03 June 2020
We’re continuing our series of articles exploring how the COVID-19 pandemic has changed the working lives of the rheumatology community.
Here we speak to Fern Higgs, a clinical specialist physiotherapist in rheumatology at University College London Hospital. She was redeployed to work on a COVID step-down ward, giving patients respiratory physio to help their recovery.
“Back in March, it was a Trust-wide decision that anyone who could get redeployed should go to the wards as soon as possible. My first thought was that I would do whatever the Trust needed me to do. So, even if that wasn’t a physiotherapy role, I was willing to do what was needed.
“I was assigned to a COVID step-down ward, taking care of patients coming out of intensive care or those who were significantly unwell but hadn’t quite needed to be escalated to intensive care. I was uneasy to begin with as I’m very used to leading my own service and managing my caseload, and then you’re put in a very unknown and unfamiliar environment. But everyone was in a similar position, having been redeployed from all over the hospital and everyone quickly formed a great working team.
“It’s been a long time since I’ve worked on a ward and I hadn’t done respiratory physio since my junior days, so I had to upskill quickly.
“The patients I’ve been dealing with were under respiratory distress, so I did a lot of chest physio, breathing techniques, helping patients to clear sputum, and then more rehab-based physio as patients got better. So, getting them back on their feet again and getting them stronger ready for home or a further rehab placement. Frequently patients remained quite dependent on oxygen, so we had to do a lot of weaning off the oxygen to test when we could get them back to not needing it.
“Family and friends have been worried about me working in a hospital setting. But having a routine of coming to work and doing my job has helped me and I feel so supported by my colleagues. I’ve felt proud of how the Trust has managed the pandemic and I’ve felt safe and looked after.
“I also worked at the Nightingale Education Faculty at the O2 for two days where I joined the Wellbeing team. We taught the Nightingale staff how their psychological PPE was just as important as their physical PPE and how to cope in such a high-stress field hospital environment. My clinical skills blended nicely to this role. Due to the success of social distancing and the Nightingale going into hibernation earlier than we thought, I didn’t get much time there but enjoyed being part of it.
“To begin, with the adrenaline gave me the energy I needed to keep going. One of things we’ve done as a team is give ourselves a challenge and each of us is running 5k every day throughout May. Exercising every day has given me a massive boost. Now we’re winding down a little bit on the wards with a bit more stability. We’re slightly on tenterhooks about whether there will be another serge, but we’re now turning our attention to restarting our rheumatology services.
“We’re going to be sticking with telephone and video clinics for now because so many of our patients are shielding. It’s made us see that there are ways to work differently by using digital platforms. I’ll be working with colleagues to look at whether there are clinics that can be virtual, how we can provide apps and web platforms to provide education in different ways. The pandemic has made us step back from the day-to-day and made us think differently about how we could do better, and what patients want from us.
“It is hard to do a physio appointment over the phone, so the Trust is working hard to set-up video clinics. On the phone you must rely quite a lot on what the patient says to you. A lot of my management is holistic, so as well as the physical side, I do a lot of the mental health and wellbeing side of things, and that does work well over the phone. But there are patients we will definitely want to see face-to-face for hands-on treatment.
“I run the hypermobility pathway and pre-COVID we were starting some service development, looking into how we could run it slightly differently. The classes that we were running before definitely aren’t going to be happening any time soon, so we’re thinking about how else we can deliver the service. We’re looking into digital platforms and whether we can create a portal with videos on for patients to access with the latest information and guidance. So long-term, we’re thinking how we can change things to benefit the patient more.”
Huge thanks to Fern, and all of those who are sharing their experience of working during the pandemic. A free wellbeing support helpline is available for NHS staff from 7am-11pm seven days a week: call 0300 131 7000 for confidential listening from trained professionals and specialist advice, including coaching, bereavement care, mental health and financial support.