In the lead up to AHP Day on Monday 14 October 2019, we are sharing an interview a day from some of our Allied Health Professional staff. Today's features the lovely Stephanie Pye, Macmillan Physiotherapist, from the North Manchester Macmillan Supportive and Palliative Care Service.
How I got here
I knew I wanted to work in a caring profession form an early age. I was really interested in science and chose to do my high school work experience in a hospital. During those weeks I was able to observe lots of different roles. I particularly enjoyed the rehabilitation side of things and working with patients to achieve their goals.
Early in my career I specialised in respiratory physiotherapy, which lead me into working in a chronic lung disease team in the community. Four years ago, I decided to specialise in palliative and oncological rehabilitation in a specialist Macmillan Physiotherapy role. I felt excited that I had transferrable skills in respiratory symptom control, pacing, exercise therapy and advanced care planning, which would be essential for this post. Plus I felt I had good insight and communication skills to support patients who were nearing end of life and guide them through this transition.
People are at the heart of what we do
The people that we support, and their needs, are incredibly varied. In general our patients are in the last 12 months of their lives. I rehabilitate patients whose health may improve for a time, such as helping people through the side effects of acute illness, radiotherapy and chemotherapy. Keeping people physically active at these times can improve their quality of life and can contribute towards extending life.
Physiotherapy is entirely person-centred – the patient sets their own goals and we see them through a journey from a potentially bad place to a better position. We also work really closely with the families and help them set goals and manage expectations. Families are an essential part of the work as they are so involved in our patients’ care.
There is a very emotional side to working in palliative care, as we provide psychological support to patients and their families; as they experience a range of feelings and emotions at this time in their lives. When we can, we try to attend the funerals of our patients to pay our respects and to support the families who we have been working so closely with.
The other area of my work is about managing and assisting people to adjust to their decline as they near the end of their life. I show them how to move and function in a different way, to be able to maintain as much independence as possible. I can offer various walking aids, home adaptations, and teach pacing and energy conservation techniques. Teaching people how to manage their breathlessness during activity can help optimise symptom control and may reduce the need for some medications. It is important to us that patients have a say in the approach to their rehabilitation so they feel more empowered and engaged.
Where people receive their care is also very important – to patients and their families. Through the combined efforts of the team, we try to ensure that they are able to stay in their preferred place of care and preferred place of death, whenever possible.
Holistic approach to care
The Manchester Macmillan Supportive and Palliative Care Team is a multidisciplinary team. We work in an integrated way so I don’t feel that I am working in isolation; I am supported. We have a great range of skill-sets to help manage people’s physical and emotional journey towards end of life.
Our 7-day service operates a triage system. Each of us is a holistic team member, which means we can all respond to calls about sudden changes in a patient’s condition or any other enquiries. Any of us respond to a call from a patient or a fellow staff member to ensure the right person is involved with the patient, to deal with any of their issues. This ensures that our service is responsive to avoid patient suffering and distress; patients need to know that if you say you’re going to follow up on something that you will.
As a team, we have to also be aware of the additional complications and pressures that our patients and their families are dealing with. The whole team is able to support them with advice regarding the benefits system and by directing them to appropriate financial support and befriending services. We network with other services to keep up to date with the local and national offer.
The whole team attend GP palliative care meetings and are involved in a wide variety of teaching about our specialist roles, for example I deliver advanced care planning workshops.
What’s the best thing about the job?
For me, it is being able to support somebody at potentially the worst point in their life – to make a difference so the patient and family can enjoy the time they have left and not have to worry. Having that rapport with someone, often in their own homes, and at that point in their life is such a privilege.