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The UK’s OTs have helped coronavirus patients rebuild their lives – but another surge in cases will bring new challenges
This spring, at the height of the coronavirus pandemic, occupational therapist Rachel Wallbank was juggling three different roles.
As well as being seconded to work in the field hospital for Covid-19 patients at the Principality Stadium in Cardiff and on a hospital acute ward supporting those who had just been discharged from intensive care, Wallbank was also trying to keep up with aspects of her job as a multiple sclerosis clinical specialist.
“[Covid] patients have had significant infection, often with life-changing issues as a result,” she says. “Fantastic doctors and nurses have probably saved their lives, but we are about the quality of that life that they have saved; it has to be more than saving a life, [but building] one that has meaning for that individual.”
Wallbank is one of the UK’s 41,000 occupational therapists (OTs) who work in health, social care, housing and education, helping people affected by physical or mental illness, injury or disability to live their lives as fully as possible.
In the Welsh field hospital, Wallbank’s role was to support patients with washing, dressing, eating and mobility, and helping them to prepare for transfers. On the hospital ward, meanwhile, she also helped her patients to manage the fatigue and concentration problems brought on by Covid.
Lauren Walker, a professional adviser with the Royal College of Occupational Therapists, says OTs, like other frontline professionals, have been hugely affected by the pandemic.
A survey by the college of 1,500 professionals and students around the UK found 98% of respondents said their work had been impacted in some way. A third were redeployed to other teams, and 60% were delivering services differently as a result of Covid, such as shifting to working online instead of seeing patients face-to-face.
Half of the survey respondents also said their work-life balance had been affected, and 46% said their health and wellbeing had been negatively affected by the pandemic.
Catherine Murchan is one of four OTs working in the acute care at home team in the Southern health and social care trust in Northern Ireland. The team’s aim is to keep patients – mostly older people – at home when they become ill.
During the first wave of the pandemic, she says, the team felt fear and anxiety about their work, including concerns around availability and effectiveness of personal protective equipment. She found work physically and emotionally draining.
At first, they trialled online and phone assessments. “But we quickly realised that because our patients were acutely unwell, they might be deteriorating, not able to get out of bed, not able to get up the stairs, and carers could be struggling.”
Murchan’s team realised that face-to-face input was essential and adapted working practices to keep professionals and patients safe.
Referrals to her team during the first wave increased by about 80%. Between March and the end of May, they saw about 350 people – a fifth of whom were Covid-positive – in their own homes and care homes. “A lot of patients wanted to avoid hospital admission,” she says. “They wanted to stay at home, and their families would prefer them to stay in their home environment.”
She says this year has demonstrated the resilience of her team. “Staff generally did feel very well-supported, and they did feel that we really did all pull together during that time, we supported each other,” she says. “The thing is, in the second [wave] will everyone have the energy to keep going?”
As the country braces for a second spike of cases, Murchan and her team have been preparing by researching Covid care and rehabilitation. They are also concerned about what she calls a “deconditioning pandemic” among non-Covid patients who either missed appointments during the first lockdown, or did not exercise as much because they were shielding or chose to spend more time indoors.
Wallbank says OTs will also be at the forefront of treating long Covid and thinks a true picture of the virus’s consequences may not be clear for years. “I expect there is going to be a tidal wave of individuals who have things like myalgic encephalomyelitis, post-viral syndrome and fatigue,” she says.
Leeds-based OT Chris Wood worked on a mental health ward during the lockdown and has now started a new job supporting homeless people. One of the biggest challenges for him during the second wave will be trying to keep the city’s rough sleepers safe.
“They don’t have access to the things we take for granted, like masks and hand sanitiser,” he says, “They don’t have access to news updates to get information and guidance on what to do, and of course they don’t have a safe space to shield or self-isolate.”
Despite the challenges facing OTs and their clients, Walker thinks the profession has proved its worth during the pandemic and believes its profile has been raised, something the college is also keen to highlight through OT week.
Wood hopes that is the case. “Given how interesting and broad and innovative OT is, it is amazing that people aren’t aware of it,” he says. “We sit in the background. We are a humble profession. Everyone knows what a nurse is, and they probably know what a paramedic is. And then there are all these other professions like OT that offer so much as well.”
First published in https://www.theguardian.com/