The COVID diaries – adjusting to the new normal

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We catch up with Anne- Marie as she navigates the tricky working terrain in a post-COVID world

Tuesday 1st September

My Google Analytics report appears in my inbox. I can see that there was a spike in interest on my website around the 20th August, when I had just finished writing my session guidelines. Most of the visits to my site were from the UK however a fair few were from the USA, then Belgium, Canada, Italy and strangely, Tanzania! People either found me directly or via Google or Facebook.

Today, I update my social media with my availability for next week, I update my Facebook business page, Twitter and also Google My Business (good job I had checked this as it still said that I was closed).

Wednesday 2nd September

I emailed my client due on Monday to remind her about completing the medical history form and obtaining the GP clearance.  I then spent the afternoon cleaning and prepping the clinic ready for the practice session with full PPE tomorrow – I set up the couch with the sheets and the PVC couch cover. I got the wipeable pillow out and put a pillow cover on this too. I cleaned the whole room and wiped down doors, skirting boards, vacuumed, laid out my uniform ready to wear and followed the session checklist to ensure that from the clients arrival, I am following the procedures that I had written.  I printed out a poster on how to put on and remove PPE properly and also a hand-washing poster as a reminder of how to do thorough handwashing before my “practice run” client arrives. 

Thursday 3rd September

Today I am doing a practice run to go through the timings, check out wearing the PPE, ensure that the medical forms are sufficient and run through the Session Checklist to ensure that everything runs smoothly.

FHT sent an email with an update on Returning to practice guidelines about clients in the high risk group: “There are two key changes we have made to our guidance when screening clients prior to treatments. If a client has previously had COVID-19, or is classed as clinically vulnerable, GP consent should still be sought, but if it cannot be obtained, it ultimately comes down to the therapist’s risk assessment. If a client is classed as clinically extremely vulnerable, then we are still strongly advising against treatment if GP consent is not obtained”. 

I will therefore update my Risk Assessment and ensure that I have a form that the client can sign if they haven’t been able to get consent but having done a full consultation we deem that a treatment would be beneficial.

I did the practice run and need to make a few changes. I need to have done as much form filling, cleaning and preparation before the client arrives so all I do when the client arrives is take their temperature, check they are wearing a face covering, show them where to leave their belongings at the entrance, ask them to use the hand sanitiser, check with them if anything has changed since they completed the COVID Screening Form 12 – 24 hours ago, take payment if required, and show them to the clinic room.

Friday 4th September

Today I spent yet more time on the forms… I had written the Session Guidelines but having done a practical session yesterday, needed to change the order of what was done when and I had also included the cleaning schedule on the Session Form but I realise that it would be better to separate it and have a separate Daily Cleaning Form to use and sign off.

I also updated the COVID Screening & Consent Form so that there is a paper copy for clients that may wish to do their form by telephone or if I was not able to access my online booking system and update the form that way.

I also produced a Therapist Temperature Record so that I can also monitor my own temperature. I also updated the paper Medical History Form so that it matched the online booking Medical History Form for continuity.

Today on the news there were different quarantine rules for England, Scotland, Ireland and Wales. This makes it quite confusing especially for therapists that may live on the borders of these countries.

My first client back confirmed she had GP clearance for her treatment on Monday – I was delighted to receive this great news! My first client after six months!

Saturday 5th September

Today I did another run through of the session – much better, flowed well and was more natural, and I felt happier that it felt more like how I used to run my business rather than a form filling exercise when the client arrives on the doorstep.  Had to buy yet more plastic containers but now I have plenty to store cleaning products in the clinic room, a box for client clothing in the clinic, another small plastic container in case the client removes their face covering when they lie face down on the couch (as I have a pillow case hanging from the face cradle instead of client wearing their face covering), and a plastic container for items they wish to leave at the entrance to the clinic. I also purchased a vinyl tablecloth to put over the bolsters that I use for reflexology, this works well as the cloth can be sprayed down after each use.

