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My name is Lesley, and I work as a pharmacy technician at University Hospitals Plymouth.
When you work in the NHS the job is ever-changing. Being part of the pharmacy family, we integrate with these changes to always improve systems of work and processes that lead to better patient centred care.
My technician career has spanned over 30 years and even now, the role is evolving. In the last year alone the pharmacy technician role has changed to a two year apprenticeship with college providers.
Pharmacy technicians, in the not so distanced past were not recognised by the General Pharmaceutical Society. That has all changed and we are now registered professionals. I would highly recommend anyone seeking a career in the NHS to have a look at the challenging varied and exciting role of pharmacy technician. As a Mum and Grandma (my daughter is a pharmacy technician) I would endorse anyone seeking a fulfilling career in healthcare to look at pharmacy services.
Previous to this I worked as an auxiliary nurse and as a physio aid at St Peters Hospital in Surrey. On relocating to Plymouth I decided to pursue a change of career. I still wanted to be involved in healthcare so I researched other healthcare roles. Looking at all these exciting roles, the job of a trainee pharmacy technician appealed to me. I was under no illusions and knew that studying to be a technician would be challenging, as I also had a young family at the time.
I successfully applied for a trainee technician job in a retail community pharmacy. This period of learning consisted of in-house training over three years. The skills I learned were first as a counter assistant, which included labelling and dispensing prescription medicines, over the counter sales and consultation skills. I found the patient contact very rewarding; helping and advising patients with their medication regimes (within my capabilities and professional boundaries).
Having completed my counter assistant’s course and gaining experience, I progressed to trainee technician. Part of this role is to train to check and sign-off dispensed prescriptions. I was aware that training to be the person responsible for signing off patients medications before they left the pharmacy was a massive responsibility. These were skills that I embraced. I developed not only as a pharmacy technician but also as a person. I get a lot of job satisfaction that has stayed with me throughout my career processing people’s medications.
Although working in the community pharmacy was a brilliant job, I wanted to seek other opportunities and skills that pharmacy technicians could have in their portfolio. These opportunities were predominately hospital based. I then made a career decision to move from retail to hospital services. Once again this was a decision that was not easy for me to make as my family were still quite young and moving into the hospital environment taking on new skills and challenges once again was something I wanted to embrace.
My decision was rewarded as I took on new roles such as medicines management controlled drugs processes; I also trained as an inanimate keyworker assessor.
Other responsibilities that I have been involved in are taking our pharmacy services from a centralised system to ward based. This involved training staff to work on the wards which I had vast experience from my medicines management role.
Pharmacy is a fast-paced ever-changing environment and no two days are ever the same. This keeps the role interesting and fulfilling as we are constantly learning new skills. I enjoy being a Pharmacy Technician and feel we have a positive impact on patient care by providing an efficient service and enabling a smooth transition back into the primary care setting.
I have been a Pharmacy Technician for around three years but have worked in pharmacy for over 10 years.
I started my journey in community pharmacy and made the transition into hospital pharmacy 18 months ago to broaden my skill set. The two year pharmacy technician course is not the end of the training process as we are continually learning every day and there are several further courses available for our personal development. I completed the Accuracy Checking course whilst still in community pharmacy enabling me to relieve the pressure on the pharmacist(s) by conducting the final accuracy check on prescriptions before they leave the pharmacy department.
Since joining the amazing team at Derriford I have also enrolled onto the Medicines Optimisation course which enables me to spend time on the wards with the patients ensuring any medication they have brought into hospital is suitable for use and facilitating inpatient supply requests and preparation of TTAs. I am also able to be part of the Medicines Reconciliation process which ensures patients are prescribed all of their regular medication prior to admission whilst they are a hospital inpatient. Although the bulk of my day consists of spending time on the wards fulfilling my Medicines Optimisation role and labelling, dispensing and accuracy checking prescriptions there are several other aspects to my role.
I could be involved in the dispensing of specialist hospital only medication that requires specific monitoring, such as clozapine or in stock management to ensure stock levels are correct in order to fulfil requests in a timely manner. I may also spend time in the controlled drugs room dispensing medications that have the potential for abuse and thus specific legal requirements for dispensing. I also contribute to the dispensing of medication for specific outpatient clinics such as Dermatology, REI and Neurology.
