‘Lockdown’ was one of the necessary steps to help manage the global pandemic that is/was coronavirus. It had a major impact; on people’s health and way of life as well as on the economy; it has affected everyone, in every walk of life.
As an allied health professional, reflecting and engaging meaningfully in learning from experience is expected. Reflective practice helps us look back and learn from experience; to make sense of the ‘why’ and ‘how’ and to consider, amongst other things, what would we do differently next time. There are several different models and Gibbs Reflective Cycle is one such example.
From a local health perspective I think many people would agree ‘lockdown’ achieved the goal of preventing the health service being overwhelmed. For me it also achieved much more, on a personal and a professional level.
I am a self confessed freak – I like to have a plan (at home and work). If I set out to achieve XYZ and the universe has other plans and decides I have to deal with ABC, I still feel the need to do XYZ today too, because that was original plan! I struggle to leave the XYZ – ‘what if I don’t have time later/tomorrow’. Invariably, this always results in me being late – to appointments, going home etc. The additional consequence is usually ending a day frustrated that I have had no time for myself.
Whilst reading a magazine article during ‘lockdown’ I had a light bulb moment! ‘Time Anxiety’ is, “an obsession with the passage of time, or distress about the constant lack of it”. Time is finite (even I know that!) but the perception of time being out of our control can create a negative relationship (Dr Kevin Chapman). Reflecting on my own perceptions I realised, I struggle with the concept of not having a purpose. There are always ‘jobs’ to do. I like the idea of rest but find it incredibly difficult to do; telling myself I will rest when the jobs are done. One sentence in the article was particularly meaningful, “when you base your happiness and success on your ability to be purposeful, to add value in some way, you feel very unsafe just watching the seconds tick by” (Alex Lickerman). Understanding that has really helped me acknowledge the burden I put on myself, but critically ‘lockdown’ gave me the time and opportunity to try and re-evaluate my thinking. I didn’t need to rush around; there was nowhere to go. It gave me time to appreciate the value of allowing yourself time. As the Gibbs cycle illustrates reflection is cyclical and the lesson I am now trying to learn is not to revert to old ways. Part of my action plan is writing this blog, as a means of holding myself accountable.
As a health professional I fully understand the importance of prioritising mental health as much as physical health, the challenge for me is ensuring I take forward the positive that this pandemic has shown me.
Professionally, the pandemic has also given me many positives.
As a team of physiotherapists for children and young people we can feel isolated from our colleagues in adult services. Like many of my paediatric colleagues across the country, at the start of the pandemic we prepared to up skill, refresh old knowledge and deploy to help our colleagues in adult services. This resulted in reconnecting with some familiar faces and a sense of us being one physio family again. I am incredibly proud of my own team who left the familiar environment of what we do and stepped up to the challenge and also grateful to all our adult colleagues who made us feel so welcome. We now need to make the effort to build on these links.
As a graduate of the NES digital health and leadership course, I am a passionate believer in using technology, for the benefits of patients and their families, but also for staff. This pandemic has seen an unprecedented increase in the use of technology to support patient care. Our team were early adopters of ‘NHS Near Me’ the virtual consultation platform. We have had the system in place since December 2019 , with the initial rollout plan being that we would use it to review existing patients, identifying those we considered ‘appropriate’ to be seen in this way. However as professionals who look primarily at physical health, convincing ourselves that ‘this consultation definitely needed done face to face’ was quite easy! Coronavirus and the restriction in face to face contact and need for social distancing changed that. If we wanted to ‘see our patients’, for the vast majority of them the best way to keep them safe, and still provide intervention, was to do it virtually. As the graph illustrates the stats for appointments completed over near me speak for themselves.
The inability to do it any other way, has encouraged us to adopt the “we may as well give it a go” approach and alongside our new honorary team members we have delivered and demonstrated a wide variety of treatments and techniques that we thought we couldn’t.
I appreciate the drive and enthusiasm not only of my physio colleagues but also for all children’s AHP staff. Joint working is a core part of what we do to support our children and young people and we have managed to transfer that into the virtual environment too. The next stage of the reflection cycle here is take time to work out, jointly with colleagues and families what this means for the future of our service.
Coronavirus has had a huge cost to many people, personally and professionally, but for me, reflecting has helped me see the little rays of sunshine and the opportunities that may have come eventually, but at a slower pace. It seems only fitting to finish with a quote from another ray of sunshine that I have discovered during ‘lockdown’ Charlie Mackesy’s wonderful book The Boy, The Mole, The Fox and The Horse.
Susan Irving is Team Leader – Physiotherapy for Children and Young People at NHS Dumfries and Galloway
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