Sunday 6th September

First impressions are important so I spent this morning tidying up the front entrance, cleaning, weeding, polishing etc and making the clinic look nice again.  I bought some plants that match my colour scheme and these were placed outside the front door. I made up the couch ready for the first client on Monday, who is having reflexology and cleaned the clinic room leaving it ready for Monday.

I took some photos of the treatment room and the front entrance and posted on social media that I am excited to be opening tomorrow! Lots of good luck messages and excitement from clients and friends.  So pleased to be returning to work having been closed for six months.  I also sent a brief newsletter just to update my clients that I am open from tomorrow and looking forward to seeing them.

Monday 7th September

The big day has arrived! I wake up feeling excited and a bit nervous but overall pleased to be back to doing what I love. Looking at my Session Checklist, I just double checked that I my client had received the updated Session Guidelines, completed her Medical History & COVID Consent Forms and got GP clearance, check if they paid online or if I should do when they arrive and a final check that it is fine for them to have a treatment. I take my temperature and note it down on the Daily Temperature Record, I check that the box that I have at the entrance to the clinic has everything I need in it (card machine, client face covering if needed, my IIR mask, visor, non contact thermometer, client forms printed out and put on the clipboard and a pen available).

A final clean of the bathroom, main entrance and hall and I am ready to go!  I also had opened the windows in the clinic to air the room prior to the clients arrival. I put on my IIR mask and visor. I tie a knot in the mask ear loops to make it a better fit.

The client arrives, knocks the door and is wearing her face covering, I greet the client, having not seen her since March, but we had been in contact over email, I take her temperature, (three times, was not sure if the non contact thermometer was correct as it gave three different readings!) and eventually record her temperature. She leaves her belongings in the box at the door, removes her shoes, uses the hand sanitizer, we do a final COVID screen, nothing had changed since she had completed her forms online, and we go upstairs to the treatment room, having advised her not to touch anything on the way to the room if possible.  

I have done my mask up too tightly as by the time I had climbed 3 flights of stairs to the clinic I couldn’t breathe that well and my glasses and visor were steaming up so I had to loosen the mask slightly, which was under the visor. My glasses were also slipping down my nose and that combined with the fogging up of both visor and glasses meant that I couldn’t see the time on my really small alarm clock so I do need to come up with some sort of solution to this as its going to be an issue in the future! I think I need a band to at least keep my glasses in the right place so will research that later. Contact lenses would be a great solution here if only I could wear them without passing out!

Once in the room, I briefly discuss with my client what we will do in the session, based on her medical history form and what she had stated she wanted to focus on, and then we begin. I cleanse her feet, and using the wonderful Songbird Reflexology Wax, massage this into her feet and the session begins with a relaxing foot massage.  The windows are slightly open, there is background noise but nothing too much to worry about, and my client begins to visibly relax as the reflexology session proceeds. I enjoy doing the session and can’t believe it has been six months since massage therapists were told to close.  The time goes quickly and the session is over, I walk my client back downstairs where she books a further three sessions of reflexology, uses the hand sanitizer and leaves.  I feel really pleased to have started back at work doing what I love and it is a great feeling! I update the online booking system with notes from the session today and then check what is booked tomorrow.

Then I clean and reset the room ready for my next client tomorrow who is having a massage. I always set up ready for the next day as this means that whatever happens, the room is ready and I just have to do the cleaning prep.

Other enquiries are coming in so this first week back is nearly full which is fantastic, and a real morale boost. Having to close down for so long really affected my confidence and it is always a worry that clients may not want to return for sessions just yet. The messages of support from clients, friends and colleagues are much appreciated too as people know that this has been a difficult year.

Tuesday 8th September

Second client of the week and I was ready with a plan for wearing the mask and visor! I shortened the loops at the side of the mask by tying a knot, and then wound the loops around the frames of my glasses, securing my glasses in place and keeping the mask in position. I then put on my visor, and I had cut out squares of the foam headband to allow more air to flow, and also had the visor just slightly tilting forward. This did make a big difference but having researched further, lots of therapists mention using the visors that are worn with built in frames and no foam to be the best for not steaming up so will look into those when I purchase more in the future.

