NHS Careers: Recovery positions

The NHS is crying out for more people to join the allied health professions. Here, three practitioners tell 'Careers Adviser' about what it's like working at the coalface
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The Independent Online

Liz Muir, 24, is a speech and language therapist based at Colchester Primary Care Trust

"I first became interested in speech and language therapy when I was about 17. I knew I wanted to do a degree, but one with a job at the end of it. My mum, who is a teaching assistant, mentioned that she'd worked with speech and language therapists and I liked the sound of what they did. To find out more, I volunteered at a local stroke group and the more I worked with people with communication difficulties, the more I became attracted to the work.

There were only about 13 universities that ran courses in speech and language therapy when I applied, and they all wanted experience, so I was lucky I'd done some. The course that I did, at De Montford University in Leicester, combined placements with things like the theory of language, human anatomy and physiology and counselling and psychology. It was hard work and long hours, compared to subjects that my house mates were doing, but it was enjoyable and easy to get a job at the end.

My first job was working three days a week with adults with acquired communication difficulties - people who had strokes, head injuries, motor neurone disease and so on. The other two days were spent working with adults with learning difficulties, and it was my job to train the carers how best to support their clients. I enjoyed the variety but became increasingly interested in strokes, so when a post came up on the stroke unit of Colchester Hospital, I went for it.

I was fortunate enough to get the job and I'm now part of the multi-disciplinary team, so I work with people like physiotherapists, occupational therapists, stroke consultants, rehabilitation assistants and nursing staff. The patients are people who, as a result of a stroke, have lost their speech and/or their ability to understand language. It's difficult when you have to explain to a patient and their family that they may never speak again, but you can often find alternative means for them to communicate - for example through gestures and drawing. Some people do get their speech back and that's really positive.

Some of the patients also have swallowing difficulties following their stroke. So another part of my role is to assess if people are safe enough to have food and drink, and very often, I recommend soft diets or thickened fluids.

Although I work in a team, I'm the only speech and language therapist, which can make me feel quite isolated. But there are five other speech and language therapists in the hospital, and we do meet up at lunchtimes to discuss things.

I think you need to be methodical, good at decision making and quite creative to do this job. In addition, you need to be highly motivated, a good communicator and happy working with a wide range of people.

If there's one message I'd like careers advisers to get across about speech and language therapy, it's that this isn't a job where you work with one person and make them speak posh! It's a very team-based role where you get to make a very valuable contribution to people's lives and their relationships."

Tahira Jabeen Razaq, 31, is a physiotherapy assistant at East Birmingham Primary Care Trust

"I saw an advert for a physiotherapy assistant in June last year, just after I'd finished an access course. My plan was to go on and do a science degree, but then the bursary was stripped so I couldn't afford it. Also, I rather liked the idea of the people side of being a physiotherapy assistant and the fact that it's an active job. I'd been working in admin for about 10 years since I left school and I didn't want to be stuck behind a desk pushing paper all day. I wanted to be hands-on and making a difference to people's lives. A friend who had gone on to work in physiotherapy also helped sell it to me because he was so enthusiastic about what he did.

It was pretty easy to get the job, even though it was the first interview I'd been to since leaving college. I think it was partly because I knew quite a bit about disability and I speak more than two languages - which helps in an area which is predominantly Asian.

Physiotherapy assistants assist physiotherapists in their clinics. In my case, I help run the exercise groups, which includes one for people with back problems and another for pain management. I also ensure all documentation is ready for clinics and I do the pre-ops - that is weights, heights and blood pressure before people go into see the specialist, as well as making sure they know what they're in for. I also help the physiotherapists in their one-to-one work with patients.

I thoroughly enjoy my job. Even when I am pushing paper around, I don't mind because you feel you're contributing to society. But the best thing is the work with patients, for example when you help them use a walking aid.

The exercise classes are great too. Many of the people who come on them have suffered with chronic pain for such a long time and we can't change their medication. But we can take them through a different route to help them manage their pain, and that is very rewarding. Often, they come in and say, "I can't manage the stairs" or "I couldn't possibly get to the shops." By the end of the six weeks, they are doing more than they could have imagined and they have far exceeded the goals they set for themselves at the beginning.

To do my job, I think you need to be a good multi-tasker, as well as a people person. In particular, you need to be able to put people at ease. There are downsides. Like any job in the NHS, you bear the brunt of staff shortages and patients not showing up. But overall, it's fantastic and I've just started an advanced diploma for physiotherapy assistants. It's a year-long course and once I've finished, I can apply for a job as a technical instructor, which is the next step up. That involves having your own case load, rather than being so dependent on the physiotherapist.

I'd like careers advisers to get the message across that physiotherapy isn't just a career for the middle classes. There are a lot more people coming into it who are working class."

Annette Cockfield, 26, is a dietician at South West Yorkshire Mental Health Trust

My first introduction to dieticians was when I went to see one as a child. I had inflammatory bowel disease and was naso-gastrically fed. I didn't give any more thought to it, but when I was about 15-years-old and I did a careers questionnaire at school, about five ideal careers came up for me, one of which was a dietician.

I read up on it and liked the fact that it was so medically oriented - in fact, you study a lot of modules with doctors such as pharmacology and biochemistry - but you don't have the long hours of a doctor's life. The other good thing about it is that you have time to really get to know your patients and you do quite a bit of psychological work with them.

The degree course was fascinating and diverse. It wasn't just about the study of food, but things like sociology, physiology, psychology and more.

Meanwhile, the variety of my placements made me realise how many areas you can specialise in as a dietician. My first placement was in the Pennine Acute Hospitals NHS Trust, where the general work gave me some good hands-on experience. Then my second placement was in a girls' overweight camp in America. I didn't agree with their methods, but that was good in itself because it taught me how not to work with patients. My final placement was at Chelsea and Westminster Hospital, where I worked in HIV and Aids.

It's only been four years since I graduated, but so much has happened in my career already. I started out working for Pennine Acute Hospitals NHS Trust, where I did my first placement. I think it was because it was familiar. There, I did community clinics in GP's surgeries. Because I was a basic grade, I didn't get very complicated cases, but nevertheless I saw a broad spectrum of people. Examples include people who needed help with reducing weight and those patients who needed advice around diabetes.

By chance, I was given some work in the local prison, which I was nervous about but soon found really exciting. That's where I first encountered eating disorders. I think it's because food is one of the only things the prisoners can control. The problem was that I felt out of my depth, so I spent a lot of time shadowing experts and realised that mental health and eating disorders was where I'd like to specialise.

That's how I moved to my current job where, as a mental health dietician, I cover the adult mental health ward. Much of my work is with people with depression. When your mood becomes low, your appetite often becomes poor, but when you lose weight that lowers your mood, so I work on helping patients get out of that viscous circle and build up their diet. I also see people with drug induced weight gain. Anti-psychotic drugs, in particular, can increase appetite and thirst, so I educate people how to manage it.

The work can be tough and there aren't enough resources to do the things we'd really like to. But when you help someone, it is incredibly rewarding.

I just wish people didn't think that dieticians are there to weigh people and discuss healthy eating and I hope careers advisers can help tell young people that. It's so much broader than that and the opportunities are endless. I had no idea when I chose my career that it would open so many doors - not just in the NHS, but on TV or in radio, working in companies and becoming self-employed.