A really long thread: thoughts & tips for #TelephonePhysio #VCPhysio remote physio consultations #COVID19 1. YOU MATTER - what helps you work with your own emotions/thoughts/behaviours? We talked through identifying &thinking about our own needs that lie behind our own emotions
#TelephonePhysio #VCPhysio 2. How to we maximise safety remotely...use functional and clothing references for symptom areas e.g. back pocket of jeans, side seam of jeans, big toe side of your calf, little toe side of your knee, above or below bra strap or top of a dining chair
#TelephonePhysio #VCPhysio 3. Practice describing red flag safety questions with a non-clinician back-to-back they then point to the area you are describing and you turn round to see if you match. Can be done remotely with FaceTime/skype - just close your eyes while you describe
#TelephonePhysio #VCPhysio 4. Use TeachBack and future scenario rehearsal techniques during subjective examination to assure understanding particularly of red flags and options during #COVID19
#TelephonePhysio #VCPhysio 5. Consider the potential interpersonal communication in telephone consultations to includes the varying intonations (e.g. when you slightly smile), pauses, interruptions, speed of speech, tone/timbre, deep listening and active listening
#TelephonePhysio #VCPhysio 6. Your coaching skills and facilitatory, empowerment skills will be invaluable. Use them. Develop them. Share them.
#TelephonePhysio #VCPhysio 7. Equipoise includes the ability to be comfortable with the uncomfortable. Shared decision making with all the contextual effects imposed by #COVID19
#TelephonePhysio #VCPhysio 8. Decision-making in uncertainty - use your well-worn heuristics (rules of thumb) but be very alert that every single one of them could be wrong - so what scenario rehearsals (if x happens then y) can you develop with your patient to prepare for this
#TelephonePhysio #VCPhysio 9. Many, many patients understand the unprecedented COVID19 situation. They are open to remote consultations, glad of them, appreciative
#TelephonePhysio #VCPhysio 10. It can be hard to manage the tensions we feel between being specific-general, many may be straight-forward but what about patients with more complexity, deeply felt safety concerns about decisions made without being able to see/physically assess
#TelephonePhysio #VCPhysio 11. Nervous about starting this. Thrown in at the deep end. Learning fast. Where do we get our reassurance from - logical reassurance v emotional reassurance?
#TelephonePhysio #VCPhysio 12. Confidence builds the more you do remote consultations... making sure that each interaction has the potential to add value really helps this
#TelephonePhysio #VCPhysio 13. Being frank, open and honest about this situation healthcare services are navigating very much includes expressing this in fully compassionate, caring, and kind ways. Take this time, be alert to the fears & concerns of every patient & of ourselves
#TelephonePhysio #VCPhysio 14. People are afraid to go out and exercise. Encourage them out with keeping physical distancing. Look at the vast array of indoor exercises available too
#TelephonePhysio #VCPhysio 15. Options to phone back after the consultation - some discussion around a grace call-back/ re-engagement period of non-discharge for x-months from 'when things get back to normal and you can go to the cinema, GP, cafes, concerts' etc.
#TelephonePhysio #VCPhysio 16. There are mixed messages. What is urgent? vs What is contextually urgent in light of current #COVID19 ? Protocols and guidance would be really useful - yet there is understanding that this is a fluid, changing, evolving situation
#TelephonePhysio #VCPhysio 17. Surprise expressed that some have really enjoyed the challenge and the experiences of remote consultations, this is mixed with concerns over challenges of decisions and relationship-building
#TelephonePhysio #VCPhysio 18. Realisation that some have spent a lot more time listening, really listening to patients. In the middle of crisis there is opportunity to develop those deep listening skills. Embrace the learning.
#TelephonePhysio #VCPhysio 19. Feelings of being much more relieved now - focussing on process is essential and this needs to also be balanced with leaning into the emotional context for all
#TelephonePhysio #VCPhysio 20. Keep sharing. The processes, the emotions, the thoughts, the practical tips, the learning. Share wide. Share far. Be there for each other.
#TelephonePhysio #VCPhysio This has all taken place in 24hrs. What a phenomenal achievement everyone - thank you for sharing your journeys. How much more can we keep sharing and learning together? The next dial-in planned is Fri 3pm, then tues 8am 😊💪🙏
