How does personal experience of illness or disability affect physios attitudes to practice and patients? Joanna Lyall spoke to some about their changed perspectives
By the age of 21 Laura Fairlamb had undergone two liver transplants and spent months in hospitals with complications but never wavered in her ambition to become a physiotherapist. ‘I wanted to be a physio from the age of eight after going with my gran to outpatient physio after her total knee replacement. I fell in love with it,’ she says. ‘I could have chosen a career that was less demanding physically but my experiences of physio as a patient fuelled my desire to enter the profession,’ she adds. ‘I had a lot of respiratory physio after the second transplant because I developed bilateral pneumonia so they used continuous positive airway pressure and other, non-invasive ventilation. And I lost a lot of muscle mass after both transplants and needed physiotherapy to aid mobility.’ The gratitude towards all those who cared for her – surgeons, nurses, health care assistants and physios – is ‘indescribable’, she says. Originally accepted to do physiotherapy at Leeds and Coventry universities, after the transplants she was told not to travel far from her home in Durham, so approached Teesside university. She told them her medical history and was accepted for the physio course. While the course was fascinating, she admits to finding some of the practical elements challenging. ‘But this became easier in time.’ Now 28, she is a band 5 physio, currently on a rotation at Farnborough Court, an intermediate care centre in Sunderland, and is clear how her experience of illness, and care, has influenced her practice. ‘Having been a patient puts you in a unique position once the tables are turned,’ she says. ‘I feel a lot of empathy for people in situations that are out of their control. The key thing I learnt was communication and interaction. I felt reassured when I could trust someone and knew they understood my concerns, even if they couldn’t solve them. That is how I try to interact with patients,’ she says. ‘I want to give back because of the chances I have been given and as thanks to the people who helped me,’ she says.
Sheila Johnston, who is 48, also stresses the importance of good, unhurried communication particularly with patients who may be having difficulty expressing themselves. ‘I know the importance of giving patients time because I know what it feels like to have difficulty getting the words out,’ she says. In 2003 Sheila was working part time as an MSK physio in outpatients, and looking after a young family, when a prolonged period of stress left her with bad eczema on her hands and a temporomandibular disorder which made her unable to work. She found her thought processes became slower and slower. ‘I could no longer comply with the handwashing regulations and my GP signed me off work,’ she recalls. ‘I found the whole situation very scary, especially when I developed problems naming day-to-day objects. People didn’t understand because I looked fine. I now understand the frustration of dysphasic patients.’ She had ‘fantastic’ support from occupational health and her GP, and received counselling, physio and acupuncture. But after 13 months off sick she had to give up her job. ‘I just wasn’t able to recover quickly enough to cope with that work environment, ‘ she says. Last year she regained her HPC registration and has just started a new job as a band 6 physio in the respiratory service in Preston, with, she believes, deepened understanding of patients’ difficulties. ‘I know just how depressing long-term illness can be, and how your confidence suffers. We need to look at patients holistically. ‘A patient may understand the need to amend their lifestyle, or follow exercises, but can’t because the whole situation is so overwhelming. Things need to be packaged into bite-size chunks with lots of reinforcement.’ She also feels that cognitive behavioural therapy, which helped her regain confidence, would benefit patients, particularly those with long-term conditions. ‘In today’s economic climate stress is going to play a huge part in most people’s lives. There needs to be more understanding about these issues in the workplace, and therapy services. ‘It has taken me seven years to get back to being “me” again with all the help I had. What must it be like for those not so lucky?’
Fear of death
Personal experience of vulnerability can draw physios to a particular group of patients. Rob Hodgkiss, aged 44, has worked at Bolton Hospice for five years, and believes he will be in palliative care for the rest of his career. ‘I can empathise with grief, and the shock and fear many patients feel,’ he says. He also knows the importance of making every day count. A former dentist, Rob developed heart disease when he was 30 and was put on the list for a transplant. ‘At the time my daughter was nine months old and I was frightened I mightn’t see her grow up.’ Left with a slight hand tremor due to the medication, after a successful transplant, he trained as a physiotherapist, and promotes organ donation. And his experience in intensive care brought home to him how distressing some procedures can be to be patients. ‘I found suctioning traumatic,‘ he says. ‘It’s important to remember what a procedure may feel like, even if it’s being done in the patient’s interest,’ he says.
Friederike Stenning, clinical lead physiotherapist in elderly rehabilitation at King’s College hospital, London, is 48 and suffered from trigeminal neuralgia for nine years: ‘The pain is awful but there is nothing you can actually see, so people don’t know how much you are suffering. I have learned that no one can feel the pain of another person, or understand what they are going through,’ she says. ‘It’s made me mellower, more understanding, less demanding and more empathetic,’ says Friederike, now pain free following two operations and a gamma knife procedure. ‘The experience has taught me to believe and trust the patient. ‘If a patient has found something “alternative” useful I believe them, even if I don’t believe it useful for anyone else. ‘I am more open minded and don’t take any step off the physiotherapy path as a personal affront,’ she says. Fl
- Any CSP member who has a health condition which is likely to be long term should contact their CSP steward and safety rep for support. They may be able to negotiate changes to work practice such as temporarily reducing hours or changing duties if this could help recovery.
- Any CSP member who considers themselves to have a disability or health condition that affects their working life is welcome to join the CSP’s confidential network group for disabled members which can provide support and advice from other members who have gone through similar experiences.
‘I can empathise with grief, and the shock and fear many patients feel. I also know the importance of making every day count’
‘I know just how depressing long-term illness can be, and how your confidence suffers. We need to look at patients holistically’
Contact Saraka Keating email firstname.lastname@example.org
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