A day in the life…

That was an interesting day.

I drove over 40 miles to sit in a room by myself. It was, in a way quite sad. I tried not to think about (except I obviously did, hence this post). I had enough things to do: emails to respond to, colleagues and parents to call, reports to write and correct and catch up on some CPD (yes it does happen sometimes). It just felt weird to have no meaningful social contact with real actual people.

In all the days of these strange and interesting times this has certainly been one of the strangest and not one I’m interested in experiencing again.

The highlight of my day was joining the MS Teams meeting in the late afternoon. Even then it was strange talking to the screen that had kept me company all day but at least it ‘talked back’! It was however so nice to see some of the faces of my colleagues.

I’m still getting used this video conferencing business. I mostly have my camera on but microphone off, but I have learnt over the past few months, that it is not possible all the time for everybody, including me, to have the camera on. I found it necessary to turn off the camera and mute myself while eating. Nobody needs to hear and see me crunching away!

I never thought that I’d hear myself thinking ‘I miss my work colleagues’ but I really do though. Some I have not seen since March, that’s an awful long time. I set up a WhatsApp group for my colleagues in March just before the lockdown, partly born out of a team feeling that we needed to communicate better, but also at the time I could see our lives were going to change quickly and it would be beneficial share information – we are, after all stronger together. I have to say, for work it’s been a lifesaver. Being able to ask a quick question (and get answers) or at the beginning when COVID-19 was ‘new’ sharing information and data was so helpful. Now it is a way of sharing news, pictures, and reminding us of our shared humanity. Also now we have no excuse to forget each other’s birthdays!

Two of my colleagues I saw last Tuesday. I was so happy to see them! We went for a short walk around the building. It turns out that there is a small wood behind my place of work. How did I not know that? I been there almost three years. I thought it was just houses and a few trees. I live and learn. I loved the walk. Just hearing my colleagues voices was like music to my ears (maybe I’ve been home too long!).

I digress, I finished my day, just after 5pm but then had to run around looking for keys to cupboards and try not to subvert the one way system, even though I was the only clinician in the building. I did what I needed to do and left. I’m not back until next week now.

The drive back home was good, I listened to an old August 2017 playlist:

Yes, that was me in my red car, zooming down the M1, singing ‘What a Feeling’! By the time I reached London, I’d got as far as Supertramps – Give A Little Bit. It’s an uplifting playlist for me.

Nacho was in when in got home and made me this delicious sandwich.

Tomato, pepper, mozzarella and avocado

Well, tomorrow I’m working from home. So I am least spared a commute before I sit at look at my screen all day. It’s my last working day before I have a few days of annual leave. I. Cannot. Wait. Work, as great as it is, is starting to get draining now and I’m mentally exhausted.

Next month we are planning to start seeing patients face to face again. It’s another level of stress that I’m trying to be rational about. We have been planning and preparing – well the team around me (and they have done an incredible amount of work) – and so it should be fine. And in some way regards nothing has changed since I last did a full clinic in March. What has of course changed is the need for PPE and procedures for infection control, maintaining the safety of our patients, their families and ourselves. Throughout the lockdown my colleagues and I have continued to see some patients. While some of the patient facing services just stopped and were deemed non-essential, our child protection work continued. After an initial ‘quiet’ phase we just got busy and there are still a stream of continuous and regular strategy meetings and child protection medicals. Yes, as the statistics have shown us, lockdown has placed the most vulnerable in our society in some incredibly challenging situations. In the cases that I have been involved in during this time, it is also clear just how important schools are will continue to be in supporting children on so many levels. We need to be clapping for teachers, Every. Single. Day.

I’m looking forward, in someways, to meeting with my regular families. Telephone reviews have their place but for the work we do, it’s only part of the story. We have all found that taking part of the history in a situation where one does not also have to be observing and making simultaneous notes on the child, to be insightful and helpful. Also for parents, those who could take calls separately from their children, it felt easier to talk about their worries without the child listening in. Better focus all round.

The next natural step for these remote consultations is video consultations. We have been getting more skilled in conducting video consultations. There is a definite etiquette involved in this process and guidance for medical professionals in this area. I’ve done 5 now, one including school staff in ‘attendance’. I have been part of a case conference and core group meeting online. It’s certainly something that has helped our services and I’m sure something that is just going to stay. I have in the past driven 20 miles in the working day to attend a multiagency meeting. That I’m sure will not be a thing of the future. I suspect even if we do start having face to face meetings the option to attend virtually by video will always be a credible and achievable option now. We’ve being doing teleconferences for years. Where I worked before in London, they were already doing video conferencing quite effectively for some of the inter departmental meetings. And I actually remember it from medical school – video lecture while sitting in the Whittington Hospital.

Technology, however will only take us so far. One of the challenges has been thinking about how are complete our social communication (autism) assessments in a time when we are meant to be socially distancing and all the limitations that this inherently brings. I have learnt that assessments can be completed in creative and flexible ways. It has been interesting to listen and take part in discussions on this. It’s new and we are still learning. I have done so much online training and work, I’ve written it up and added to my CPD folder (appraisals will happen again one day). I am certain we will be tweaking and adjusting as we go along.

The next thing will be getting through the waiting lists…

The resumption of face to face work will of course mean for me, the return of the ‘commute’. I’ll be in at least three days a week. I’ll have to work hard to prevent the exhaustion and burnout that plagued me in the past.

I will have to learn to pace myself, I don’t always get it right even though I’m sat in my own home. It’s not so much the length of time that I work that is a problem, it’s more that way I work. I should take more breaks in the day. I found that doing telephone clinics, it was quite possible to sit in my chair for from just after eight in the morning up to one o’clock in the afternoon. How on earth? Clinic preparation, back to back calls, meetings. Then I’d get up and raid the fridge for something sweet and liquid (orange juice in my case). The back to the laptop again for the afternoon session, writing up the morning clinic notes, dictating letters, chipping away at the never ending tasks and reviewing the piles of electronic correspondence. It was and is easy to feel that one should work somehow harder because of being at home. I’m not even sure about the origins of such unhelpful feelings.

Coming back to the work building I guess, I will get up between patients , leave the clinic room, go to my office, take a breathe. Talk to people. I’ll also have to be reasonable and realistic about what I can do in one working day. No staying late. I probably should not aim to have the security guard asking me to leave because the building is about to close. This sort of ‘behaviour’ is not something I can afford to continue. If I have learnt something, or at least, not learnt but I am reminded that I need to value my health and well-being. If I don’t do that, I can’t help anybody else around me.

Yup, phase 3 of our ‘new normal’ is upon us…

Well, that’s all for now. But you know there’s always more 🙂

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