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Physios take on critical care roles
NHS Lanarkshire physiotherapists added a new emotional challenge to their work skills by stepping into unfamiliar critical care roles to help tackle the coronavirus.
Although respiratory physiotherapy staff undertake duties in an intensive care unit ( ICU) regularly, during this challenging period a substantial number of physios volunteered to go into the life-saving facility to assist nursing and medical colleagues to treat patients who were critically unwell with Covid-19.
Along with colleagues from other allied health professional services such as dietetics and speech and language therapy, the physios donned full personal protective equipment (PPE) to carry out their roles, helping patients at Monklands, Hairmyres and Wishaw university hospitals.
NHS Lanarkshire head of physiotherapy services Claire Rae said: “I’m immensely proud of the team, who faced up to the harsh emotional challenges of working in ICU as the virus escalated and, sadly, saw patients lose their lives to the disease.
“Some colleagues were there as part of their normal duties, which include ‘ mobilisation’ of ventilated patients, for example, helping them to sit on the edge of the bed or move into a chair.
“Others were new to the ICU or only worked there as part of their on-call duties.
“The situation was even more challenging for them all due to the need to wear full PPE.
“Working alongside the ICU nursing and medical staff, physios took on 12-hour shifts which included duties more associated with nursing staff, such as monitoring patients and helping with their personal care.
“They all had appropriate training from both their physiotherapy and nursing colleagues, and it was a measure of their commitment that physios who normally work in areas such as orthopaedics or women’s services had no hesitation in joining their colleagues who regularly work in critical care.”
The physios have now stepped down from their additional ICU duties, but training is continuing to ensure that, across the three hospitals, physiotherapy personnel are available to add to the staffing complement to help out in the same way should there be another rise in coronavirus cases.
Claire added: “As part of their recovery after the physically traumatic experience of ICU, patients are treated by physios when they move to a ‘step-down ward’, as is anyone else treated in hospital for coronavirus.
“Rehabilitation is essential at this point to get individuals back to their normal level of function.
“We’re changing our ways of working because many patients experience extreme fatigue post-Covid-19, which means we have to use shorter therapy sessions, more often.”
Lorraine Senior is physiotherapy team lead for surgical and critical care at University Hospital Monklands, so is used to the ICU environment – but coronavirus brought its challenges.
Lorraine commented: “The highest number of coronavirus patients when I was there was 15, aged from their twenties to their eighties.
“We would typically know a lot about our patients, so it was very difficult not having their families visiting as this helps inspire people to get better.
“There were 12 physiotherapists in total, and we all did 12-hour shifts, day and night, for four weeks.
“Each physio was assigned a patient to look after which required us to assist in completing 24-hour observations charts, hourly fluid balance recording, adjusting and changing infusions of drugs under the direction of nursing staff, taking blood samples off for analysis, and personal patient care.
“In our traditional roles we were still providing chest physio to those patients needing help to clear sputum from their airways, and assisting teams to turn patients onto their stomachs, which helps improve their oxygen levels, as well as optimally positioning patients and mobilising them where it was appropriate.
“The emotional toll in ICU was far higher than usual. It amazed me how responsible you felt for the patient due to nursing them for 12 hours at a time as we usually rehabilitate patients for an hour a day.
“Nursing staff deal with end-of-life care regularly and this was one aspect that was more difficult for the physios to experience.
“One patient who recovered in ICU told me she had paid a special tribute to a patient in another bed.
“Sadly, he did not survive so, in tribute, the lady named her walking frame after him; she said that he was coming home with her to help her meet her rehabilitation goals.”