This article was published in the APCP Newsletter on the 24th May 2021
There’s nothing like a global pandemic to hone your communication skills! When face to face contact for physiotherapists ceased in March 2020, we moved to virtual appointments relatively quickly. With that, came training in Attend Anywhere and navigating the technical challenges of freezing, pixelating screens and “you’re on mute” that we all know and love so well!
But for me the most worthwhile skill to be adapted was teaching a home-exercise programme over the screen.
Where previously we were able to utilise our physical demonstrations to teach new exercises, and hands-on adjustments for patient’s techniques, we lost these modalities. Our initial virtual environments were in glass box offices with a viewing gallery of the multiple healthcare professionals and administration staff treated to the view of us trying to demonstrate a hamstring stretch at a close range camera (which was most likely pixelating for the patient!)
Add into this additional challenges of English as a second language, and parents trying to manage their own work calls and home-schooling for siblings. I quickly learnt that I needed to focus on only a couple of exercises and teach them really well. I learnt how to direct patients to position themselves so I could view the exercise technique and feedback appropriately. I learnt how to direct their parent or carer to use the camera to aid this process. I used shorter, step by step instructions, and asked for their feedback. We were also lucky enough as a Trust to obtain a license for Physitrack, for sharing a tailored home exercise programme with pre-recorded videos of a range of exercises which I can’t rate highly enough. This past year has certainly been a steep learning curve, and I believe this skill will remain a useful one in future years.
Hazel Bartley, Committee Co-Chair
Paediatric Physiotherapists, up and down the country, used their innovative problem solving skills to quickly adapt to a
new way of working during the Covid pandemic. Digital innovation with appointments via video call platforms allowed us to reach our patients while the risk of face to face assessment and treatment outweighed the benefits. The Paediatric Musculoskeletal Physiotherapy Team in East Kent rapidly created resources, available on youtube, for parents on how to get the most out of a video consultation and with the help of their new found friend “made to move yoga pose Barbie” (other proportionally incorrect dolls also available) continued to provide a service to children and young people with musculoskeletal complaints.
Suzanne Gray, Committee Co-chair.
A day in my life as an MSK paediatric physio…..Getting ready to see my first patient. Mask, eye protection, apron, wash hands and wriggle them into a pair of gloves and I’m ready to go.
First patient of the day is a 14-year-old lad who’s complaining of upper back pain. He slouches in the chair and responds to my questions with a few inaudible grunts from behind his mask. We establish that during this lockdown he has spent on average 12 – 15 hours per day playing xbox and he wonders why he has back pain!
Next patient is a very energetic 4-year-old who enters the treatment area like a little whirlwind, running around, climbing on all the plinths, throwing the gym ball and touching everything they can get their little hands on. It’s clear her hip is feeling much better. Appointment over, a successful discharge. Now, as per infection control policy, it’s time to clean all surfaces that the patient/parent came into contact with. What did they touch? What didn’t they touch? Let’s just clean everything!
The rest of the morning is relatively uneventful and it’s time for lunch.
It’s time for an afternoon of virtual appointments. The common phrases come into play:
“You’re on mute”
“Is your mum or dad there? Oh they’re on a conference a call in the other room? Can you go and get them please?”
“Can you angle the camera/phone down a bit, no up a bit, to the left a bit”
“Oh look here’s the dog/cat/younger sibling come to join in with the exercises”
“I’m sorry the picture has frozen, can you still hear me?”
Log off, notes completed, time to whip the mask off, take a deep breath and go home.
Hayley Johnson, Committee member.
I was fortunate enough to not be redeployed during either wave of covid and so formed part of a skeleton crew of MSK physios.
I very rapidly learnt to complete virtual appointments and most definitely learnt not to let the 4 year olds walk around with an iPad showing you their house. I have seen some of the best places to make mud pies in various gardens but also suffered from motion sickness as we have danced around living rooms and most importantly seen where the dog makes his bad smells from..in HD! I have also met a chameleon, several chickens, a pig, snakes, a buzzard and lots of dogs and cats who all seem to enjoy taking part in physio assessments.
Virtual appointments were a brilliant way to be able to still see most of our patients without the risk of bringing them in, however, in the back of my mind was always “is this just a simple toe walker or mechanical back pain or is it something more”. The lack of ability to touch our patients and really feel what was going on in their body felt like a huge backwards step – as physios we pride ourselves on being able to make diagnosis through what we see, feel and hear rather than what an x-ray may tell us and not being able to just move a hip to ensure they hadn’t lost range was unnerving.
Fortunately, we had a lower threshold than our adult colleagues for what we considered to require a face to face appointment and so were able to see anything we really needed to get hands on. This led to perhaps my biggest improvement over Covid…my ability to draw!! My first attempt at creating a more child friendly PPE experience was not great, however, I like to think with a year’s worth of practice things have improved…and now feel a little sad that one day I won’t be able to customise my uniform on a daily basis. Who am I kidding – I can’t wait to get back to normal, hug my colleagues again, high five my patients on the way out and just be able to do my actual job without fear of missing something or causing someone to contract a deadly disease…also quite looking forward to not having to self-swab twice a week! Roll on Novid-21!
Lucy Cassidy, committee member.