Rez Rodgers, Vice Chair of the University Hospital Plymouth BAME Network, pens a blog about the influence of overseas workers on the beginnings of the NHS…
The post-war labour minister Aneurin Bevin believed that society should collectively contribute to a healthcare system with equal opportunity and availability to all, and thus the foundation of the Nation Health Service was born in July 1948. However, due to the impact of World War I and II on the British economy, medical professionals were hard to recruit; men returning from the war did not want to fulfil a job requiring long working hours and women, after performing men’s jobs whilst at war, discovered more career opportunities and developments outside of the traditional marriage and domestic roles.
After World War II had left the British economy depleted, the government advertised to 16 of the then Commonwealth and former colonial countries, including Poland, Ireland, Malaysia, India and the Caribbean, to recruit nursing staff. Between 1948-1961, almost half a million people living in England and Wales were born overseas, the majority of which included the Caribbean Islands. Senior nursing staff travelled from Britain to Barbados, Jamaica, Trinidad and Tobago to recruit individuals between the ages of 18-30 years who were willing to commit to a three-year contract. Following the next two decades, steady streams of nurses were recruited to meet the demands of the UK and improved patient health conditions and staffing shortages within the NHS.
Upon arrival in the UK, only a few were met at train stations and taken to their contracted hospital, and many were left to find their own way. The nurses were grouped together in housing blocks next to the hospitals they were placed at, and were often placed with nurses from other Commonwealth countries. As one former nurse reported, “when anyone new came and brought food, the girls got together, sitting on the floor…like a big family…dividing it up between all of us.” This provided a support system and community whilst living away from their loved ones.
Two types of qualifications existed for nursing: the internationally recognised State Registered Nurse (SRN) and the State Enrolled Nurse (SEN) which allowed practice solely in the UK. After achieving and qualifying as a practising nurse, many could not progress higher and would not be promoted at all. Job roles were restricted to areas of the highest need, including psychiatry, geriatrics and hospitals for those terminally ill; overseas nurses were also more likely to be given anti-social hours and night shifts which were poorly staffed. During such shifts, nurses reported having to be wholly in charge of patients with no adjustments made in pay. Moreover, nurses were exposed to many discriminatory attitudes, racial slurs and even violence from patients who would throw their possessions at them; one nurse stated, “we were treated differently…but we didn’t worry because we know what we wanted to achieve and what we had to do and we did it.”
Nursing authorities argued that racial characteristics limited intellectual capabilities and motivational levels to achieve the international nursing qualification, thus many overseas nurses were forced into the state-enrolled nursing qualification which limited their options even further if they wanted to leave the UK.
In the 1960s, health minister Enoch Powell championed overseas recruitment as it provided ‘cheap labour, reduced wastage and undermined the [NHS staffing] shortage argument’ however this simultaneously strengthened his campaign against nurses’ pay claim, thus used the influx of BAME Nurses in 1960s as a weapon against unequal unequal/discriminatory pay.
There are lots of people from different organisations who make up the extended #1BigTeam at University Hospitals Plymouth (UHP). Abby Williams is an Emergency Medical Technician (EMT), trainer and assessor who has been part of St John Ambulance for nearly three years. St John Ambulance volunteers have been helping out at UHP since July this year supporting the Emergency Department at Derriford Hospital and helping to transfer patients.
“I joined St John Ambulance while I was at university studying to become a teacher. I love volunteering and being able to help people and I understand how important it is to know first aid. St John Ambulance does all of the above. Like most people at St John Ambulance I joined as a first aider and progressed through the roles to EMT, which means I have a wider scope of practices and can now crew ambulances through St John Ambulance. I also work with the training team, which brings my love of teaching and first aid together. Recently, along with a colleague, we’ve been busy training a new course to allow members to volunteer in hospital. This is where my experience at UHP comes in handy.
“Normally at this time of year, I would be offering first aid support at large events. Since lockdown these have obviously all been cancelled, which has been really odd. COVID-19 has meant that we have been able to support the NHS by going into hospitals, like Derriford, which has been an amazing experience.
“When we are doing a shift at Derriford, we arrive and introduce ourselves to the Nurse in Charge, saying hello to everyone else on the way. Once they know we are there we have a look and see if there is anything we can do straight away such as any call bells going off. We are able to offer a huge range of skills such as observations, personal care, providing tea and coffee. We also support transfers to other parts of the hospital. One of the most important things we do is give time to the patients. The Emergency Department gets really busy and there is always loads to do. We are happy to spend time talking to the patients, which is wonderful. No two days are the same and this keeps us on our toes!
