A day in the life of a physiotherapist working with Covid-19 patients on Intensive Care
Alarm goes off I am up at 6.30 am I get dressed, have breakfast, ensure I have a good lunch to take to work. ID and uniform. Physiotherapists wear classic navy trousers with a tunic or polo shirt with navy trim, comfy but not so stylish!
As with all hospitals, parking can be an issue so I usually arrive 20 minutes before I am due to start (start at 8.00am). ID is needed to access the hospital. I enter the department. Due to Covid-19 there are restrictions on the number of staff allowed into the changing room (4 only), the same restrictions to get into the staff room to access the fridge. So we queue to wait for fellow colleagues.
Once changed I meet with the critical care physiotherapists. Staffing is checked for the day, checking everyone is well. Any on call activity is checked from the night before. A physiotherapist is on call for poorly patients every night. We head for the intensive care unit. Once there we need to get changed out of our physiotherapy uniform and into ‘blues’ or scrubs. These are a uniform that consists of drawstring trousers and a v-necked shirt. We cannot risk our physio uniform coming into contact with the virus hence we change.
Next job is to put on our PPE (personal protective equipment). Each healthcare worker has a mask fit to check which mask provides the maximum protection. PPE is one of the biggest challenges, gowning up is essential with all Covid-19 patients or suspected Covid-19 cases. It consists of a mask, gown, goggles or visor, gloves – at least two pairs sometimes three pairs of gloves if bodily fluids are expected. It is all very time consuming. You must not wear jewellery, nail varnish. Your hair needs to be covered too. You must avoid touching your face.
PPE is put on (don) in a specific order and removed (doff) in an order. It took me a few days to get used to the order and in the evening I tried to memorise the PPE process. It is essential but all very time-consuming.
Don is short for do (put) on
Doff is short for do (take) off / doffing removal of
The government website provides more information on PPE :
Assets.publishing.service.gov.uk
Once we have had a handover of events from the nurse in charge we begin to see patients. The majority on our unit are Covid-19 positive. On intensive care we work as a team providing collaborative working. Before seeing my first patient a bedside handover is given and I check all the patients vital signs. Our role is to provide acute respiratory care, limb and trunk maintenance whilst patients are sedated and ventilated. Once patients start to wake up and wean off the ventilator we provide rehabilitation. This may be sitting up on the edge of the bed, sitting out in a chair or walking. Sitting on the edge of the bed for a ventilated patient is like running a marathon. Due to the length of time being ventilated a lot of the Covid-19 patients have a tracheotomy, we also have a role in the weaning of the tracheotomy getting the patient eating/drinking and talking again.
Treatment depends on the patients parameters, each patient is treated individually. We liaise with the medics and feed back our professional opinions and the plan we would like to deliver in the coming days. Eye contact is essential from behind the plastic with the team and more importantly with our patients.
My maximum is two/three hours in PPE before I am in need of a drink. It is very warm and breathing in and out wearing a mask is extremely drying on my mouth. The PPE has to be taken off in the correct order, hand washing, shoe cleaning and repeated hand washing is all completed before leaving intensive care. I then need to get changed out of my theatre blues put my physio uniform back on and return to the physiotherapy department.
After treatments it is then necessary to write the patients notes electronically
After lunch patients are visited again, they are those who require additional treatments or those patients who we were unable to see in the morning for one reason or another.
The process of undressing/dressing, donning PPE, doffing PPE is repeated.
Once returning home there are no cuddles for my children. It is straight in the shower, hair washing is essential each day too. I feel incredibly lucky to have this opportunity to work in the NHS again.
This experience can be very daunting and sad, I sometimes play back the day in my head. I want to do my best and treat these patients as if they were my mother, father, sister, brother. It is an important process to reflect on my day.
