So my brother has asked me to write about my Covid experience as a physiotherapist working in a Hand Therapy Unit.
I would say, like for many other AHP’s, it’s been a bit of a roller coaster.
1st March started like any normal day until we received an early email from school to say that it was closed due to a confirmed case of Covid-19. That was a shock; sleepy little Torbay is usually way behind the curve. Then my phone rang; the confirmed case was my daughter’s best buddy – so my eldest daughter started her 14 days of self isolation – it all seemed so strange and scary back then. That was a tough 2 weeks both at home and at work. I was being questioned as to whether I should be at work; was I contagious? But more importantly, I was worried about my daughter – for both her physical and mental health. She was due to start her GCSE’s in a few weeks and the stress and anxiety for her of being isolated in her bedroom for 14 days was unbearable. Public Health were fantastic though; we had several very reassuring phone calls and they sent a text every night to check on her symptoms – which thankfully, she did not develop.
As cases in the UK increased, the Hand Therapy service gradually decreased. The four members of our team reduced as 3 were redeployed. I carried on with a very reduced face to face clinic for category 3 patients, but this didn’t fill my time so I went up on the ward and did my basic observation training including how to weigh a bowl of vomit (not forgetting to subtract 7gms for the bowl)! However, after several online training sessions, the wards turned out to be really quiet; so, as I had previously worked in the community, I went out there instead!
More online training and AHP upskilling sessions; MS Teams chats from the respiratory physios who did a fantastic job of reminding us of our respiratory skills.
One of the difficult aspects was the barrier of PPE; waking up an elderly person in their home and explaining the PPE when they are disorientated and a little scared is really tough; and it is so difficult to be understood from behind a mask. It was tiring working in PPE; the constant donning and doffing – especially in the community setting, trying to be discreet outside someone’s house. I made my own scrubs as I was running out of uniform with the regular changing of clothes; I had a duvet cover on the seat of my car; the amount of contact I was having with the public concerned me but I felt confident that I was doing everything I could to minimise risk to my family.
Community work was still quiet though – referral rates were down and staffing levels had increased with redeployed physios. I was alone running the hands service 2 days a week – triaging referrals, telephoning patients and trying to manage their varying conditions. Then volunteers were needed to train as FIT testers – up I stepped for some more training – I just wanted to be useful and busy! Training completed, I did a couple of sessions in theatres and also in Red ED – I liked the detail of mask fitting but not the salty taste it left in your mouth when I was out running later that evening!
By the end of April, the hands service was getting too busy for me to manage just 2 days a week so I stopped FIT testing. Referrals were increasing, more patients presenting with injuries they had ignored at the start of lockdown, more traumatic DIY injuries, all of which take longer to manage. A hand injury is generally seen as a trivial minor injury – but in reality, a hand that does not function properly can have a major effect on every aspect of a persons being and getting rehabilitation in a timely manner is crucial.
I also needed to complete the many risk assessments, predicted PPE usage spreadsheets etc that were falling into my inbox everyday. I started to implement Attend Anywhere video consultation clinics and this was a real benefit for the service as describing movements of the hand is very tricky over the phone.
We are currently retrieving our staff from redeployment but we have had to move rooms to accommodate the COVID19 swabbing team so we no longer have enough space for 4 clinicians; we have 3 of us running a mixture of F2F, telephone and video clinics; we are using and directing patients to Apps and technologies for managing their conditions from home. All in all our service looks very different to pre-Covid – some of the changes we have made have improved and progressed our service; but the lack of F2F availability is a constant frustration which will hopefully ease in time.
Personally, I have learned a lot about myself during the challenge of the last few months. It has proved to me that I am capable of running the service alone; of making decisions; of being pro-active with patients rehabilitation and defending my clinical reasoning. I have also enjoyed engaging with multiple Zoom lectures from excellent establishments such as the Pulvertaft in Derby who provided access to fantastic talks from leading experts in the field of hand surgery and therapy.
In terms of family life, I have struggled with not being there for our girls. My eldest has had her GCSE’s cancelled; all her sailing events cancelled and has drifted aimlessly, struggling to focus on anything. My youngest has had work from school which she said she was doing, until she broke down at half term admitting that she had a huge backlog of work because she couldn’t maintain her focus – she didn’t feel that she could ask me for help as she knew that I was so busy and tired with work.
They are both anxious with regard to this new world, new virus and the impact that it was having on all our lives – I still feel very guilty that I have not been home to guide them through this difficult time.
By Suzie Smith, Hand Therapist & Physiotherapist at Torbay Hospital