COVID-19 Redeployment to Intensive Care
To help with the COVID-19 pandemic, everyone across the NHS was required to be responsive and flexible to the needs of our organisation and society.
Lots of NHS staff were redeployed to different areas of work and were required to adapt to change; others were needed to stay and keep the structure of their services afloat and maintain a standard of care. All jobs are equally as important and we all worked together in
an attempt to save as many lives as possible.
I was tasked with the challenge of redeployment to the Intensive Care Unit (ICU) at East Surrey Hospital alongside two of my musculoskeletal physiotherapy colleagues and friends. We were chosen to help as we all had previous experience treating ventilated patients from when we used to work with the respiratory team as rotational physiotherapists. Granted our skills were a little rusty - 18 month - 2 years out of date! - but we were told they really needed hands to help and we were happy to do so.
I often get asked “What do physiotherapists do in ICU?”
There are many different areas of physiotherapy. The one most people are familiar with is musculoskeletal outpatients and this is the area I have specialised in; we have specialist
skills in assessing and treating muscular, bone and joint related conditions and injuries. However there are all kinds of different physiotherapists from those who rehabilitate people after a stroke, a fall, an amputation, heart or brain surgery to those who help the elderly in the community to regain their independence or helping end-of-life patients in hospices. The list of types of physiotherapy is almost endless but the fundamental principle behind each specialism is the same: helping people regain function and life by getting you moving and stronger!
The role of physiotherapists in the ICU is of great significance and this has been highlighted as a result of the COVID-19 pandemic. Respiratory physiotherapy is probably the most misunderstood speciality, often unknown unless you have experienced it first-hand or through someone close to you. Respiratory physio involves the treatment and management of patients who have difficulty breathing or clearing secretions from their chest. This is not only essential as a daily treatment but is often required in emergencies - therefore respiratory physios work weekends and on-calls overnight.
So what exactly were we doing on ICU?
It is hard to sum up the experience of working in the ICU during the pandemic. Everyone working on the unit became such a close team and all our roles merged more than ever, so we could help each other out as best we could.
We were of course using respiratory physio skills to help treat the patients such as proning (rolling people onto their tummy to help with their breathing), using suction catheters and specialist breathing equipment to help patients cough, whilst using manual techniques to vibrate their chest walls and help clear their secretions.
We were also using our rehabilitation skills. While the patients were sedated (to help give their lungs a rest), we had to maintain the range of movement in their joints to make sure they weren't at risk of developing complications such as muscle contractures - the shortening of muscles if not used for an extended period of time - which could later impact their rehab (such as their ability to stand and walk when they are woken up). When/if (if - very sad but the reality of the situation) the patients were woken up, we were then helping them regain strength to sit, stand, and eventually walk again. This could be a very slow process. There were also lots of lines attached to the patient for monitoring various body functions - as well as their all important breathing tube - so it was a very complicated maneuver!
We were also helping the nurses with general (but essential) care, such as rolling patients onto their sides to check their skin for sores and personal hygiene, and helping them brush their teeth and comb their hair. One day I spent almost 2 hours brushing a lady’s beautiful long hair - the length was almost down her hips once I had finished but it started in a big matted ball on the top of her head! Of course, when you are admitted to ICU, your hair is the least of your worries but once you start to recover and begin your rehab - having a bit of basic self-care can make you feel human again. And - as someone who often grows their hair long - I can imagine that after everything this lady had been through she wouldn’t want to end up with big bits of hair chopped off!
Another role I ended up helping out with was portering patients across the hospital from our normal ICU to our newly adapted ICU from a respiratory ward. Often patients were needing to be moved about the hospital while the numbers of admissions increased (so that we were able to try and safely manage our staff to patient ratios).
While we were adapting to our role and helping in all these ways, so was everyone else across the NHS. From admin staff, cleaners and porters, to therapists, nurses and doctors, the list is almost endless. Everyone was willingly spending their time at work directly or indirectly in contact with the virus in an attempt to save as many lives as possible.
What helped me through redeployment and lockdown:
● Supportive physio team
● Supportive family and friends
● Yummy home cooked dinners to look forward to on return home
● Sunshine
● Gin and Tonics (off-duty of course!)
● Reading some light-hearted fiction (Alice in Wonderland)
● Running across my local fields
● Running virtual physio pilates
● Regular virtual bootcamp workout sessions
● Writing a diary (never did this before!)
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