The COVID-19 health crisis mobilizes professionals but also students.

Several of our students, whatever their training year, have been, are or will be mobilized to strengthen the healthcare teams. Thus CEERRF as a whole, is mobilized on the one hand, to ensure pedagogical continuity and on the other hand, to take part into this collective effort.

Guillain, a K4 student, shares his experience.

“The COVID-19 health crisis from an apprentice physiotherapist masseur point of view”

The text you are about to read is the vision of a student in the final year of physiotherapy, it reflects his perception of the events which occurred since March 12, 2020 in the intensive care unit of Foch Hospital.

The week of March 10, 2020 is the first one to have been so different from the previous ones. This week was particularly calm and did not really represent a classic week in the intensive care unit. She looked even less like those who were to follow. From March 12 onward, the service including 25 intensive care beds is emptied. It empties to welcome the “wave” of patients with COVID-19.

Tuesday, March 17, after the second speech by Emmanuel Macron, I am therefore preparing to face the dramatic situation of the service. It won’t be. Indeed, the services having been emptied, the intensive care unit takes care of fewer patients than usual.

On the other hand, one of the service units had been sized to accommodate “Covid” patients. So there is now a SAS to enter it in full dress as we can see in the photo (Casaque + FFP2 mask + cap + protective visor + gloves). This unit, I will not be going there right away, not this week. Indeed, the hospital needing to limit the use of gowns and masks, only M.Ds were allowed to enter in order to avoid a shortage. The service is also preparing to be completely modified in order to accommodate the maximum number of patients with contagious conditions. That week I would no longer be a real intern because I mainly do office and equipment moving. I am also reviewing the physiotherapy management of an acute respiratory distress syndrome because I have been informed that the patients who arrive will present this clinical picture.

From Friday March 20th, the recovery room and the surgical units are requisitioned to receive COVID resuscitation patients. At the end of the day, we go to see with my tutor the arrangement of these rooms so that I have an overview of the reception conditions to be more independent in my care from Monday 23 onward.

At first glance, it seems complicated to me to receive patients in such conditions and I doubt my ability to cope with such a situation. Indeed, in intensive care the rooms are very large and allow easy movement around the patient. In these rooms, the space between patients is limited and the machines take up a lot of space. The space we need to perform care is therefore considerably reduced.

The next thing that concerns me is the gathering of patients. Indeed, I do not see any partitions, only a room for 25 people, which does not allow them to enjoy the privacy they usually have in the intensive care unit. It gives me an impression of degraded care.

I then imagine that the overload which we will have to face, will not allow me to rely on the staff, which, until now, reassured me. This impression will prove to be false because the caregivers have been particularly supportive and understanding.

Finally, upon closer observation of these new resuscitation beds, I realize the size of the ventilators that are intended to be used on Covid patients. These are small and not the ones I used to use for acute respiratory distress syndrome. Indeed, we will use here artificial transport respirators to ventilate patients for several weeks. The latter do not have the same finesse in terms of adjustments and are therefore more traumatic for the lungs.

When I leave the rooms, I am very worried for the weeks to come and wonder to what extent we will be able to provide optimal care despite an unprecedented health situation.

The following weeks were complicated both psychologically and physically.

With my nursing colleagues, we put patients in the prone position to allow them better ventilation. It is therefore a question of turning them regularly (every 16 hours) to observe if an improvement occurs with the medical and paramedical care provided by the teams.

I then have the impression that my work is not very varied because I carry out passive mobilizations in the chain without having the time to know the patient’s file.

It is extremely hot in our suits and behind our masks and visors. It is difficult to recognize colleagues which complicates communication. The days are long and exhausting.

Fortunately, this type of care and days come to an end and some patients wake up; for some they spent several weeks in an artificial coma. The physiotherapists in my department and I mobilized them every day in this coma so that they lose as little muscle as possible and their joints do not get stiff. Most progress quickly and leave the service fairly quickly. It’s disappointing to see them leave so quickly. Usually we have time to start their rehabilitation, not this time. Space must be made available for potential future patients.

There were also nice things: the quantity of cakes and drawings from children which now cover the walls of the well-neglected laying room. But also and above all the healthcare teams who stick together as they are medical, paramedical, self or household or reception, the entire hospital is running at full speed with the same goal: to treat the maximum number of people in the best possible conditions.