From rehab to respiratory
In the first of my 2nd year physiotherapy placements, my specialisation area was adult rehab. You can read about it here. This blog post covers the second placement of year 2: my cardiorespiratoy placement.
The first thing to say is that I thoroughly enjoyed the cardiorespiratory module as taught at the University of Salford. I found that there was something comforting in the facts and the numbers. We learned to read blood gases, figure out partial pressures, and fathomed equal pressure points. I’m sure that as much as I enjoyed that aspect, others on my course might not have taken such pleasure. For me, though, elements of my Access course came flooding back and I took pleasure in the science of it all. The practicals were also interesting, but when learning to use the different adjuncts to aid in secretion clearance, it was hard not to dwell too much on the secretions themselves. Perhaps that’s why I sought solace in the science! Much less … icky.
It turned out that my cardiorespiratory placement was also really enjoyable. Not so much because of the science, but because of the secretions I had tried so hard not to think on! The science is really important to understand and knowledge of specific pathologies obviously informs intervention. Still, when a patient is retaining secretions they can’t clear themselves, secretion clearance by a therapist can improve their lung function in the short term. I learned to do just that, using therapies such as the amazingly effective active cycle of breathing technique, and deep-closed suctioning of sedated and ventilated patients. On the high-dependency wards I worked on, patients were attached to computer monitoring. This meant the consequences of my intervention were easy to read; oxygen saturation levels improved following successful treatment, CO2 levels went down. The feedback was instant.
The secret of secretions
It was a hard placement, I make no bones about that. I do feel though that I developed significantly as a physiotherapist in that setting. It had lots to do with the excellent team I had the chance to work with, and a really supportive clinical educator who encouraged the development of my clinical skills and techniques. It was also to do with the specialty. I encourage those who might be wary of encountering secretions to instead think of what those secretions can tell you. Auscultation helps us pinpoint secretions in the airways and gauge the accuracy of our treatment, colour and even the smell of secretions clue us into the presence of or stage of infection.
If you’ve yet to do a respiratory placement, I hope you’ll enjoy it as much as I did mine. Feel free to fire any of your questions at me. Let me know how you get on. If you’ve already finished one, tell me about the aspects you enjoyed, the bits you least liked, the lot!