“Outside of volunteering for St John Ambulance (most members of St John Ambulance are volunteers and hold full-time jobs) I am a primary school teacher and work for a local charity that helps special children. I like to keep busy, however, and during the summer holidays most of my time has been spent volunteering with St John Ambulance and supporting the NHS.
“The role has certainly changed over recent time, but it has allowed us a more diverse experience and I’ve learnt loads about medical terminology and been able to enhance my skills. It’s a change being stood in a hot Emergency Department rather than a field when it’s pouring down with rain!
“The experience of working in the Emergency Department has been brilliant. I’ve learnt so much and have enjoyed every minute whether it be putting skills into practice or simply having a chat with a patient. The Emergency Department staff do an incredible job and have been so welcoming and made us feel at home.
“The diversity of the role is certainly one of the best bits. I also love the fact that even when the Emergency Department is really busy, we are able to spend the time talking to patients, reassuring them and making their time in the Emergency Department that little bit better.
“For me, as a teacher, school is starting in September so the time I am able to give will be reduced. I hope to be able to do a few shifts on the weekend. I’ll also continue to train our members to enable them to support the NHS in hospitals and ensure they are ready for events when they start again.”
The Southwest Transplant Centre (SWTC) is a regional centre which offers a service for kidney patients across Plymouth, Cornwall and the South of Exeter. We provide both a deceased and living donor programme and currently follow up approximately 400 patients who have been transplanted. National statistics show we have one of the lowest waiting times in the country with most patients waiting around 18 months before receiving a kidney transplant.
COVID -19 presented the centre with many challenges; intensive care beds normally used to care for our donors were potentially needed for vulnerable patients requiring specialist treatment as a result of COVID-19. In addition newly transplanted patients who are given a high level of immunosuppression were extremely vulnerable if exposed to the virus.
In April following extensive discussions with other centres, our own referring centres and NHS Blood and Transplant we made the decision to temporarily close our programme in the best interest of our patients.
Two months later we began to tentatively re open the programme, activating patients back onto the transplant waiting list in phases with national guidance. Under the direction of Dr Imran Saif Director for Transplantation, the medical, surgical, immunology and nursing staff have worked incredibly hard to ensure the programme was reopened taking into consideration the safety of the patient. The transplant waiting list has been growing week by week and since reopening we have successfully transplanted 20 patients across our region which is an incredible achievement for all those involved in the programme and for those patients returning home with a new transplant and the prospect of not returning to or starting dialysis.
This has been a combined effort from many different services across the hospital, the renal unit (Mayflower ward) and support from the Trust management has ensured a safe environment for patients returning to the ward following surgery. Other services such as microbiology have been working hard in the background to swab patients and staff both routinely and in emergency situations to minimise the risk of infection from the virus. The support of the theatre and radiology departments has ensured the timely assessment and transplantation of patients.
Linda Boorer, Lead for Transplantation, would like to thank the on call team in conjunction with the immunology team in maintaining the on call rota during this period, still taking potential screening offers which although did not directly affect patients in our region they did benefit patients listed in other centres Also the transplant team have pro-actively managed both the suspension and re-activation of recipients in a short space of time and provided reassurance and information to anxious patients and their families.
Patient, Trudy said: I was sitting in the sunshine sipping a glass of white wine when I got the call. It was Wednesday, 29th July at 5.30pm. Owing to Covid19, the transplant list had been suspended. I had been reinstated on the newly opened list just two days beforehand. A rush of excitement and tears of joy ensued. I had been waiting for this call for almost three years owing to antibody issues.
“Arriving at the Mayflower Ward, firstly I was tested for Covid19. I am so grateful to the team who operated on me and everyone who continues to take care of me post-op. The high levels of attentive care surely must be the best and is administered in the most testing of Covid times. In the early days I had several clinical interventions daily, where Covid regulations were strictly adhered to throughout. What more could I ask for? In these dark Coronavirus days, to date I am one of the patients at Mayflower who unexpectedly has been given this exceptional life enhancing opportunity.”
Patient, Clive Sandercock and his wife Julie have also shared their feedback of being able to have telephone appointments during the COVID period:
“For us it is a 3 hour round journey to attend Derriford plus our time in the hospital,” said Julie. “It has worked really well Clive having his bloods done at home by our District Nurse and then we get them taken to Launceston and then onto Derriford. A weekly appointment is then made for a call from one of the Renal Team to discuss the bloods and alter medications if necessary. This has obviously cut down on the stress of us having to attend the hospital weekly for several months. We must stress that the Renal Team have been excellent throughout this difficult time and someone is always available to speak to should we have any problems.
