Leading by example through the pandemic

Anwar Hassan APAM, MACP—NSW Allied Health Professional of the Year

As a senior cardiorespiratory physiotherapist in the Nepean Hospital’s Intensive Care Unit (ICU), Anwar Hassan has made many contributions as a clinician, researcher and leader in the hospital’s allied health team.

Anwar’s many achievements in improving patient care and during the COVID-19 pandemic have recently been recognised at the NSW Excellence in Allied Health Awards, where he was named Allied Health Professional of the Year.

Anwar says that the need to be a good role model for his staff during the COVID-19 pandemic kept him going during the tough months of 2020 and 2021.

As team leader for the cardiorespiratory physiotherapists working in the ICU, he was on the front line of the pandemic and had to adapt quickly to the new ways of working with patients.

As cardiorespiratory team leader, he found that the responsibility to help the physiotherapy staff upskill fell to him.

‘When the pandemic started, people didn’t know much about COVID-19.

'Everybody was just looking at each other and expecting that someone would know something about it.

'I had to do a lot of teaching and training for physios and other allied health staff to work on the COVID-19 ward and in the ICU,’ Anwar says.

‘It was unprecedented.

'We didn’t know much about personal protective equipment and it was pretty intense to learn how to gear up from top to bottom and this varied between the wards.

'The main thing early on was the fear; everybody was very, very scared—even the littlest compromise was scary.’

In addition to getting used to working for hours at a time while wearing personal protective equipment, Anwar also had to educate his staff and himself about managing COVID-19 patients in ICU and on the COVID wards, using techniques such as proning, where the patients are flipped onto their stomachs to help them breathe.

He developed a pathway for early discharge and education for patients so they could go home on oxygen and he was involved in setting up a post-COVID-19 clinic.

He has also been working to establish new roles for allied health in a post-ICU clinic.

As a newly minted expert on working with COVID-19 patients, Anwar was also called on to help educate staff across the hospital’s allied health teams and even within the district.

‘I ran lots of sessions to educate the whole staff about COVID-19—explaining what people needed to know and clearing up the myths—to make sure that people felt more educated, more empowered and less fearful about working on the front line, treating the patients, because it was very challenging,’ he says.

Anwar has been a physiotherapist for 22 years, working mainly in cardiorespiratory physiotherapy.

‘I like the challenge in ICU because it’s very acute, it’s very interesting and even after 22 years it still makes me think.

'Working in acute care or the ICU keeps my brain ticking, which is what I like.

'And I like that you can make a difference,’ he says.

Prior to the focus on COVID-19 patient management, Anwar set up a new program at Nepean Hospital to reduce the length of stay and risk of ICU admission for surgical patients.

Called the Pre-operative Exercise and Prehabilitation Program, it has significantly reduced complications, decreased length of stay, decreased the risk of intubation and improved post-surgical outcomes and recovery in patients undergoing major abdominal and thoracic surgery.

‘The whole program is run from this hospital for people who are waiting for their surgery.

'They come to our program and we make them stronger and in better condition for surgery by putting them through two to four weeks of exercise at our gymnasium,’ he says.

‘There’s also a lot of education for the patient about the process of surgery.

'They understand about the postoperative complications; they know about their medication; they know about their physiotherapy after surgery.

‘We have had some fantastic results and by reducing the length of stay we are achieving pretty massive cost savings for the hospital.’

Anwar is working with the Agency for Clinical Innovation surgical taskforce to develop prehabilitation guidelines.

He is also contributing to clinical research while completing his PhD at the University of Sydney, where he is looking at the effect of using intrapulmonary percussive ventilation in the ICU.

Anwar says that winning the award is an honour and a big achievement, both for him and for the Nepean Blue Mountains Local Health District, one of the smaller health districts in New South Wales.

‘It means a lot to win this award and not just for me but also for people who supported me, including the hospital’s management team and my physio colleagues.

