Attracting the brightest physiotherapists to CF care
We spoke to Nuala Harnett, the Principal Physiotherapist in the regional centre for paediatric cystic fibrosis in Newcastle upon Tyne. She talks about her years of experience as a physiotherapist and explains why it's so important to encourage new talent into this vital field with programmes like our new Clinical Fellowship for Physiotherapy.
Getting to know Nuala
"I’m Nuala Harnett, the Principal Physiotherapist working in the regional centre for paediatric cystic fibrosis in Newcastle upon Tyne. I am also the chair of the Association of Chartered Physiotherapists in Cystic Fibrosis (ACPCF). I trained in Dublin (my home town) and, once qualified, moved to the UK as jobs were few and far between in Ireland at the time. The one thing I knew was that I wanted to work with children, and I was very lucky to get a job at Great Ormond Street Hospital where I worked for eight years. I spent time in lots of different areas and then chose to specialise in respiratory care. I was the senior physiotherapist covering both paediatric intensive care and CF; very different areas. In that time I studied for a Masters degree in research methodology and my thesis was about airway clearance in CF. I moved from there to St Mary’s Hospital in Paddington London to work in their paediatric intensive care unit. However, I found that I really missed working in the field of cystic fibrosis. Sometimes you don’t realise how much you enjoy something until it’s no longer there!
Nuala’s inspiration and motivation
"I have always loved the long-term relationship you build up with families. I am constantly amazed by the children and their capacity to enjoy life despite dealing with a chronic condition, spells in hospital and deteriorating health. The physiotherapist isn’t always the most popular member of the team and you can hear the groans as you turn up in the morning to wake them all up for their first treatment session… You develop a thick skin in our job! Although they hate doing their physiotherapy, they do know how much it helps. I asked some of my teenagers to write down something about physio and these are two of the quotes I got back:
“Physio feels amazing afterwards and helps me breathe happy” – Chloe
“Sick to death of physio but it keeps me out of hospital” – Hamza
On the job
"For the last 16 years I have managed the physiotherapy CF service in Newcastle upon Tyne. We look after patients on the ward, in clinics and in their homes. I particularly enjoy home visits as you get to see children in their home setting where they are often more relaxed and you can get a better idea of reasons why treatment may be difficult to achieve. I get to meet their brothers and sisters, friends and pets and get a much better sense of their lives than in a hospital setting. I have also put my Masters degree to good use and research is a part of my job. I think it’s vital that we keep questioning what we do and striving to offer the best evidence-based care that we can.
"Having worked in this area for many years I have witnessed the changing face of cystic fibrosis. Our patients are so much healthier than 20 years ago and the adult clinics are growing by the day. Physiotherapy no longer just involves airway clearance; we are heavily involved in exercise, posture management, incontinence and sinus problems as well as pre- and post-transplant care.
"I get immense satisfaction from my job. Whether it is helping a parent deal with toddler temper tantrums, persuading a stroppy teenager to do some physio or exercise, encouraging them to achieve their full potential in life and working as part of a large multidisciplinary team.
The Fellowship programme
"I am very excited about the CF Physiotherapy fellowship. Currently there is no formal structure to the career path to leading a CF physiotherapy service. It has been noted by physiotherapists carrying out peer review that there is great variability in the skills and experience of the lead physiotherapist at each centre/network. There have also been issues within a number of centres with the ability to fill CF physiotherapy leadership posts with suitably skilled and experienced staff. This has led to the downgrading of some leadership roles. Also, progression within a physiotherapy career does not require movement through different hospitals and trusts unlike that of the medical profession. This can mean less exposure to different practices and cultures.
"This fellowship will give a physiotherapist the opportunity to gain experience in all aspects of CF care at a variety of adult and paediatric centres, spend time at the Cystic Fibrosis Trust, attend national and international conferences, complete a leadership course and a service evaluation project. At the end of the year’s fellowship, the successful applicant will have the required experience to lead a regional CF physiotherapy service. I really wish this had been available when I was starting out on my CF career!
Enthusiasm and dedication…
"I have always found that CF physiotherapists are incredibly dedicated to their job and the people they look after. Enthusiasm is always evident and I see that in the ACPCF all the time. Our committee is comprised of both paediatric and adult physiotherapists who give up their free time to work on projects, fulfil their committee roles and strive to provide the best service they can for their patients. I think that this enthusiasm shone through in our initial proposal for the physiotherapy fellowship and I am very grateful to the Cystic Fibrosis Trust for choosing our profession as the first allied health fellowship."
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