Practical Placements with SpA: My University Experience Part 2

After discussing my previous post (Studying with Spondyloarthritis) with a friend over at the National Ankylosing Spondylitis Society's ASone, I have decided to write a follow up post about how I managed my arthritis on placement. 

Over my three year degree I completed 7 placements that lasted between 2 and 6 weeks (most were 4 or 6 weeks long) in a variety of settings. Over the placements, I was expected to develop my clinical practice and use increasingly advanced and appropriate treatments while under the supervision of a qualified physiotherapist. On placements I could do anything from giving advice, to heavy moving and handling, to facilitating normal movement patterns, to providing walking aids. While some of these were quite light work, others took a lot of effort and most placements involved standing for long periods of time with few breaks.

Earlier on in my degree, I really didn't feel comfortable telling my educators that I had arthritis and managed it myself because I didn't want anyone to think that I wasn't fit to work, or to be a problem. I generally changed the way I would work to manage what I was trying to do myself. When I started on Methotrexate in February 2016, I decided to be more open about my arthritis as I needed to tell my educators that I wasn't supposed to come into direct contact with active shingles infections on advice from my Rheumatology team. 

Initially, I was worried about how people would react; would they think that I could still be a good physio even though I have arthritis? Would my diagnosis put them off asking me to help out with any heavy manual handling tasks? I wasn't sure if I could handle people telling me to my face that my arthritis would stop me from doing the normal things required as a physio student so I decided to tell my educators in advance via email. I was always fairly brief about my diagnosis but I would give a summary of how my arthritis was affecting me at the time and if I needed any adjustments to be able to work. I would make sure to mention if I had any appointments or blood tests during the placement and I would also always copy my lead lecturer into these emails just to make sure that my University were aware of any issues (although I regularly kept them up-to-date) and to cover my back if anyone at placement did kick up a fuss. You can see an example of the emails I would send below:


It turned out I had nothing to worry about! All of my placement educators were absolutely amazing about my arthritis, and often would check if there were any patients with shingles on their wards and let me know so I could avoid these patients as per my Rheumatology team's instructions. We often wouldn't have a big conversation about my arthritis, and would just confirm that nothing had changed between when I had sent the email and my placement. When I did have small flare ups in peripheral joints while I was on placement, my educators were super at advising different positions that I could sit in or stand in to take some of the pressure off of my sore joints, which meant that I could still join in on the placement fully. 

Due to my profession, I was very fortunate that everyone had a good basic understanding of inflammatory arthritis and, therefore, didn't need any explanation on what inflammatory arthritis is. I think that if I was on placement outside of the healthcare field I would probably give a brief explanation of what inflammatory arthritis is to help my educators understand how it might affect me. 

I think one of the most important things for me having placements in a healthcare setting  was understanding what infectious diseases to avoid. I had quite a few discussions with my Rheumatologist, Rheumatology nurse and later my biologics nurse about what patients I could and couldn't treat as I hadn't been assessed for personal protective equipment and so wouldn't be able to treat people with Flu, TB etc.. I would then liaise this with my educators, and occasionally if someone had a rare infectious condition I would avoid being involved in their care until I had confirmed this was safe with my team. Since I have qualified and have been assessed for specific personal protection equipment by my Hospital Trust, I am able to treat all of the patients I couldn't as a student as I now have the appropriate equipment to limit the risk of getting that condition. 

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