DIVERSIFICATION Physiotherapists have seen their roles change enormously over the last decade, with far more now expected that just the conventional massage therapy.
Exercise, stretches, massage, sport, knees, backs, shoulders. These are all words that people readily associate with Chartered Physiotherapists. There are a few other words that might not spring to mind so quickly, but that are equally important.
Stethoscopes, strokes, sputum and surgery create a nice bit of physiotherapy alliteration and illustrate the point nicely. When I was considering physiotherapy as a career, I wasn’t aware of a number of the different settings that I could end up working in.
To be truthful, I doubt I’m fully aware of all the settings physios work in today, such is the variety. Many people assume that physiotherapy is predominantly concerned with musculoskeletal conditions in an outpatient setting. But the reality is that somewhere around a third of physiotherapists work in hospital settings doing a variety of roles.
In my first year out of university I worked in one of the big teaching hospitals in Sydney where new graduates rotated through different departments. My first rotation was acute neurology, dealing mainly with people who had recently had brain or neurosurgery, but also some complicated neurological conditions. A day could involve anything from using a tilt table to see whether a patient with Locked in Syndrome could tolerate being partly upright, to going for a walk outside to assess someone’s ability to handle stairs, uneven ground and changes in light. At the same time, a friend was working in the Sydney Children’s Hospital next door. It appeared that her days involved cuddling babies, playing football and watching movies.
There is a special breed of physios who work solely within respiratory medicine. These folks spend their days listening to the chests of people with COPD, cystic fibrosis and various other short- and long-term lung conditions and doing what they can to improve their ability to tolerate exercise and, well, cough up sputum. I remember being taught that how much sputum a person produced in a session should be measured in finger nails, shot glasses or cups. Sometimes, when coughing isn’t enough, they get to slide a suction tube down into a patient’s lung to bring the sputum out. Not a job for the queasy!
Then there are the burns physios. An acute burns ward is an awful place to find yourself as a patient and, having observed a session or two as a student, also not a place for the faint-hearted physio. As well as the obvious jobs of keeping muscles and limbs flexible and patients mobile, part of a burns physio’s job in those days was to remove assist in the removal of dead skin. I won’t go into detail, but trust me when I say that practice is the very definition of being cruel to be kind.
In another realm are the physiotherapists who work in research. There are times when I envy those who are constantly trying to advance the profession as a whole. Wouldn’t it be cool to have something published in a noted scientific journal? Something ground-breaking that changes the lives of thousands of people. The answer is yes, it would be. But the hours of poring over statistics (and actually understanding what they mean) could be mind-numbing before reaching the ground-breaking stage. Researchers in any field are often unfairly perceived as socially awkward and lab-bound. Quite the reverse is true, some of the most interesting physios around work in research, people whose passion for their chosen field is exceeded only by their ability to explain their findings to lay people.
Outside of these groups there are physiotherapists who work in sleep clinics and nursing homes, with cancer patients and policy makers. There are physios developing software and apps to make it easier for patients to follow their exercise regime and there are some physios who spend more time coaching healthy athletes than treating injured ones.
All in all, it’s a wide and wonderful world that we inhabit. So much so, that if I was facing into the challenge of Leaving Certificate exams and CAO options, I’d still have Physiotherapy at the top.
Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.