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Okay. Hi, everyone. Hello there. My name is Cherry. We are from mind the bleep and today I have no other than the Fabulous Hannah project who's one of our physiotherapist at Somerset FD Foundation Trust. So she's here to speak to us about a career in physiotherapy, her experiences so far and what she recommends future physiotherapist to keep in mind. Um, I hope you enjoyed this presentation and without further a, do I invite Hannah? Hello. Thank you ever so much for having me. Um, as Terry mentioned, my name is Hannah. I work in my as well Park Hospital in Taunton. Um, and, um, just an form of introduction. Um, I've, um, qualified in Poland, so I'm an overseas qualified physiotherapist. I qualified in 2012. Um, and I've got Bachelor degree in physiotherapy. Um, straight after my, um, acquiring my degree, I came to the U K haven't been here before for a short period of time. So I came in here straight after my, um, getting my degree. However, I didn't work in my profession. Um, I didn't feel my English was up to scratch, um, at that point. So I worked for about four years as a healthcare assistant in one of the care homes where I was learning English. Um And in the meantime, I was also completing my um G C S C um in maths and English. As I thought that's gonna be a requirement for me to um get the degree or trans translation of the degree in the UK. Um After getting some help and support from um someone who worked in the hospital at that time, who, who was also an overseas qualified physiotherapist. Um She kind of gave me some guidance and in 2016, I started working as a um physiotherapy assistant um to be a physiotherapy assistant you don't need or don't require any um official qualifications. Um But it's a good way to get into physiotherapy, but I will talk about it a little bit later. Um So I've started working as a physiotherapy assistant um initially in the trauma and orthopedics team and then I moved on to um the stroke team um curing that process. Um I've started um acquiring all of my documentation and I was encouraged to do so as well. So I've had a lot of support throughout the process to um get all of my documentation, translate them and registered with the regulatory body in the UK, which is the H CPC Healthcare Professional Council. Um And soon after I had my, all of my documentation recognized, I've started working as about five physiotherapist qualified physiotherapist in one of the community hospitals um on a, on a rehab ward, I've spent there about a year and then, um as I always wanted to work in an acute setting. Um and there was a job opening in Moscow Park Hospital again. I've applied for um job with the Jet Team emergency therapy team and I've been with them ever since. So it's now been good five years. Um So that's pretty much all about me. Um Now, just to talk a little bit about um how to become a physio in the UK, there are different options, there are different routes. Um The most common one is obviously um getting a university degree to get into um university um in the UK um on the physiotherapy course, which takes three years. Um you'd have to have at least three um A levels or end five G C S D levels or alternatively, um complete ab tech, sort of extended national diploma, another option which is fairly new and I'm not sure whether it's rolled out across all of the trust. Um But it's to go on an apprenticeship to go on apprenticeship. Um One would have to have been working in a, in a hospital or in a healthcare setting. Um It's usually the physiotherapy assistant who wants to progress um into a physiotherapist role. Um However, some form of education is required and um that person would have to have one, a level and three G C S C level um at level C or above in maths English um and sciences. This route does take four years. Um And people do you think about it um quite intensively because um if someone is working at the band three level, then this person stays at the band three level um throughout the apprenticeship. However, if someone's abound four, um during the apprenticeship, they'll have to come down to two a band three levels. So obviously, they'll have to think about it from financial point of view as well. Um And then the third root, which is for um all of the people who have qualified overseas. Um And it's the application with the HCP. See it does vary depending on the country. Um All I had to do was just translate all of my documentation and they have accepted it as it was. I know that um some of my Filipino colleagues um had to have to provide a formal form of portfolio or a case study um to have all of their documentations um accepted. Now, one, someone has become or physio or got the qualification as a physio. Um The usual um sort of start is at a band five level and all of the new um starting physios um are encouraged to um um to do a court rotation to complete all of their co rotations, which is usually your MSK A neuro author respiratory. Um It usually takes about because every rotation depending again, on the trust um last about 4 to 6 months. So it can take a couple of years when someone gets an experience. Um after which time, um depending on sort of if there is a need in a hospital, um people can move um up to ban six position and again, sometimes they will have to complete all of the rotations. Um Sometimes people can move from band five up to ban six on this a condiment or maternity cover post um to get a bit more experience. The difference is the Ban Sixes um slightly senior with more experience. Um And it does take a bit more of a leadership role. Um looking after the junior staff within, within that team and taking some of the leadership responsibilities and then progressing into a van seven rule which can be either sort of clinical or more leadership or a bit of both with both in some cases. Um The trust may require a further the master's degree or masters modules to be completed. Um I'm just going to move on to another post say where I work, I work in the joint emergency um therapy team. And um we do work slightly differently than your typical physios or typical otis on the ward. Um So we, our main aims are to um prevent unnecessary and I will highlight that word unnecessary emissions because um people often misconstrued, misconstrued and think that we're just trying to get people out there it's all only people who don't need to stay in the hospital for any medical reasons. We try and arrange um to get them home, we initiate early discharge planning. Um We try also reduce hospital um stay as has been proven to be detrimental to especially the older frailer population. And we complete for healthy assessment. As a team, we cover a any acute medical unit and acute frailty unit. Um Our biggest emphasis is on the a and that's