31 October 2021

A day in the life of a Patient Activity Leader (PAL)

Judith Thomas Brown has worked at Blackheath Brain Injury Rehabilitation Centre for ten years. She was presented with her ten-year service badge by John Huntley, Hospital Director who congratulated and thanked Judith on her long service.    She has worked in many roles over the past ten years after applying for a rotational post, which saw her experience Physiotherapy, Occupational Therapy and then Speech and Language Therapy before settling in to the role of Patient Activity Leader. To acknowledge her long service, we thought we’d ask her about a typical day in the life of a Patient Activity Leader.

PALS  stands for Patient Activity Leaders.  At Blackheath Brain Injury Rehabilitation Centre there are currently two PALS, who support our patients with activities and trips out of the unit.  The role is very patient-focussed and patient-facing and involves co-ordinating patient activities so that each patient has a weekly timetable of planned activities.

What does your role involve?

‘When a patient is admitted they are seen by our Multi-Disciplinary Team (MDT) and their therapy and nursing care is planned and implemented.  When the MDT agrees that a patient is ready, I will then make an appointment to see them, and this can be as soon as two days after admission.  This is also dependent on when they feel they want to take on something else and when they feel up to it.  I will sometimes just say ‘Hi!’ if that’s all the patient wants at that time.  When they agree to see me, I will do an initial assessment and ask them about their interests and hobbies. This allows me time to get to know the person and form a relationship with them. We do not have to do an activity and sometimes our patients just want to sit and chat.’  Judith tells us that this is something she is naturally very good at!

‘This is a very busy role and we can see many different patients in one day.  All of the patients have one-to-one time with me and they can choose what they want to do.  We recently started to use our new big television to screen films for the patients as the cinemas were closed due to COVID-19.  We bought popcorn and soft drinks to make it feel more authentic.

The role certainly became more challenging due to Covid 19.  But we just need to be more imaginative with what we can do, like the cinema afternoons.  We will spend time keeping the patients’ spirits up, especially since they have not been able to have any visitors. Patients have said it’s just nice to sit and chat and play a game.’


‘We write up care notes and a preference assessment, which looks at patients’ past interests, which might have been playing cards or dominions, or going out for walks or cinema.  If people want to go out, we are ideally located in a great place for activities, like museums and the Cutty Sark.  We can even take a riverboat up the Thames. This is, of course, all dependent on the MDT and risk assessments that have been carried out and, taking into account the Covid -19 pandemic and the changes it has bought to our roles.  Once the activity has been completed, we will record what happened and how the patient was whilst doing the activity.’

What do you like best about working at Blackheath?

‘I have been here for ten years now and I think for me the best thing about working here is the people.  They come from all different cultures and backgrounds and I have been able to get to know them and learn from all of them. This has been really interesting for me, as I feel that I have worked in an inclusive environment where people, cultures and ways of doing things have been embraced. Most importantly this is a place where learning is held as a high priority.  It’s a learning environment, due to the diverse people that work here and those that have worked here. I would go as far as to say: “I do not need to travel the world as I have met the world here at Blackheath”.’

How did you find out about the role?  

‘I have a lot of experience in care and have worked as a community Re-enablement Officer.  I saw an advert in the Metro newspaper,  applied, was interviewed and the rest is history! What attracted me initially was the rotational position, which meant that I would get experience of Physiotherapy, Occupational therapy (OT) and Speech and language therapy (SLT).  I thought “Ok, now that’s some exposure and learning there!”  I was quite excited as I had never had experience of any of these professions before, so it gave me a bit of taster of each.  On starting at Blackheath, I went straight to the Physiotherapy office where I stayed for a year, as a physiotherapy technician. It was an exciting role and I must say, I learned so much in that first year.  I then rotated to OT where I stayed for a further year.  After a further two years in SLT , the rotation sadly stopped. I say sadly, as I was unable to spend any time in the Psychology department which I have to admit is an interest of mine.  I then took maternity leave and when I came back, I was offered this position in the PALS team.’

Did you get any special training?

‘I have had a lot of training, especially when working in SLT where I learnt all about communication and speech exercises, communication approaches and strategies. Working in OT, I learnt about task analysis – the processes you use when making a cup of tea for instance –  and assessing cognitive capabilities that are used in that process.   I use most of my past experience in my current role.  I think this is what has maintained my passion for the work I do now, as I have had a sound platform of experience and training that helps me support my patients.    I have to mention that I have just completed my Care Certificate, which has been a really informative and, at times, a challenging set of subjects that I think all people considering coming into care should think about.’

What, if anything, do you find challenging in your role?

‘I think my main challenge right now is keeping the patients engaged, when we cannot go out or have entertainers in. I think once we return to some sort of normality, things will improve again and then we will all have to get used to the new normal.’

What would your number one tip for new starters be?

‘I would suggest that you give things a go.  If you can do the Care Certificate then do so, and most importantly, communicate with your work colleagues. Ask questions and give yourself time to settle in.’

Author: Paul Chesnaye, Practice Development Nurse, Blackheath Brain Injury Rehabilitation Centre