June 22, 2020, by David Coveney
Physios on the frontline during COVID-19 – Eleanor’s experience
This week’s blog post is from Eleanor, one of our physiotherapy lecturers who shares her experience of working on the frontline during the COVID-19 pandemic.
I am a Lecturer/Practitioner physiotherapist who works at the University of Nottingham in the Division of Physiotherapy and Rehabilitation Sciences and at Nottingham University Hospitals, NUH Trust. My area of clinical speciality is Critical Care and in my university role I teach on undergraduate and post-graduate physiotherapy courses.
We have been involved in the management of patients with COVID-19 who have required admission to our intensive care units (ICU) at NUH. Our role as physiotherapists involves assisting patients to keep their lungs clear of mucus whilst they are on breathing machines and helping them to ‘wean’ (reduce support) from the breathing machine as they recover. Some patients have required a tracheostomy (a tube placed in the windpipe) to help them to wean, which we help to manage. We commence ‘early rehabilitation’ in the ICU, as soon as patients are medically stable. This involves moving patients’ limbs to prevent joint and muscle contractures, sitting patients on the edge of the bed or in a chair (sometimes using a hoist) and mobilising them as soon as possible. We exercise patients at a level appropriate to their exercise tolerance, this ranges from the very acute stage whilst they are very weak and still needing help from the breathing machine to progressing them to be fit for discharge home. We use innovative equipment to exercise patients in the acute illness stage such, as using exercise bikes on a ‘hoist-like’ structure so patients can exercise passively whilst immobile in bed.
Working in ICU during the COVID-19 outbreak has required many of the skills and attributes we develop when training at university these include: excellent communication, teamwork, organisation, problem-solving, time management, delegation and prioritisation.
You also need stamina it gets very hot when performing our role in full personal protective equipment (PPE)!
During the COVID-19 outbreak physiotherapy staff working in other specialities such as musculo-skeletal and orthopaedics have been redeployed to work in ICU. This has given me the opportunity to work with several students I taught at undergraduate level who now work at NUH. It has been fantastic for me to see how much they have developed as autonomous practitioners and how professional and dedicated they are to delivering excellent patient care.