“We think this is the way forward to cut patients having to attend hospital for appointments that can be dealt with by telephone. We certainly are happy if this continues. We would also like to thank everyone in the Renal Unit for your care and support throughout.”
If you would like to know more about transplantation in your local area please visithttps://www.odt.nhs.uk/transplantation/kidney/kidney-transplant-units/
If you are interested in living donation please contact either Gemma McCullough or Philip Isaac the Living Donor Coordinators on 01752 439955
2020 as a third-year student nurse has been a roller coaster, the kind that throws you about, bruises your ears, pretends to stop and then the person controlling it sends you on another relentless loop. Anyone that’s been on the mine train on a quiet day at Alton Towers will understand.
We went into lockdown with some vague rumours that there would be an extended paid placement or early graduation, but nobody really knew and anyone we asked was equally none the wiser. So we sat in limbo knowing only that we weren’t going to finish as normal. Then one day while watching the soap opera that was the Government’s daily update, it was announced that 18,000 third year student nurses were ready to deploy. We weren’t. We were sat on the sofa in our PJs wondering if chocolate chip cookies and a glass of milk would meet the tea time nutritional requirements of our children.
So, a few weeks, some rather dodgy TikToks and some hastily scheduled employment checks later we were off out in the wild. Not a nurse or a student but an “Aspirant Nurse”. That title lasted as long as it took us to realise that nobody knew what it was and as we really didn’t know either we just went back to saying “student”.
I was lucky enough to be assigned Braunton ward in the red zone. I say lucky because actually if I’m going to have my life turned upside down by a brand-new disease, I want to meet that disease head on. Plus, I’m also really risk adverse and wanted all the PPE so deemed Braunton to be the safest place in the hospital. Turns out most of Team Covid had similar rationale and I found my people.
Not without some nerves (read “bricking it”) I went for my first shift in “The Red Zone”. With the first goal of locating the changing room, appropriate size scrubs and making it back to the ward completed (thank you fellow student for showing me) I began to feel a little better. And so my Covid, not- quite-nursing journey began.
I can honestly say that I’ve never met a more welcoming group of staff. “Are you here for the shift? We’re so pleased to have you.” Was a phrase that was often used, not just for me but for everyone on the team. As a newly formed team I soon found out that people were meeting people for the first time everyday and so it was actually easy to fit in and not be ‘the new girl’, while actually being the new girl. Working in full PPE is an experience. What I hadn’t considered before donning for the first time was that I’m actually quite claustrophobic, so that was an interesting internal chat to myself, thankfully I won that war and didn’t run crying from the ward in fear of someone putting a visor on me. As an aside, I can now go snorkelling because covid PPE cured me of the fear of the mask.
What also struck me is the levelling capacity of scrubs. Team Covid really was a team, one working towards the same agenda of keeping each other safe and doing the best for our patients. We had roles to fulfil but the hierarchy was essentially gone because everybody’s job was important, they always are, but if you don’t know if you’re talking to consultants or house keeping staff it opens the ground for communication, plus everyone has the same inhospitable working conditions, “It’s too hot” and “I need a wee” being the two most used phrases.
A short blog isn’t enough to express my student experience of Covid. But I’ll finish by saying I’ve made some amazing friends. I’ve had shifts that I’ve laughed until I cried, as well as shifts at the other end of the happiness spectrum. I genuinely can’t think of a better introduction to my nursing career. To my fellow 2020 graduates……we’ve got this.
Ria George has been working from home since March as part of the Operational Resourcing team
Like so many others I began working from home in March once the government announced a national lockdown.
It all seemed very surreal. Since our return from Christmas and New Year leave our office had been watching the unfolding disaster from China and monitoring the daily increase in infections. We discussed how terrible it all was, but not really acknowledging the impact it may have on us in the UK. As the days progressed and things got steadily worse with outbreaks spreading, instead of the light-hearted chit-chat in the office there was the realisation that this was going to affect us and thoughts soon turned to how were we going to cope and navigate through this.
Throughout February and the beginning of March, our team (Operational Resourcing) were busy getting things in place for when things got real. Adding additional absence reasons for national reporting and monitoring, additional training and support for staff, manning the Sickness Hub and so on. Every evening watching the 5pm government update from our mobiles in the office wondering what the impact was going to be and how we could be ready to react.
By mid-March the majority of the floor had started to work from home already and the once bustling office was already eerily quiet with fewer and fewer staff in every day. We had been getting things in place in order for the team to work from home and still provide the service we needed to, then the announcement came about lockdown. The open-plan office environment disappeared and was replaced by my laptop and a spare monitor I borrowed from my other half set up on a camping table in my lounge.
