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A Day in the Life of a Physiotherapist at NGH

Raj Periyakaruppan, a Respiratory Physiotherapist working in the ICU of Naas General Hospital tells us how the team help critically ill patients in the ICU & how his role has changed during COVID-19. This article featured in the Leinster Leader and Kildare Now on 29th April 2020.

A Day in the Life of COVID-19 Frontline Worker
By Raj Periyakaruppan, Chartered Physiotherapist, Naas General Hospital

From school closures to social distancing, from donning and doffing PPE, to proning rotas - this pandemic brought many changes to our lives.

My name is Raj. I am a physiotherapist in Naas General Hospital. My area of speciality is respiratory, working with patients with breathing issues in the hospital. None of us would have thought our lives would change this much as a result of the COVID-19 Pandemic.

I certainly did not!

6:00 to 8:00am:

I wake up at 6am. I am a father to three girls and my wife is also a healthcare worker. She works nights in a nursing home in Naas. 

I set up the home schooling for the day and we then all have breakfast together at 7.30am and after a quick prayer I leave for work.

8:00- 9:00am:

I reach the hospital by 8:25am, change into my uniform, get my temperature checked and meet the rest of the physiotherapists in a team huddle to plan the day. As we are split into three teams to minimise exposure to each other, communication can be a challenge.

9:00am – 13:00pm: ICU

As a respiratory physiotherapist, I work as part of a team in the Intensive Care Unit (ICU) along with doctors, nurses, dieticians, pharmacists, radiographers and other healthcare workers. This is where the critically ill patients are treated on ventilators.

Going into ICU we need to put on our appropriate PPE: a full suit, special mask, goggles, visor, gloves and shoe covers. We have a picture of ourselves on our PPE so other staff and patients can see the face behind the mask!!

Raj Periyakaruppan NGH

Physiotherapy treatment of patients in ICU follows international best practise guidelines.  With COVID-19 ICU routines having changed considerably as patients are treated in prone (lying on their tummy) as this is best for their lungs and oxygenation. I am part of this proning team. It is very labour intensive and involves a lot of staff including anaesthetists, nurses, physiotherapists, occupational therapists and other Allied Health Professionals.

I assess the patient’s ventilator and how they are responding to it. I assess their x-ray and laboratory results to see if the lungs are improving and I use my physiotherapy techniques to treat the lungs and suction (pass a catheter into the lungs) to remove excess sputum.

In addition to looking after the patient’s lungs and breathing, I also help patients move and exercise in ICU. For some patients this means doing all their arm and leg movements for them as they are unable to do so themselves. This prevents muscles and joints becoming deconditioned and stiff. For other patients, the physiotherapist will get them out sitting (our occupational therapy colleagues provide specialised seating) and standing by their bedside and start an exercise programme. It’s heartening for the patient and the whole team when they can stand by their bedside after being so sick!

10:30am Morning Break

It is very warm in the PPE and I often need to shower and change at break. I meet the Physio team again to share information and discuss new patients.  I then return to ICU.

Lunch: 13:00 -13:30pm

We usually have our lunch in the hospital canteen. However, at present to ensure social distancing I have been having my lunch outside to get some fresh air.

I use this time to call my elderly mother back in India who is cocooning alone, also my sister.

13:30 - 16:30pm

I return to ICU or go to the COVID-19 ward with my colleagues and treat patients there.

In addition I may have a meeting to attend. I am a team member in the ICU COVID-19 subgroup and Naas Respiratory Team. These teams discuss the current COVID-19 status in Naas General Hospital and all international guidelines and contingency plans for escalation. COVID-19 has helped with a development of Telehealth within the hospital – using technology for monitoring and assisting with treatments for our patients.

16:30pm

On a good day I get to go home. However of late I have been leaving later and later.

19:00pm

A number of nights each week I have had a video conference call with physiotherapists working in ICUs across Ireland. We share information, experiences, guidelines and assist with documentation for the Irish Society of Chartered Physiotherapists. Additionally I attend webinars (these could be from the UK or Australia) and keep track of professional items on Twitter!!!

Changes at home:

With three young kids all at national school and my wife who is a healthcare worker in a nursing home we have had to adapt, like many other families.

  • In the morning I set up home schooling so my wife can grab a few hours’ sleep after coming off night duty.
  • We take turns supervising home works - my wife contributes more ..! And dealing with childcare is a struggle as we are both working.
  • In the evening we take some time to exercise/play in the back garden – to keep us all sane!

My personal reflections on the last 6 weeks:

From school closures to social distancing, from donning and doffing PPE, to proning rotas - this pandemic brought many changes to our lives. This is similar for many healthcare workers. It’s amazing how quickly and readily we all can adapt to new things for the safety and health of our fellow human beings.

There is a fantastic ethos of team work in Naas General Hospital and COVID-19 has strengthened that. I go home exhausted after long day’s work but delighted as a physiotherapist to be able help patients and our nation at the time of this pandemic.