John Tiernan, senior clinical engineer, Enable Ireland Disability Services finds his time split 50:50 between engineering and clinical assessment
My background is mechanical engineering. The service I work for is called the Eastern Region Postural Management Service. There are about 12 of us in the facility, which is a division within Enable Ireland.
I'm very lucky - I cycle to work so I avoid the stress. I'm based in Sandymount and living in Mount Merrion. I wear two hats - a clinicians hat and an engineering hat.
It is a quite unusual job and people wonder what the connection is with engineering, but when you're in it, it becomes quite obvious.
My time is split 50:50. I have two designated clinic days and on those I tend to see three to four people. Also because my caseload has been primarily a school caseload so we have to fit in with the school day, so there are a lot of constraints.
With my clinician's hat, I'm involved in the assessment of need, the specification of requirement, the selection of product and, where necessary, the design and manufacture of custom-made devices for people. I'm involved in fitting those devices, setting them up and configuring them, issuing them and making sure people understand how they function, why they have them, how they operate and what the limits are. Then I follow-through six months down the line to see if the equipment is still suitable, whether it's achieving the stated goal.
The majority of service users, who visit us have cerebral palsy. When someone comes in, we assess their requirements by sitting down with them as a multi- disciplinary team comprising a physiotherapist or an occupational therapist and a member of the ERPM team.
I'm consulted on the more technical aspects. Having decided on a mobility base, we then move on to the seating and we do a physical assessment for the individual. We're also looking at their range of motion and their pelvic position because your position is dictated by your pelvis when you're sitting.
We focus on the the person's pelvis, its flexibility and whether we're trying to correct it. If it's a child, generally we are. Or if there is a fixed deformity there as a result of asymmetric tone, as can be the case in an adult, we look at accommodating that.
What we are striving to do ideally is to reverse the situation but frequently, at best, to prevent any deterioration and it has to be done in conjunction with their lying position as well which is something that's only coming to the fore in recent research.
The clinical work spawns a whole lot of paperwork of itself, so the two days frequently go into three. Directly linked to the clinical side is our information resource. I've three lever-arch folders on manual wheelchairs alone, two on powered wheelchairs and that gives you an idea of the amount of product that's out there.
On the engineering side, a huge bulk of my work to date has been to ensure that our services conform to the European Medical Devices Directive, which came into force in 1993. That took up the majority of my first two years in the service, putting in systems to see that we comply and then meeting with the Irish Medicines Board who are the enforcers of that regulation to ensure we are doing everything we are supposed to. A lot of what I was doing initially was retrospective design, i.e. drawing up design documentation for what we already do. Only in the last year I've been able to come up with prospective design, holding design meetings to try and improve our product and look at our materials and designs to see how we can make things better.
I love it, I really do. It's what gets you out of bed in the morning. Unlike many engineering jobs where you're working on a project for six or nine months and then it takes another five months to see the fruits of your labour, when we've done something for someone you see it straight away and it's daily contact with the client which is really nice.