The COVID Maze of Working in Community Rehab
Running a private community rehab practice (specialising in home visits to patients across NSW/ACT) feels like a never ending maze at the moment. Negotiating sudden changes in travel restrictions, borders opening / closing and what defines “essential service” has placed so many twists and turns to running our small business. My pre-COVID “Friday facial or pedicure” has now uncomfortably turned into a “Monday morning nose swab” to reassure my patients ( and myself !) I am not carrying the virus.
Last week, we received a referral for a palliative care patient in South West Sydney who has been diagnosed with asbestosis. Do I send one of my occupational therapists (OT) to do a home visit? The risk is so great and weighs heavily on my shoulders. My colourful flow chart and detailed procedures from 2020 on COVID risk assessment pathways and screening checklists don’t help me - in the end it’s my gut instinct and the OTs strong clinical skills that lead to a solution.
Another referral - a teacher whose husband has a severe brain injury; she is struggling to manage his CPAP machine and overnight care. Can I delay the assessment to when restrictions lift? When will that be? What if he deteriorates further, and I can’t assess him properly via Telehealth?
And then there’s the border changes. End of June saw a mad rush of appointment changes for our medicolegal team servicing Canberra. Telehealth was offered, files were reallocated to my Riverina clinicians; only to find Canberra’s borders slammed shut, and then the whole of the state locked down in a flash.
My energies were then redirected on negotiating a new route; recruiting local clinicians in each region to avoid border blocks. New procedures, training, report formats, checklists and marketing were now needed. More thinking, creating, problem solving, proposals and contracts.
But I am exhausted. Like many parents I am home schooling with my left hand whilst putting out fires with my right. Trying to steer our business out of this labyrinth, and guide our team of 30 in these unpredictable times.
And then in a quiet moment I take a deep breath and reflect. My team are still providing an amazing service to our clients, supporting their health needs and making a positive difference to their recovery. The phone is still ringing with referrals, and our customers are receptive to our new ideas and services. The clinicians are adapting to remote service provision, and are gaining confidence with Telehealth and how to connect with clients behind a blue mask and PPE. The teamwork, collaboration, creativity and loyalty in our company has continued to strengthen!
So I will keep going, maybe a little slower, learning not to run too far ahead. I will lean on my team and trust that the path we are on is going to lead to a smoother journey (and a relaxing holiday!) when restrictions ease.
About the Author
Kate Moore is co-owner and Clinical Director of Moore Rehab Outcomes. Kate has been working as an Occupational therapist for 23 years and is passionate about helping clients in their recovery post accident and inspiring health professionals to make a difference in their work.