I am the neonatal physiotherapist on the unit at Somerset NHS Foundation Trust.
At the beginning of the week I start my day joining the ward round on the neonatal unit. This is an important part of the day for me as it’s when I gather information about the babies and whether they are likely to need specialist developmental support whilst on the unit and also on discharge home. Some babies are at a higher of risk of movement or developmental difficulties because they have been born very early, experienced problems at birth, have problems with their joints or muscles or have underlying conditions. During the ward round, I check with nursing staff and parents whether the baby needs any extra support with their developmental care needs, for instance positioning and handling, and that parents are being supported to carry out any developmental care e.g. skin to skin. For those babies that are at higher risk of neurodevelopmental difficulties I will undertake a movement assessment by videoing the baby’s movements. This is called the General Movement Assessment and it analyses the quality of the baby’s movements to help plan ongoing therapy needs. I may also carry out a neurological assessment that involves handling the baby to assess tone, reflexes, movements and how they tolerate handling. For those babies who may need early support for their development I will provide an individualised physiotherapy programme. I will go through this programme with parents so that they have an understanding of what support their baby needs and why, and support them to carry out the programme as part of the baby’s daily care routine. I will regularly assess the babies and review these programmes according to the baby’s and family’s needs. I am available for parents whenever they want advice regarding their baby’s development and, as families are preparing to take their baby home, I will meet with them to advise on activities to help promote their development. Once a month, at the end of the morning, I will provide input to our neonatal graduates group. This is a group for babies and their families who attend, post discharge, to gain advice for their babies development and feeding and also for peer support.
Lunchtime is usually when I try to attend teaching sessions, catch up on emails or do my administrative tasks. Neonatal physiotherapists often work as a sole professional on a neonatal unit so it’s really important to make sure I keep up to date with all the latest changes and advances in the neonatal world. Even though I have been a physiotherapist for over 30 years I still learn something new every day, either from my work colleagues, families or the babies themselves!
After lunch I either join the neonatal follow up clinics or have a neonatal physiotherapy clinic. The neonatal follow up clinics are for babies who need monitoring on discharge, this could be for medical and developmental needs. All babies grow and develop differently, and it is important that we spot early those that might need extra support, for instance with their development or feeding. In the clinic I will look at how a baby is developing and check that they are keeping up with their milestones. If they are falling behind a little bit in their development I may provide some extra activities to carry out at home or give them an appointment to come to my separate physiotherapy clinic for more intensive developmental input. If it is likely that the baby is going to need longer term input for their development I may refer out to my community therapy colleagues who will continue to provide therapy support in the community, either at home or in their treatment centres. Some babies will continue to come to the clinic until they are 2 years old and, around their 2nd birthday, they will be invited for a detailed developmental assessment, called the Bayley Assessment. This assessment looks at all areas of development including learning, language and motor skills.
I really enjoy my job and feel very lucky to be able to work with families and babies and be part of their neonatal journey. It is also great to be part of a multi-disciplinary neonatal team that feels like an extended family!