The first few days were exciting, this was a different experience and it was so nice not to worry about the traffic and finding a parking space or deciding what to take in for lunch. Excitement soon turned into a feeling of anxiety, pressure, stress and worry. There was so much work to do it was very difficult to switch off and walk away.
I found myself often working past my normal office hours into the late night, desperate to get things done. But the longer I worked the more and more work kept coming. I would clear one email and it would be replaced by five more, it was so demoralising. With the pandemic getting worse, I couldn’t sleep through worry about work outstanding and about friends, family and colleagues . I felt lost and that everything was out of my control. Not only was I trying to navigate my own thoughts and feelings while trying to work but I also had the kids to reassure and support with their worries, anxieties, and of course, the dreaded homeschooling. Then there was the dog! Wanting to be walked and played with at every opportunity just because we were all suddenly home.
Even though I am part of a team I felt like I was alone in a storm and that we weren’t connected to each other. There was so much going on around I couldn’t see a way out of what felt like hell. Then we started talking, using the MS Teams platform. I soon realised that we were all feeling tired, worried, anxious, exhausted, and that really helped. I wasn’t alone in this, although I couldn’t physically see my colleagues in the office we were still all part of a team, experiencing similar issues. We weren’t in the same boat but we were riding the same storm together! Daily team catch-ups started to happen and this gave us the platform we had been missing to check in on each other and offer the help and support needed from a work point of view and on an emotional level too.
Talking about our own challenges helped me to realise that it’s OK to work my hours and then switch the laptop off and walk away as I would in the office environment. Once I got my head around this, I was then able to support my colleagues in realising we only have one pair of hands and a set amount of time. I realised it is OK to switch off when we need to and to get that balance of work/life in place even while working in a slightly different way.
Now I have the right support in place and I am not so hard on myself, working from home is a more positive experience. Still with kids and pets as a challenge, but more positive on the whole. I have set up my computer and screens (collected from the office) correctly on the dining room table so I am ergonomically safe. I am more productive and find myself achieving more things in my working hours than I would in the open plan office.
Instead of being worried and anxious about how we move forward and emerge stronger, I am excited about what changes the future might hold and, based on our experiences and what we’ve learnt over the past few months, the opportunities that await.
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!
Data Manager, Roger Gardner and Physiotherapist, Susie Wolstenholme have shared their experience of being part of a new multidisciplinary team in the face of COVID:
Roger Gardner – Cardiothoracic and Cardiology Data Manager
Whether we like it or not technology is here to stay and in fact COVID-19 has led many of us away from our traditions and forced to adopt new practises. I always favoured an agile approach of designing solutions quickly involving users, doing what’s difficult but achievable. The COVID response recognised the need for this given its urgency.
Putting patients at the centre of projects is so important. I have had the privilege to work with many great clinicians who saw the significance of data in their decision making. Over many years I’ve learnt to be sceptical of data (and I am more than most) you only need see just how important data will be in ending the pandemic. I ask the question where did the data come from and how reliable is it? I never fail to offer my services to ICU as what they ask is considered and valued. They have more data than you can shake a stick (20 GB of live data at any one time) so it’s some task. Whilst our ability to record data has eased (I remember Psion organisers and dBase and the pain that came with them) analysing very large amounts of data has become a new challenge. We often have too much data to write a simple query and we have to be selective about what we choose to examine.
I’ve done two things to support ICU at this time. Firstly I did an amalgamation (massive data dump) of patient variables/ventilation data for COVID patients from the back end of the main ICU database, Innovian. This system records lots of data at various intervals. We were eventually able to ‘bin’ the data for useful analysis and generate SOFA scores (severity of illness scores) for COVID patients during points in their stay, the principle being to identify effective treatments – watch this space. Many thanks to Rob Jackson, Sergei Dudnikov and Debbie Webster for their patience in helping me get the data right. It took four weeks of iteration.
Data whilst in ICU is one thing, patients hopefully go back to general wards and then into the community for their ongoing care. To this end the ICU team and I also developed a physiotherapy database that recorded key interventions and wellness, producing a summary at the end of their stay. It collated data and drafted an email physios could easily share with community colleagues so that care could be continued in an informative and joined up manner.
