The Royal Marsden Children and young people

A day in the life: Michelle Payne, Specialist Paediatric Physiotherapist

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Based in the rehabilitation room of the Oak Centre for Children and Young People, Michelle helps young patients to regain their mobility during cancer treatment

I have worked at The Royal Marsden for more than 17 years, and I can honestly say that there is nothing that can compare to working with a child – who may have been confined to a bed for a long period – and seeing them regain the skills to take part in activities that they enjoy.

I’m based in the therapies room on the ground floor of the Oak Centre for Children and Young People, along with a speech and language therapist, dietitian and occupational therapist. We see patients aged from one to 14, and meet regularly to discuss their progress. I see patients either in the therapies room or at their bedside, depending on their level of mobility.

Bright and positive

When patients first come to the therapies room, they are usually quite nervous, as they are used to going to different parts of the hospital for radiotherapy or surgery. But the room is a very positive environment – brightly decorated and filled with wonderful sensory toys and games – so patients usually love coming back for subsequent visits.

I feel strongly that physiotherapy should be patient-led: setting goals with them and their parents to maximise their abilities, and enabling them to have the best possible quality of life. At The Royal Marsden, physiotherapy is one part of their treatment where they can be given a choice. If a doctor says a patient needs chemotherapy, surgery or radiotherapy, then that is their treatment plan – but I can empower them with choices.

I try to tap into what makes patients tick so they don’t feel pressured. If you ask a child to stand up, they will try really hard to do that one task – often in an unnatural way, because they know you are looking at them. But if you ask them to get their favourite toy, positioned just out of reach, with appropriate support they will stand without thinking.

It is incredible to make a positive impact on a young patient

Group therapy

Most of my work is on a one-to-one basis, apart from on a Tuesday, when I run two age-appropriate group sessions. In the morning, I run jigsaw for pre-schoolers. This is a chance for them to take part in a group activity in a non-hospital environment – they have the space on the floor to crawl and play while parents chat, with the therapy team monitoring the child’s development.

In the afternoon, in conjunction with the teachers from the schoolroom, I run a PE class for school-age children. It’s an opportunity to build up strength and maintain skills. After this, I attend the multidisciplinary meeting with clinical staff from the Oak Centre, where we discuss our patients’ treatment plans. This really helps me prioritise patient referrals and makes me aware of the input from the rest of the team.

It can be emotional for parents when their children come to me – they have watched their child go through so much treatment, and this is a positive step in their recovery. But it is incredible to make a positive impact on a young patient – helping a child get back on their feet during cancer treatment is one of the most rewarding parts of my job.