Reflections on Remote Working as an Ophthalmology Trainee

Working from home as an ophthalmology trainee was not something that I envisaged at the start of my training however, due to the COVID-19 pandemic, I quickly found myself having to adopt a new way of working. Busy shifts in eye casualty, subspecialty clinics and theatre were suddenly replaced with risk stratifying lists of patient appointments, carrying out video and telephone consultations with patients and taking on administrative roles to help with the set-up of the increasing use of video consultation clinics. Here are some of my thoughts and reflections about some of the aspects of remote working and what I learnt along the way.

Technology

The initial challenge I faced upon switching to working from home was obtaining remote access, a trust mobile phone (you don’t want to give  patients your own mobile number inadvertently!) and ensuring I could access the patient appointment systems. Once this had been set up I soon realised how much could be achieved from my front room. I also uncovered that becoming proficient in the use of the patient appointment system serves you very well by being able to quickly tell patients when their future appointments are booked, which definitely was well received by a number of patients. A lesson I learnt was never to assume a lack of proficiency in the use of technology by patients based on age. I helped with video consultations via the attend anywhere platform that were carried out smoothly by patients in their 80s and 90s, demonstrating the great potential for the wider use of video consultations in ophthalmology in the future.

How to manage remote consultations

Carrying out remote consultations was completely new to me and quickly I realised how different video and telephone reviews are from face to face clinic appointments. Firstly deciding upon an appropriate time to call patients was a new consideration for me, on more than one occasion I found myself waking patients up with phone calls between 9-10am, prompting me to often start calls a little later in the morning! I also found it very useful to develop a ‘script’ to begin remote consultations allowing me to introduce myself, explain the purpose of the consultation and set expectations for what patients could expect from me. Without being able to examine patients, history taking and communication skills became more important than ever and forming management and follow up plans without the benefit of examination findings was certainly challenging at first. This however has enabled me to develop and hone my history taking and communication skills which can certainly be neglected at times in busy face to face clinics. I made sure to allow an extra few minutes when talking to patients to address any concerns they may have had or to explain how we would manage their care moving forward. This was certainly rewarding and hopefully offered some reassurances, especially to patients who would normally have been seen on a regular basis within our service. 

Structuring your Day

Probably the biggest adjustment (and benefit) to remote working was no longer having to commute to the hospital and having a set clinic/theatre timetable for the week. This meant I needed to structure my day around remote clinics, list scrutiny and other clinical and admin tasks. This flexibility was extremely beneficial especially with the wide availability of online teaching and enabled me to attend more teaching than would have been possible prior to the COVID-19 pandemic. A particular challenge I faced with remote working was deciding when to finish for the day, especially when your place of work and home are the same, it can become difficult to make the distinction as to when your working day is over. Over the first few weeks I would often work later, but I soon set myself a fixed finish time in order to enable myself to relax and switch off from work. I did this by making a list towards the end of every day with any essential tasks I needed to complete before I finished working that day and other less urgent tasks which I could carry over to the following day. Once I finished work for the day, I would often go for a run or walk and I found this certainly helped me to switch off from work and removed the temptation to continue to work further into the evening.

My experience of remote working during the COVID-19 pandemic as an ophthalmology trainee has certainly given me a different perspective of working and has allowed me to develop a number of different and new skills. It has highlighted to me that as a specialty, we are able to manage a number of issues without need for face to face consultation. With the advent of video consultations this may be crucial if there is to be a ‘second wave’ of COVID-19 requiring a further reduction in face to face services. From a personal viewpoint even though I hadn’t examined physically examined in around 3 months, I was able to continue to be actively involved in patient care and learnt some invaluable lessons that I will take with me as I progress through my career​.


Invited Author

Stafford Sandsome – ST2 Ophthalmology trainee

Edited by Eyeducation


Previous Eyeducation posts


Leave a Reply