say with confidence to my patients that they will be getting rehabilitation when they need it most.  COVID has weirdly provided us with the opportunity to do this – with no community services to fall upon and the right team it works, and it works well!