Catherine Moffat is a specialist physiotherapist in the Breathlessness Intervention Service (BIS) in Palliative Care. She joined CUH in 2003 when she felt she needed a bigger challenge. Here Catherine tells us more about her 20 years at CUH and 24 years in the NHS and how things have changed.
What is your name and your role in our hospitals?
My name is Catherine Moffat and I am a specialist physiotherapist in the Breathlessness Intervention Service (BIS) in Palliative Care. I support people who have chronic breathlessness, no matter what condition is causing the breathlessness. As palliative care encompasses symptom management, the patients I support may, or may not, be nearing end of life.
What do you enjoy most about your role?
There is so much to enjoy, where do I start!
I value working with wonderful, supportive colleagues, having the ability to make a real difference to the lives of the patients and families I support, and having the opportunity to be involved in teaching and research.
Tell us a bit about your CUH journey.
I have worked for the NHS for 24 years now since training at the University of Hertfordshire. I first came to Addenbrookes in July 2003, just over 20 years ago. Prior to this I had worked at West Suffolk Hospital in Bury St Edmunds. I loved the close, supportive, family feel of working in a small district general hospital, but after three years of working there I found I was repeating rotations and working on the same wards again. I felt I needed a bigger challenge, and so I moved to CUH in 2003.
I was initially a full-time rotational “Senior II” as it was then known (now Band 6) rotating through the in-patient wards. I later became the team lead for the medical physiotherapy team. In 2009 I went part-time after coming back from maternity leave. I ended up covering another physiotherapist’s maternity leave in BIS. The physiotherapist I was covering decided to move aboard and so I stayed in the BIS by happy accident. However, I also continued to work weekends for the physiotherapy department, providing respiratory physiotherapy and post-surgical rehabilitation, until 2021.
Why you like working at CUH?
I love the team and the department I currently work for.
I feel having supportive and caring colleagues is the main reason I have stayed at CUH for so long.
Working in BIS, within palliative care, allows me to spend time with my patients, and their families, and focus on what is important for them. I also love the variety of work within BIS from teaching on study days, including teaching abroad, being involved in research, writing papers and even a book, as well as having the opportunity to undertake a professional doctorate.
What does a usual day look like for you?
BIS usually supports people in their own homes. I drive from my home in Essex to my patient’s homes, spending around an hour with them, providing advice and support for the self-management of breathlessness. We always carry hand held fans to give to patients, as cooling the face eases breathlessness. I teach breathing techniques, positions of ease, anxiety and frustration management, and exercise. I also consider equipment that may help and any social issues, as well as supporting the family. I feel I have morphed from being a physiotherapist to being a hybrid of a physiotherapist, occupational therapist, psychologist and social worker. My lunchtime is usually spent in a supermarket café or car park. The back of supermarket car parks at lunchtime are full of travelling workers eating lunch! Having the opportunity to listen to audio books as I drive from house to house is a perk of the job.
Tell us about a case study/experience at CUH that really stands out to you.
During the first wave of the COVID pandemic, like many others, I volunteered to work full-time on the intensive care units. We weren’t allowed to do any home visits in BIS at that time and I felt my acute skills could be best put to use elsewhere. As physiotherapists we worked 12 hour shifts, initially sometimes covering nursing roles looking after ventilated patients, although later our roles returned to more traditional physiotherapy respiratory and rehabilitation work. It was the hardest three months of my life, emotionally and physically. The colleagues I worked with, across professions, were amazing. Their resilience, adaptability and compassion shone through. We were in it together, we supported each other, and we never gave up on any of our patients. We tried our very best for each and every one.
How do you feel your role benefits our patients?
Breathlessness can be frightening and very disabling, impacting the person who is breathless, as well as their families. Although we spend a long time with patients, we may only visit a few times, however the long sessions allow us to “go deep” and get to the bottom of the complexity that is chronic breathlessness. We help patients, and their loved ones, feel less anxious and gain a sense of mastery and confidence in managing their breathlessness. I have helped patients gain the confidence to attend pulmonary rehabilitation, when they had previously refused, to be able to walk in the park or their garden, take a bath or shower by themselves, reduce reliever inhaler overuse, and even reduce 999 call outs. Our service also reduces admissions to CUH, and so hopefully takes some pressure off of the main hospital, which I know is vital.
What is the most notable thing that has changed at CUH in your time working here?
A few things actually. One being electronically held patient notes. Before Epic arrived in 2014 I would have to request a patient’s notes from medical records and look through these before seeing a patient for BIS. Sometimes I would be given three thick volumes of notes to look through. When I started working as a physiotherapist x-rays were on film, which we viewed using light boxes on the wall.
Finding patient’s homes using printouts from Google Maps prior to SatNav was a nightmare!
What is the most notable thing that has changed in your profession/career in the years you’ve worked in the NHS?
The speed of throughput through the hospital has increased tremendously. For example, when I started working for the NHS in 2000, if a person was to undergo surgery I would meet them the day before to teach chest clearance and how to get out of bed post-surgery. The day after surgery they would sit over the edge of the bed and then get back in. The next day I would help them to the chair. The third day they may walk a short distance. Now patients are up and walking on day one. I feel this is down to progress in pain control.