'Being an allied health professional and getting an award among 13,000 allied health workers in this state—it’s good for physiotherapy and it’s good for my health district.’

Cultural safety and COVID-19 vaccines

Cameron Edwards APAM—Aboriginal Allied Health Professional of the Year

At the recent NSW Excellence in Allied Health Awards, Cameron Edwards was named Aboriginal Allied Health Professional of the Year for his work at Blacktown and Mount Druitt Hospitals in the Western Sydney Local Health District with Aboriginal and Torres Strait Islander physiotherapy students, and as a vaccinator during the COVID-19 pandemic.

While at Blacktown Hospital, Cameron became aware that some Indigenous physiotherapy students were not having good experiences in their clinical placements.

He took the initiative, with the support of his manager, the hospital and the University of Sydney, to provide several third-year and fourth-year Aboriginal and Torres Strait Islander physiotherapy students with culturally safe and responsive placements, acting as a mentor to the students both during and after their placements.

‘I still have connections with those students; they ring me about things or ask me questions, so that’s really special,’ he says.

It’s just one of several Aboriginal and Torres Strait Islander-focused initiatives that Cameron, a Kamilaroi man who grew up on Dharug country in Sydney, has been a part of in his time at Blacktown Hospital, including the work he has done at the hospital to make Acknowledgement of Country more personal and less tokenistic and to provide culturally safe care to Aboriginal and Torres Strait Islander patients.

Cameron is also the host of the APA’s The Deadly Physios podcast series and a member of the Aboriginal and Torres Strait Islander Health Committee.

‘I’ve been invited to speak to different districts about Reconciliation and about ideas for how allied health can be involved in Closing the Gap.

'I think part of that is due to the podcast The Deadly Physios—people have listened to that and really enjoyed the format and conversation,’ he says.

One of the bigger projects in the past couple of years has been taking his newly acquired vaccination skills out to the Aboriginal community in Western Sydney.

‘During the pandemic, I put my hand up to help in any way possible.

'This included knocking on doors at Wentworth Point during an outbreak in one of the apartments, telling people to stay inside until they got swabbed,’ Cameron says.

‘They were non-typical roles for a physiotherapist.

'One time I did a nursing shift—I didn’t administer meds or anything like that, but I assisted the nursing staff, who were taking a beating during the pandemic.’

Cameron also trained as a COVID-19 vaccinator, working in the district’s vaccination hubs at the height of the pandemic in 2021.

This led him to provide vaccinations at Kimberwalli, an Aboriginal Centre of Excellence in Whalan that was repurposed to be a vaccination hub for the Aboriginal community in Western Sydney, with a lot of input from the community’s Elders to ensure that the centre and the vaccinations were delivered in a culturally appropriate and safe process.

Cameron says that part of making it culturally safe was providing plenty of explanations and education to the vaccine recipients and allowing them to proceed through the vaccination process at their own pace.

‘It was designed to alleviate concerns that the Aboriginal and Torres Strait Islander community might have about those kinds of mass vaccination centres.

'There was never a point where there’s no return, where they suddenly had a needle in their arm that they didn’t ask for.

'If you’re not comfortable, you don’t go to the next chair.

'It’s about having that conversation and answering your questions or concerns,’ he says.

‘I was the first one to vaccinate one of the Elders out there to begin the program.

'It was a very special moment for building trust in the local community.

'We talked for about 15 to 20 minutes beforehand about culture and about the vaccine and how it works.’

Cameron recently took up a new position at the Children’s Hospital at Westmead, where he is currently working in the paediatric intensive care unit, the neonatal intensive care unit and the respiratory wards.

He plans to continue advocating to improve the care and experiences of Aboriginal and Torres Strait Islander patients and their families.

‘It’s been one of my passions to support progress in health regarding our interactions with Aboriginal and Torres Strait Islander communities,’ he says.

Main image: Anwar Hassan (second from left) and Cameron Edwards (third from left) with other award recipients. Photo: Cameron Edwards.