Ciara Cullen, chartered physiotherapist, tells us about her typical day.
I drop the kids to school en route to work — Luke (15), Ruth (13) and Una (11). If I’ve a multi-disciplinary team (MDT) meeting or an education meeting, I’ve an earlier start but, if not, the first half hour is usually given over to emails.
Clinic starts. I run five MSK rheumatology triage clinics a week, between the two hospitals. These run alongside the consultant rheumatologists clinic. I don’t operate in isolation — my clinic is embedded in the rheumatology service. I am the first point-of-contact for certain referrals — my job is to assess and triage people — which is assigning a degree of urgency in terms of onward referral. Physiotherapists cannot order X-rays or prescribe medication; however, by working in a supported environment alongside the medical team, investigations can be organised for the same day, if needs be.
In clinic, I see a range of musculoskeletal disorders. Patients can be referred with single- or multiple-joint problems. Following assessment, the patient may be referred on to the rheumatology team, to another specialty, if appropriate, or referred to a chartered physiotherapist for treatment. Some people want advice regarding appropriate self-management and appropriate, community-based exercise. Fear of pain can often be a bigger inhibitor for people managing a chronic condition than pain, so prompt access to a suitable healthcare professional can help people to remain active and improve self-efficacy.
I grab some food, before heading to the afternoon clinic.
Depending on the day, I may have a physiotherapy clinic in the afternoon. I hold two physiotherapy sessions a week, one in each hospital. The most common problems I treat are back pain and shoulder pain. I treat patients from my own MSK clinic and also patients post-fracture.
I also recently trained in injection therapy and this is a useful adjunct to treatment for certain, specific conditions. However, exercise prescription remains the mainstay of management for the majority of my patients.
I try to finish early two days a week, at 2.30pm, to be at home when my kids come from school. On the other days, I’ve a terrific childminder.
* Ciara Cullen is a chartered physiotherapist, musculoskeletal (MSK) rheumatology triage, Cork University Hospital and South Infirmary Victoria University Hospital.
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