where we um are mostly funded um to work in and it is our priority. Um the patient that as a healthcare professional, working in a hospital in that environment, someone may refer our patient's who are um sort of usually above the age of 65 65 years old, but that frailty sort of um line is moving up a little bit. Patient's who, who had a full, whether it's in a care home, nursing home, raising home, we're trying to prevent further falls. Um when there's been a change to someone's sort of mobility, their functional ability when they're struggling at home. Um Patient's with a new injury that may affect the limb, whether it's apple or lower limb or the movement in rule um at any age range. Um and patient's who are a carer for independent individual. So a patient may disclose that. Um they are really keen to go home from hospital because they are the main carer for the partner for the wife for the child. Um And if they stay in a hospital, there will be no one to look after that person. Um We done very closely liaise with our adult social care team to support that person. Um and initiate organizing support for the for the person that's, that's at home. Um As a team, what do we offer? We work very closely with um the M D T team to prevent um unnecessary admission's. We complete mobility assessment, falls assessment, we assess patients' function, how they manage at home. We provide a lot of support um for, for patient's, for carers, a lot of information and advice. Um People often, even though obviously internet is widely accessible, there is so much information, people don't know how to look for the appropriate information. Um So we provide that support in that aspect as well. We can arrange temporary support um at home. Um Working very closely with the community services who provide set support. Um But it's only temporary at the moment. Um At least our trust, I'm not sure whether it's national wide, but our trust do not organize any long term care packages. Um There is an initial assessment that happens in the hospital um And then when the patient's become medically fit medically safe um for this judge to go home, um that part of assessment moves to their own environment um if they're safe to remain in that environment or um we can also organize further rehab in community hospitals. Um if patient's can't go home, but they don't, from medical point of view, they don't need to stay in a hospital. We also issue um equipment, whether it's six frames, um toilet ing equipment and all the and also higher level um equipment. Um Now as every health care professional, um we all face different challenges in uh day today. Um work the first and most obvious one will be time. Um Obviously working mainly in, in A and A um are the breach times, a lot of pressures in um coming up with a plan, getting patient's moving, getting patient's. Um this start if they don't need to be um in a hospital environment, healthcare professionals understanding of jet. Again, not every trust, not every hospital have got jet like model. Uh People still don't often know what we offer what we provide. Um We try and organize um uh sort of induction for all of the doctors starting um in A and E and on A M you just to get to know them, let them know what we're doing that we, what do we do where we work? Um Again, another sort of obvious one is the environment, especially with how busy the A any departments have become lately when we have to complete assessments often in the corridors. Um because that's where the the sort of medically stable, stable patient's are moved when the cubicle is required for unwell patient um it is very challenging to complete a mobility assessment um in a corridor, especially if um the patient has got any cognitive problems, memory problems, it can be very distracting, very challenging. Um A lot of the patient's obviously don't like that. There is an issue with the sort of dignity um with um sort of asking, we do ask a lot of information, we've got um something called um green therapy Assessment form or Therapy Assessment form. Um And there are a lot of personal questions, questions about um patient's toilet ing, they're sort of toilet inhabits pressure areas. Um So that privacy and confidentiality is a big, big aspect um caseload again. Um As everybody knows the, the A N D departments so busy that um we may have um one or two patient's refer um to our team for our assessment because we do work mostly on a referral basis, although we try and be present whichever area um that we are required in the most. Um But the caseload may go from one or two patient's to 10 patient's within an hour. So our caseload is very unpredictable. Obviously, as I've mentioned before, we cover three different areas. Um and we are very flexible. So if more people from our team, um I needed down in A and E as we say, um then we try and we try and adapt to that and I think I forgot to mention that in within our joint uh emergency therapy team. We've got physios, we've got occupational therapist and, and therapy technicians as well. Um Furthermore, about the, about the challenging community services again, as everybody knows, there is a big stretch, um uh big pressure um off on the community services. Um I'm speaking mainly about the care packages. Um organizing, there is um often not a lot of capacity um for care packages to even though they're temporary but to start immediately. Um And sometimes there is a weight for that um and managing expectations again. Um What I try and think about when I'm seeing a patient in any, um when someone comes to an emergency departments, usually because something um big happened in, in their life, something that required for them to come into an emergency department and be seen urgently by a doctor. Um So often people coming in a great distrust. Um There are loads of heightened motions from the patient's from the family. Um So if patient comes into hospital and um has been seen by a doctor or advanced care practitioner, and we've got the blood results, we've got the imaging. Um and we are told that the patient is medically safe to be destroyed, they've been reviewed, they're medically safe to go home. Um It's often quite unexpected both for patient and the relatives. So when we found a relative that, you know, the patient's been reviewed and um they from medical point of view, they can be discharged home often. What we hear is that, you know, this is not possible that someone who's been that unwell for four or five hours ago is now medically safe to be destroyed. So there, there are a lot of um managing those expectations and um what can be achieved at home. Um Often the patient's will say that they feel they um need support at home um or they want to change where they live or go into a more supportive environment, which unfortunately, um