15 July 2020

Pre-reg during a pandemic - part two

Join Seraphina Yap, pre-reg trainee at PLM Optometrists in Scotland, as she reflects on her life as a pre-reg during the start of the pandemic with her supervisor David Cummins MCOptom DipTP (IP).

Please note: This series explores Seraphina’s journey from the start of the pandemic, and continues to present day.

Life during lockdown

“Life as a pre-reg trainee has changed completely. A week after lockdown, due to the unfeasibility of social distancing, pre-reg assessments were put on hold by the College until further notice. This came with a sense of relief. Since helping manage the front desk, I haven’t had a chance to sit down and focus on my pre-reg tasks. My typical day is spent on the phone triaging patients, doing contact lens tele-consultations and receiving referrals from GPs and optical practices. When I am not on the phone, I’m preparing documents for patient appointments, packing spectacles and contact lenses, and arranging collection appointments. A lot of time also goes into reviving mangled specs. It was quite a challenge to get these tasks done while having members of the public knocking on the door, and more calls while already on one!

“Having experienced being in the shoes of the optical assistants and reception staff, I’ve come to truly appreciate all they do to keep the practice running smoothly. It requires a lot of multitasking, energy, and patience to get through the day. Most patients have been very understanding and appreciated all the efforts we take to protect them and ourselves, but it is no surprise, there were a few patients who were frustrated with the new restrictions and protocols. 

“Life is different for David too. Before this pandemic, most patients we saw had healthy eyes. Since lockdown, our diary has been full with patients that have potentially sight threatening conditions. In the early weeks after lockdown, I remember the tense atmosphere whenever a patient arrived for their face-to-face appointment. In a bid to minimise contact time, small talk was kept at bay and only the necessary examinations were performed. David would dictate his clinical findings as I wrote them down onto the patient’s record sheets. It didn’t help ease the tense atmosphere when our masks obscured facial expressions, and the PPE made David look half chef, half surgeon! There was also an initial problem with the fogging up of specs, slit lamps and fundus camera lenses. Surgical tape to seal off the gap between the mask and face has been very effective in reducing this. 

“In the initial weeks, David would see between one and four face-to-face consultations a day. Each face-to-face appointment was accompanied by lengthy amounts of preparation work to ensure the benefits outweighed the risk of bringing the patients in. This included requesting medical summaries from the patient’s GP and collecting previous records from their optometrist. There was uncertainty of how the virus spread at that time, and coming out of the house could be very risky to these patients. At times, heartbreaking discussions had to be made with patients who were highly vulnerable to the virus. It was between risking their loss of vision or the possibility of losing their life. For David, each day was exhausting not just from the work, but from the sheer weight of problem-solving and decision-making required.

“Besides seeing patients for emergency eye conditions, David is also an optometric adviser. In this role he spends most of the day answering enquiries from other practices and having discussions with the Scottish Government Advisory Board, optometrists and ophthalmologists. After planning and discussions, Emergency Eye treatment Centres (EETCs) were set up across Fife. The EETCs were a handful of optical practices with IP optometrists who were the designated port of call for eye emergencies and essential eye services within the community. Optical practices, GPs and hospital eye services would refer patients to the IP optometrists in these EETCs for face-to-face consultations. Shared care of these patients has shown to be efficient and effective during these times.  

“With PLM Leven participating as an EETC, David worked on Wednesdays to Saturdays for face-to-face appointments, where optical practices that were not EETCs would refer patients with eye emergencies. Likewise, on the days that David was not in, I referred any emergencies to the nearest EETC. It was heartwarming to see the optometrists, GPs and ophthalmologists in Fife working together to get things going.” 

Read part one of Seraphina's journey.

Seraphina Yap is a Pre-Registration Optometrist at PLM Optometrists in Fife, Scotland. She currently works in an Emergency Eye Treatment Centre in Leven with her supervisor, David Cummins MCOptom DipTP (IP).

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