Wednesday 9th September

 I receive a government update: New measures to suppress the virus and keep the number of infections down. Prime Minister Boris Johnson has made a statement on new measures to suppress the virus and keep the number of infections down.

What has changed for businesses in England: Businesses will have a clear duty to support NHS Test and Trace. From 18th September, it will be mandatory for certain businesses to have a system to collect NHS Test and Trace data, and keep this for 21 days. Core COVID-19 Secure requirements will be mandated for hospitality businesses, and egregious breaches enforced.

I already have the NHS Test & Trace Consent on the COVID Screening Form so will amend the wording slightly to say that it is mandatory from the 18th Sept to collect Test & Trace Data. If clients won’t agree to this then unfortunately I will not be able to see them.

Thursday 10th September

I saw two clients today – one was a new client and the new session guidelines worked really well, the whole session went smoothly – apart from when a wasp managed to get into the treatment room when I was just 5 mins into the session – fortunately after coaxing it back out with the nearest item to hand (my professional industry magazine!) it flew back out but it did make me think that yes, we have to have the windows open as much as possible however there is the issue of insects flying in! So need to think how to deal with that should it happen again.

Another government update: Priority actions to take – what businesses need to do to protect staff and clients. “Five more things to be aware of if your business provides close contact services: Wear a visor and mask. Encourage practitioners to wear both a clear visor or goggles and a Type II face mask to keep their clients safe. Provide training on how to wear face masks safely”.

So therapists are now allowed to wear goggles rather than a visor! I am not sure that I will as I wear glasses and can see that goggles may steam up, but I think that this is a positive move as it is giving therapists the choice of what to wear. Personally, I think that just a face covering is enough, all my clients have said that I don’t need to wear the visor during their session but I have had to say that this is a government requirement so really I must wear it, however when I am massaging and the client is face down breathing into a pillow case fitted to the face cradle, it does make me think that my visor is completely unnecessary at times.

Monday 14th September 2020

Today I am doing a half hour back massage on a lovely elderly client, 85 years old, fit and well, plays tennis regularly and walks her dog.  She had obtained GP permission for a massage which is great and really enjoyed her session.  She had trouble completing the forms electronically in advance, so I did spend 5 minutes at the beginning of the session going through the forms with her.  Next time it will be quicker as it will only be the COVID Screening & Consent Form for return visits. 

Tuesday 15th September 2020

Today’s sessions went smoothly! As I have found that the amount of laundry has increased dramatically I have been looking at ways to reduce the washing. One really easy way was to remove the covering that is directly on the couch that sits on the wipeable couch cover, as I was changing this per client and the material was thick and took ages to dry. Instead I have put this cover underneath the pvc cover, then on top of the pvc cover am using couch roll. It doesn’t seem to affect the treatment and this has cut down on washing. Ideally I would like to use disposable sheets, similar to Enki Towels or similar as this saves on washing, and then I would only have to wash the throws, pillow cases and face cradle covers which does make a difference.

Taking time to reflect on the past week since opening, I feel that it has gone really well, clients have booked online, paid online in some instances, read and followed the session guidelines, know what they are doing when they arrive for their session and most importantly have told me that they feel safe coming to see me.  What hasn’t gone quite so well is the amount of laundry and time spent cleaning, so this will be refined over the coming weeks. 

As we follow Anne-Marie’s journey, we would love to hear your stories, too. Can you relate to Anne-Marie’s experience? Have you felt overwhelmed by the information available? What have you struggled with/? Please share in the comments and please sign up to become a member of PPH to receive industry news and updates.

We would like to stress that all information given in our COVID series is not exhaustive and while we have tried to ensure that the information provided in this document is accurate, PPH cannot be held liable for any errors or omissions. The COVID situation is constantly evolving and the information is changing on a daily basis. We urge you to closely follow your government, professional association and insurance company’s latest guidelines and updates, taking precedence over any recommendations communicated by PPH.