Amanda Welsh – Adaptation: A Dosimetrists Tale

March 2020 is a date firmly set in all our heads but little did I know how, over the coming weeks and months I, along with the rest of the Physics Department, would have to adapt.

‘Hands, Face, Space’ three small words, but how would our team manage to comply with the new rules? Hands – well that was easy, we bathe in hand gel and are used to regular hand washing. Face Masks – to wear permanently on site? – we can do this! Space – the biggest challenge – not enough room to keep our colleagues at a distance.

However, within days of the new restrictions, several members of the team were dispatched to work from home. Me included, due to health issues. I had spent 27 years working for the NHS and now I was being told I could NOT come into the hospital. Could I do this? How would I be able to continue to do the best for my patients, manage my team and get through the workload all from home?

In the early days fear crept in. Did my team think I was drinking tea and watching TV? Were they aware of the hours sat in one position staring at a screen, no break as there was no distraction? Was I fully aware of everything happening on site so that I could do my job properly? Being out of sight, was I also out of mind? On top of this was the guilt for all the staff working on the front line. My colleagues seeing patients face to face, living with the fear of infection daily but soldiering on regardless.

Anyone working remotely realises quickly that the onus is on them to make it work. I set about embracing the change and continued to put our patients first. Radiotherapy planning is computer heavy work. In fact my IT husband thinks I spend more time on a PC than he does! Fortunately, our equipment allows for working remotely, but until now it had never been accessed in this manner. The physicists in the team worked tirelessly along with the IT department to set things in motion. Equipment was in short supply and high demand and had to be pulled in from all over. We quickly embraced Teams and those of us working from home found ourselves magically transported into the hospital where our colleagues still were. Hours spent planning could be discussed with an oncologist virtually. Real time conversations were held without the need for a phone. Peer review of plans could be done without concern that part of the team were off-site.

My dosimetrist team found on-site working more efficient, and were able to fit around each other to increase productivity. I was later able to spend some hours back in the department and the physicists adapted daily to ensure all of physics was covered, flexibility being the name of the game.

COVID meant extensive changes in planning and new regimes were speedily ratified. A reduction in patients undergoing surgery meant an increase in the number of patients needing radiotherapy. Many patients had the number of treatment fractions reduced, but each plan still had to be carefully calculated and checked. Cancer does not stop for COVID. The months rolled on and all the members of our team worked tirelessly behind the scenes, being an essential part of the radiotherapy pathway, even though many patients and some hospital staff have never heard of us!

Adaption became the new mantra – regular meetings paving the way for safety changes, new work patterns emerged, longer days for some – all to balance an ever changing environment.

Looking back over the last 12 months, what have I learned?

1) Change is okay and can work.

2) Flexibility of remote working has increased capacity.

3) With our radiotherapy patients always in mind, we have been able to adapt our way of working to harness the best in our staff.

4) I relish the social aspect of seeing my colleagues face to face, and seeing patients again brings a reassurance of what my job is all about.

With so much negativity around, has this period of adaption been a positive experience? A resounding Yes! Being able to work at home has given an efficiency like never before. Meetings are carried out on Teams so no time gets wasted. Many training updates and conferences have also been held remotely, helping to add to growth within the team. The positive impact has been felt across the entire department. The physicists have pushed forward with a Paperlite Project, reducing the amount of paper required during treatment & SABR (stereotactic ablative radiotherapy). Implementation has begun which at this critical time is fantastic.

It is a privilege to work for the NHS, I do not underestimate this. I love my job even if it is a huge challenge at times but I am proud to say I work hard to put our patients first and do the best by them. This year has been extremely difficult and really hard work but as a physics team we have adapted and thrived, even preparing to go live with a new technique – and we have most certainly not been held back!

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