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‘We Give Patients Their Voices Back’: The Speech Therapists on the COVID-19 Frontline

Intensive Care Unit

I lead a group of NHS speech and language therapists at St Thomas’ hospital in London. I decided to become a speech and language therapist because the job is so varied. But I never thought it would lead me to the centre of a pandemic.

My profession is often misunderstood and the name doesn’t do justice to everything we do. Our role in the response to COVID-19 has been vital; we have been in the thick of it, treating patients with coronavirus in intensive care units (ICUs).

We are there as patients are woken up after being ventilated. The look of terror in their eyes is easy to see. The tube that has been down their throat to keep them breathing has been replaced by another, a tracheostomy, and they can’t say anything. They are frightened. Often they don’t realise what is going on. They may have come into hospital with coronavirus feeling a bit unwell and then gone downhill very quickly. There are no relatives with them and they’re surrounded by people in full personal protective equipment (PPE) who look like Martians.

Our job is to help patients in critical care who have difficulty swallowing and eating, and who need help weaning from tracheostomy tubes. The bread and butter of what my team does is helping people return to eating and drinking. A huge number of patients who are ventilated lose the ability to swallow safely. When that happens, food and drink go into lungs instead of the stomach; it’s a big cause of pneumonia and death.

We also help people to communicate and establish a voice. Sometimes when they wake up and have a tracheostomy tube in, we’ll give them a whiteboard to write things on, or we’ll use charts with letters and pictures they can point to. When the tube comes out, swelling in their throat or damage to the voice box means they can’t speak. We give people therapy to get their voice back.

We knew COVID-19 was coming, but it still seemed to happen overnight. The first British super-spreader was treated at the hospital and within a couple of weeks, we were treating patient after patient with coronavirus. We have a massive ICU and tripled our number of beds to meet the need.

Wearing PPE constantly is exhausting, hot and sweaty. The number of COVID-19 patients has declined but the virus is still around. We treat everyone as if they might have it and we have to be on alert for a second wave. It feels like now should be the time when the B-team comes in and gives everyone time off to regroup but we all have to keep going. We’re in masks all day long. That’s our new reality and it’s really difficult.

We’ve helped patients who could barely swallow their own saliva be able to go home, eat and drink and communicate with family. That is our achievement and we need to carry on. At the same time, it’s frightening because there are still deaths every day.

by Sarah Johnson


Courtesy of Guardian News & Media Ltd. This article was originally published in The Guardian.