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04/26/2021
By Katharine Webster

If a doctor had a spare moment at the end of visiting a COVID-19 patient, she emptied the trash. Physical therapists changed bedsheets. Nurses removed food trays.

Taking care of ordinary housekeeping tasks was just one of the ways that health care professionals adapted to protect each other and their patients while caring for people with COVID-19, nearly 130 physical therapy and nutritional science students learned during a virtual mini-conference on interprofessional collaboration.

鈥淭he lines were blurred between roles 鈥� from the physiatrist all the way to janitorial staff,鈥� says second-year Doctor of Physical Therapy student Rachel Seeley 鈥�19.

鈥淭he doctor said sometimes she would be doing bed mobility with patients, which is our role in physical therapy. Physical therapists were helping with speech therapy, or they would work on the patient sitting at the edge of the bed so the patient could increase their sitting tolerance for eating and swallowing,鈥� Seeley says. 鈥淭hey maximized their creativity so they could have as few people having contact with the patients as possible.鈥�

The mini-conference was the idea of Assoc. Teaching Prof. JoAnn Moriarty-Baron, who teaches Neurological Physical Therapy, a course for second-year doctor of physical therapy students, and , director of in-patient rehabilitation at Northeast Rehab鈥檚 hospital in Salem, New Hampshire.

Moriarty-Baron, who has worked as a clinical mentor and per diem therapist at Northeast Rehab, normally takes her students to visit the hospital so that they can see an acute, in-patient rehab facility and better understand what it鈥檚 like to do physical therapy on someone who is neurologically impaired.

鈥淎 rehab hospital is a whole different experience鈥� from an outpatient physical therapy clinic, Moriarty-Baron says. 鈥淢ost students haven鈥檛 been exposed to people who鈥檝e had a traumatic brain injury or other neurological injuries.鈥�

Image by Courtesy

Moriarty-Baron was already working with Poulin, who had put together video case studies of stroke patients for use in her remote classes during the pandemic, when they came up with the idea for the mini-conference. Northeast Rehab, which employs many UML alumni, also accepts many physical therapy students for clinical rotations.

Last month, Poulin gathered with seven colleagues in a single room, including a doctor, a physical therapist, a nurse, an occupational therapist, a speech pathologist, the nutrition manager and the COVID unit manager.

With a camera trained on them so that students could see them on Zoom, they talked about the challenges and rewards of their work when they agreed to take COVID-19 patients during the pandemic鈥檚 first surge in spring 2020 鈥� and then again in November, when an outbreak among patients and a second surge required them to re-establish a COVID unit.

Students in Moriarty-Baron鈥檚 course and a graduate Cardiopulmonary Physical Therapy I class, along with undergraduate nutritional science majors taking Life Cycle Nutrition and Medical Nutrition Therapy, watched it live. They submitted questions in advance, and Poulin moderated. (A recording was so that others could watch afterward, too.)

鈥淲hat stood out to me is that we, as an organization, stepped outside of our traditional roles and became very comfortable performing tasks from other disciplines,鈥� Poulin said.

Physical therapy doctoral student Emma George says she was surprised to learn that the dieticians couldn鈥檛 meet in person with patients in the ICU and instead had to speak with them on the phone or rely on what other team members could tell them about each patient鈥檚 condition and nutritional needs.

鈥淚 thought it was a really great experience,鈥� George says of the mini-conference. 鈥淚t was good to hear from each member of a medical care team. We talk about interprofessional collaboration in class a lot, but we haven鈥檛 really been able to see it. This was the best substitute for in-person experience that we could have.鈥�

Jeremy Duford, a junior majoring in nutritional science, says he gained a new appreciation for both the emotional toll of working with COVID-19 patients 鈥� and the challenges of getting them to eat enough to recover.

鈥淚 knew COVID patients had no taste and no smell, but I never thought about how that would impact their nutritional recovery,鈥� he says. 鈥淲hen eating is strictly a chore, it鈥檚 difficult getting those calories in. And COVID is a respiratory and throat issue, too.鈥�

When writing a reflection paper afterward, Seeley says she realized that there is a difference between working on a team and being a team player.

鈥淏eing a team player was what these people had to do; it was like hierarchy didn鈥檛 exist,鈥� she says. 鈥淓veryone was kind of leveled, because when it came down to it, there was one goal: Don鈥檛 get COVID, don鈥檛 spread COVID, and give your patients the treatment they deserve.鈥