Giving ICU patients a voice-Therapist shares her highs and lows of working through a pandemic.

Dani a speech and language therapist at Barking, Havering and Redbridge University Hospital Trust, has spoken about her experience during the pandemic working in critical care and with cancer patients.

She said: “My role involves helping to wean patients off ventilators, and tracheostomies (tube in the throat to help you breathe), assessing their communication, swallowing, and getting them eating and drinking again. I get to be the person to give them their first drink of water after being ventilated for a long time.

“My favourite thing about my job in critical care is that I get to give patients a voice, when adding a speaking valve to a tracheostomy. A lot of people don’t realise how involved we are in communication. Often these patients can’t speak, so we find ways for them to communicate.”

This can include a whiteboard and pens for patients able to move, however, for those who have limited mobility they use an E-Tran frame, a Perspex board with letters which patients are able to select with their eyes. This allows them to ask for basic things like water, an extra blanket if they’re cold, or to be moved into a more comfortable position.

Dani added: “Patients in critical care can be confused as they have no sense of time. They are also vulnerable and can get frustrated. Everyone can communicate and it’s important we take the time to find out how for each patient.

“During the pandemic there were so many more tracheostomy patients so we were very busy. I found I made more friends, and closer relationships with my colleagues, particularly physiotherapists, dietetics and nurses, as we were all relying on each other.”

Critical care is only half of Dani’s role, she also works with head and neck cancer patients: “During the pandemic, many of these clinics became virtual which made forming patient-therapist relationships more challenging due to the lack of face-to-face contact.

“Social distancing can be difficult for people going through treatments like chemo or radiotherapy, so keeping in contact and being a support network for my patients was important to me.”

Simple things like mouth care also became even more important during the pandemic, as poor care in this area can lead to nasty infections, it’s also key for patient dignity.

Dani added: “I remember doing mouth care for one gentleman who was about to die, before his family came to say goodbye. It really affected me as it was a small thing, but the last that would be done for him. As therapists, we’re used to helping people live more independently, so it was very hard.”

Aside from forging closer bonds with colleagues, there have been other positives: “It’s been good to see the profile of speech therapy in critical care increase, and for colleagues to see how much it benefits our patients. I’ve also gained knowledge from working more closely with others.

“It’s nice knowing patients have got back to eating and drinking, and been able to get home more quickly, thanks to us, and the rest of the incredible healthcare professionals working across our departments.”

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