hospital is very tricky to be arraigned. So we try and organize that support at home. Um And also from other healthcare professionals. Um Some, sometimes we get um sort of different expectations um from, from our colleagues as well and, and it's managing that sort of on a day to day basis. Um Now, just to talk about how um jet. So the joint emergency therapy is different from maybe the other teams in even within our hospitals and, and, and other hospitals. Um we work very holistically. So, whereas on your typical wards, um a patient who require therapy and put may be seen by a physio physiotherapists and an occupational therapist um in jet team, that patient is seen by one therapist only. So as a physiotherapist, because I can only speak for myself as a physiotherapist. I, I have to think about the occupational therapy side of things about the social care side of things. So as a physio, I would not only look at patient's mobility, their transfers, their gait pattern and analyze that, but I would think about what equipment they may need at home. Um Think about their continents. Has there been any change for their pressure areas or like do they need any pressure relieving equipment which is fairly atypical for a physio to the 12 into? Um And because we um I'd like to often think of myself as a key worker for that patient. Um So for from the moment I start assessing that patient to the moment they leave the moment they go out of hospital or move toward, I try and think about everything um that I need to think about including medications. Do they have a key to their house? I will try and liaise with um admin stuff to organize transport, we will speak with carers with the relatives um to, to organize support or two um restart the support. Um So it's very robust discharge planning, buying one individual which also carries a lot of responsibility as a physio. If I had a particularly challenging patient from an ot perspective, I may go to my ot colleagues and we do chat to each other a lot and I may go to my ot colleagues saying, um or asking, you know, do you think I should be thinking about this equipment or from pressure point, pressure relieving point of view. Do I need to be organizing or, or leasing with the district nurses um equally vice versa. My ot colleagues um if they came across a patient who had particular MSK a problem or you're a problem that would um come to one of the physios to ask us for advice or help. But generally speaking that the patient is seen by one um therapist and another thing that especially from a and E perspective, I think how we differ. So I'm just keeping, keeping an eye on the time. Um knowing that I've started late already. Um But just um what we, what it's different within injecting that especially in the any I feel sometimes we're part of the diagnosis, diagnostic process. And I'm not trying to be big, big headed here until um but often when patient, especially a simple example, when patient comes into hospital with a full or after having a full um they will be thoroughly um checked by a doctor or care professional. Um often they will have imaging done like x rays. Um And we are told, can you go and see that patient see whether they can wait, better see what the pain level is like. So we would go and assess that patient with a very open mind. We would often do line and standing BP to check for postural drop, which may have caused the four. Um we, if the patient can't wait but weightbear, we would then liaise with the doctors um checking. If maybe a CT would be a good idea to, to further diagnose that patient. So this is like a simple example of what we often do. Um But I feel that there's so many different healthcare professionals within sort of um A and E department that it's a bigger part to um sort of diagnose um that patient. Um So if you were thinking about um sort of what can you take from, from me chatting to you guys um today, um I think Jed think physiotherapy or, or occupational therapy, especially in any department if you have got jet team or jet like model um in a any just when you're seeing your patient um as a doctor, think about, you know, is this patient managing at home? Are they giving you any signs that actually they're really struggling at home? Are the relatives saying sometimes, sometimes it will even be a neighbor calling saying, you know, my my neighbor isn't managing at home, she's really struggling, you know, have they had any falls? Have they mentioned that they're starting to struggle with getting washed and dressed with functional ability with preparing meals? They're getting really fatigued, they need more support at home, you know, have their mobility and function started deteriorating. Um Or are they remain care for an individual for an individual and they are really struggling because that may be the case as well that um they will be um worried to say anything um in in case, you know, people think that they are failing that that person at home. But actually, it may be a sign that we need to sort of start looking into these things, even if it's just to have a chat with them, to provide advice, to provide information, to link them with the services in the community or to show them how to get in touch with the services in the community so they can get that help for themselves. Um So just something to think about. Um And this is pretty much it from my point of view. Um I'm sure there is much more. I hope it all makes sense. Um But I'm open to any questions. If anybody have any questions, you know, you can um I'd asked cherry or email me. Um not a problem. Um But yeah, I think that that's pretty much what my job and what my um day today um the patient interactions look like and yes, thank you very much for listening. I hope it, it was worthwhile. Thank you so much, Hannah. Honestly, I think everyone can see how big of an impact for the oh therapist play in the holistic care of patients' and how much training they need to go to, to get to your level and you covered that beautifully. Well, um as a snapshot in this presentation, I'm sure there's so, so much more to talk about because you guys do so many different things. But um this was a clear overview. It's very good for me to actually learn about, you know, all the training you guys have to go to what you do. You know the fact that you guys do the line standing BP, all of those different things that you do in your day to day work and how that impacts the patient. So I think that was really excellent and I'm glad everyone will be very glad to have this on our website to get an understanding. Maybe we'll get a potential, a lot more physiotherapist joining us because of this all. Thanks to you, but thank you so much. I'm going to stop recording now. Let's see. Where can we do that record and try to stop recording?