Occupational Therapy News OTnews May 2020 | Page 41

COVID-19 FEATURE
Trying to assess and facilitate a patient’s movement – often for
the very first time since they had become acutely unwell – with that
extra barrier is incredibly restricting. The unrelenting heat places
extra physical strain on our own bodies, necessitating regular
breaks in between each patient just to catch our breath and quickly
rehydrate.
The PPE also induced difficulties in building a rapport with the
patient. It is usual practice to introduce yourself for the first time by
communicating with facial expression and body language, as well
as with light-hearted conversation, to make the patient feel at ease.
But with only our eyes visible, and our voices muffled from
behind a mask, rapport building was impeded by the unnerving
physical barrier between therapist and patient, making those
human connections that usually come naturally much more difficult
to cultivate.
We quickly took to writing our names and
professions on our aprons before our
approach and relied heavily on humour
‘‘
their armchairs. We also facilitated card games between patients
to practise sitting tolerance, balance, co-ordination and assess
communication and memory.
With firm restrictions on visitors and many patients not having
access to a telephone, for many people, these interactions became
the highlight of their day.
Due to extensive changes to community services, the usual
routes to patient independence when discharge planning were
vastly different.
Rather that being at the forefront of the discharge planning
process, we were asked for a daily summary of patients’ general
level of ability over the previous 24 hours.
This summary would then provide the newly-appointed
‘discharge hub’ – made up of social workers and community
therapy staff – with an overview of patients’ needs, to enable the
team to support patients as they left the hospital once
medically fit.
This manifested in a spike in adaptive
The morale within
to lighten the mood.
equipment provision, made more
Second, the presentation of the
complex by not being able to risk
the entire multidisciplinary
virus in our patients was nothing like
assess a patient’s home prior to
team has been enriched with a
other respiratory conditions we were
their discharge.
deeper respect and understanding
used to seeing in Medicine for
Again, we adapted by
of
everyone’s
role
and
valuable
Older People.
completing this assessment over
For example, when a patient
the telephone with a relative and
skill set. I hope that these
is admitted with exacerbation of
requesting measurements of the
unprecedented times can further
Chronic Obstructive Pulmonary
environment and photographs
elevate the vital role an occupational
Disease (COPD) or pneumonia, we
via email.
therapist plays in a person’s journey
are guided by their symptoms as to
While this method was
how far we can progress the patient
not
ideal,
it did at least enable
from ill health to recovery and
day by day.
the relatives, who often felt more
independence.
But with COVID-19, many patients
removed from the picture, due to the
were not obviously symptomatic at all. There
social distancing and visiting restrictions,
would not necessarily be shortness of breath
to participate and play an active role in the
during or after exertion, or an increased respiratory
patient’s journey.
rate. Yet the slightest of interventions, such as practising sitting on
In addition to these practical challenges, being an occupational
the edge of the bed, would cause exhaustion for the patient.
therapist on a COVID ward has been an anxious and emotive
A review of their oxygen levels would commonly show that
rollercoaster. There has, understandably, been times of uncertainty
the patient had desaturated to dangerously low levels and we
and occasional sadness. Never before have we had cause for
would often have to call for support from the nursing staff or
concern over our work directly impacting upon our own health and
physiotherapist colleagues to adjust their oxygen.
that of our families and colleagues.
This would usually hail an abrupt end to the therapy session,
However, there have also been feelings of immense pride for my
with a view to returning in a few hours to try again. Short, sharp
colleagues, the work we are doing, and what we have been able to
bursts of therapy seemed to be the most effective way of making
learn and achieve during this time of such adversity.
any progress.
The morale within the entire multidisciplinary team has been
Third, trying to foster meaningful therapeutic intervention within
enriched with a deeper respect and understanding of everyone’s
the constraints of a closed ward posed its own problems. Due to
role and valuable skill set. I hope that these unprecedented times
infection control measures, we were unable to take patients to the
can further elevate the vital role an occupational therapist plays in a
therapy kitchen, gym, day room or bathroom.
person’s journey from ill health to recovery and independence.
Instead, we had to become creative in order to motivate and
inspire people to get out of their beds and practise daily activities.
Gemma Viccars, specialist occupational therapist in the
Through donations from the local community, we set up a
Medicine for Older People Team at University Hospital
mini library and offered books to patients to read while out in
Southampton
OTnews May 2020 41