Speak Out June 2020

A Victorian perspective

by Kimberley Knight

Royal Melbourne Hospital and Department of Education and Training Victoria introduced video conferencing for meetings and professional development. They also implemented telehealth services for selected out-patient consultations, particularly in the community therapy services team. Private practitioners are embracing telehealth platforms. “Some of my clients are immuno- compromised and this really was safest for everyone,” commented Chrystal Symons, of Chrystal Symons & Associates in Watsonia. “Clients who initially declined have come back and said that they would like to give telehealth a try and we have even taken on new clients. There’s no complaints so far.” Kirsty Lay, Director of Loud & Clear Speech Pathology in Doncaster East, reported many last-minute appointment cancellations. “Clinicians have had to think more innovatively. Telepractice has been exhausting and planning for sessions have been taking longer.” Kirsty predicts clients will resume face-to-face sessions when her premises re-open. They’ve walked a delicate tightrope between keeping themselves, their colleagues and their clients safe... The unique challenges of working on-site are best demonstrated by the efforts of the Royal Melbourne Hospital’s Speech Pathology Department. They’ve walked a delicate tightrope between keeping themselves, their colleagues and their clients safe, while striving to deliver essential services. “Clinicians are minimising travel between wards, and we are critically evaluating the timing and necessity of our assessment and interventions,” commented Maddie Gwynne. Speech pathologists at the hospital have further mitigated risk through collaboration with other departments. “We are fortunate to work alongside some incredible experts in infection prevention and respiratory medicine, who have guided us on which procedures are aerosol generating and are considered higher risk.” As a result, some clinical procedures have ceased (like FEES) and others, such as tracheostomy management, have been modified. At a recent meeting of the Western Melbourne Area, Department of Education and Training Victoria, speech pathologists welcomed the opportunity to connect while isolated. Using WebEx, they planned for professional development and service delivery while working remotely. Department of Education speech

When Premier Daniel Andrews declared the gradual shutdown of Victoria, what followed was a series of directives that have seen our day-to-day reality flipped on its head overnight. Restaurants became take-away only, retail outlets closed, then beaches and parks, and just when we asked ourselves, ‘Could it get worse?’, pubs closed. Observances like Easter and ANZAC day, where we come together as family, community, and country, were casualties of the pandemic. And what of NAIDOC week? Yet faced with economic turmoil, job losses and ubiquitous uncertainty, speech pathologists, professionally and personally, have stepped-up. We have—very rapidly— wrangled existing technologies and adapted our practices to tackle the myriad challenges of our new reality. And like speechies nation-wide, we Victorian speech pathologists, have our narratives of challenges, innovation and triumph. Very early in the pandemic, the Royal Melbourne Hospital prepared for what looked to be a dramatic surge in COVID-19 positive patients. They introduced social distancing while staying the course and delivering services. They staggered shifts to reduce the amount of staff working at any one time. Like many essential service workers, Royal Melbourne Hospital speech pathologist, Maddie Gwynne was also acutely aware of the threat poised to her family’s safety. “Many of us have chosen to purchase scrubs to ensure we are reducing potential transmission of the virus to our homes.” With school closures, many Department of Education and Training Victoria staff were sent home to work remotely, which posed a slew of new challenges. For some, working from home was welcomed. But the challenges of isolation have taken their toll. Many have struggled not only with new working arrangements, but with defining their roles, with playing teacher, day care worker, and parent in addition to executing their professional duties. Chrystal Symons, like many private practitioners forced to shut their premises and provide telehealth, is feeling the effects. “Schooling my own four children and being in Zoom sessions has been challenging. My kids are now understanding how this new work model looks!” For others it’s the opposite problem, with some young professionals desperate to stem the boredom. Older professionals are missing their families, forced to throw chocolates and other items for the grandkids into their children’s front yards, and wave and blow kisses from car windows. This remote working experiment has stretched our vocabulary too: COVID-19, social distancing, telecommuting, immunocompromised, remote learning, self-isolation. Then there’s telehealth platforms Zoom, WebEx, Coviu, Skype, and some of us heard ‘dongle’ for the first time. But familiar or not, staff have learned quickly.

Positive change and innovation June 2020 www.speechpathologyaustralia.org.au Speak Out 17