These projects really demonstrate that clinicians need the right cut of data to assist their treatments and that as data specialists we should be flexible enough to transform data into what is useful and that means learning enough clinical information to assimilate data and to challenge requirements. You could call that effective data mining. Learning from data is a journey and a privilege given how much more difficult it must have been in previous times such as 1918 flu pandemic.
Susie Wolstenholme – Physiotherapist
Following a recent short deployment to Samoa over Christmas 2019 with UKEMT (Emergency Medical Team) to support their healthcare system during a measles pandemic, when I was asked to support the set up of a COVID rehabilitation team I was quite happy to do so. At no point was I ever worried about my health, merely that of others.
As a physiotherapist with primarily neurological and critical knowledge, until my experience in Samoa, I would probably have shied away from a medical caseload but during that time I treated every type of patient from babies to adult amputees, so felt far more confident that my skills were transferable to COVID.
Starting on ITU in full PPE was daunting but after the first session I quickly realised it was no different except a little warmer! The opportunity to treat patients throughout their inpatient journey with a proper seven day service has been amazing.
Providing patients with interesting and more effective rehab including circuits, group work, and in the rehab garden has had excellent engagement and addressed both physical and emotional wellbeing. The outcomes in particular for post ITU patients say it all really and as a team we are so proud to say that all step down patients have walked out of hospital and gone straight home!
Working with other therapists from different departments and specialities has been incredibly rewarding and we have all learnt so much from each other. In particular OT’s having the capacity to provide rehab rather than just discharge planning has been invaluable.
Despite it being a challenging time with rapidly changing processes, my overriding feeling of the period has been incredibly positive as a time where we were able to provide a service that we would like to be the norm. I only hope that now we have deescalated and people have returned to their normal roles, that the joint working and more intensive rehabilitation is able to continue across specialities recognising everyone’s ‘Right to Rehab’.
Occupational Therapist, Helen Totton and Physiotherapist, Paul Minty have shared their experience of being part of a new multidisciplinary team in the face of COVID-19:
Helen Totton – Occupational Therapist
When I was asked to work within the COVID team at first I had anxieties about what to expect and how to keep myself safe. It felt like starting a new job! My worries were alleviated quickly; the COVID team were so welcoming and wanted to work as a therapies team not as individual professions. Any time I spent on the ‘red’ wards I actually felt reassured by the PPE we had to wear, it felt very secure. I was very grateful that I did not have to wear it all day like the nurses had to as it was so hot but felt very protective. The ‘donning’ and ‘doffing’ was very time consuming and I was always aware of trying to ensure I saw as many patients as possible while I had ‘donned’.
This experience has provided me with opportunities to learn from colleagues, especially as the team developed their skills to appropriately support and rehabilitate the patients recovering from COVID. My own skills regarding my approach to initial assessments had to adjust due not being able to take paperwork in/out of the ‘red/amber’ zones. Therefore not only did I need to remember all points to assess but also the answers provided. Working within the COVID team has been, I feel, a valuable experience in developing my knowledge and skills, however there is still so much I need to learn! This team has provided us an opportunity to, in my opinion, demonstrate the need for therapy interventions within a patient’s journey along with the need for MDT working to facilitate safe and timely discharges and appropriate follow-up at home. It has been a privilege to be a part of this incredible team.
Paul Minty – Physiotherapist
My name is Paul Minty and I am a physiotherapist who works in MSK outpatients and in pain management at Rowan House. I was redeployed to the COVID-19 Rehab team in early April. Initially, this was very a challenging time as I had not been on a ward for nearly two years. Luckily, a super multidisciplinary team was being formed so there were others in the same boat as me which is always helpful.
To begin with the patients were either too ill or feeling rough due to fighting the virus, which made it difficult for me. I was there to get people up, moving and back on their feet which was the last thing some patients wanted to do. As time went on and patients felt better, they were able to engage more with physiotherapy and I was able to utilise more of my skills to get people moving.
On the ward we set up a gym space where we were able to take patients to work hard for 30-40 minutes helping them regain their strength and fitness to be able to return home. This made the rehab much more enjoyable despite being in full PPE which made this type of work very hot. Alongside this we regularly took patients out to the secret rehab garden to get some exercise outside in the sunlight and fresh air.
Ironically, during the horror of the COVID-19 crisis the care that we were able to provide patients with was amazing compared to my experience as an inpatient physiotherapist earlier in my career. We worked in an innovative way as a large multidisciplinary team, allowing us to give the best possible care we could. We had the required amount of time and resources to do our job better than ever which was reflected by our ability to get patients up, out of hospital and back home to their families, not only surviving COVID-19, but thriving.