I am currently on an outpatient’s placement. A 16 year old girl presented to the clinic post surgery following a # of the base of the 5th metacarpal. The injury came as a result of the client punching the wall after being involved in an argument with her mother. The physiotherapist treating the client introduced the client to myself and asked if she minded if I could perform a subjective examination. The client responded abruptly and commented “oh if she has to”. She attended with her friend who appeared the same age and her mother who remained in the waiting room. Initially I was taken back by the comment and how she had responded to the idea and laughed at her friend. I felt intimidated and nervous about completing the Ax as the client displayed a very negative attitude that suggested that she did not want to be there. The subjective Ax took place with very little compliance from the client with answers to the questions being ‘does it matter’ and ‘I don’t know, who cares’. I finished the Ax feeling like I had not accomplished the task adequately and felt dishearten on the responses I received from the client. I tried to remain professional and friendly and booked a another appointment with the client.
Speaking with the Physiotherapist after the Ax, I believed that the presence of her friend worsened the scenario. Further the PT stated that whilst making a hand splint for the client, she was very protective of her hand and constantly was saying ‘don’t hurt me, don’t hurt me’ which could suggest the client responding to be tough due to being placed into a vulnerable position. A suggestion for the mother to sit into the next session was advised.
It is valuable experience dealing with an array of different clients especially clients that are not compliant towards PT treatment. From this situation I now realise that it requires different and similar skills, such as conformity towards the individual client, integrity and remaining focused, to deal with a non compliant adult vs. teenager. I am also now more aware that showing that you feel confident in what you are doing, even though you may not feel 100% confident can build a professional rapport between you and the client.
If place in a similar scenario, I will try to be more assertive and direct with the way I approach the question, whilst trying to observe the methods that elicit a positive. It highlights that not all clients you treat will respond to you as a health professional in a positive way.
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1 comment:
I had a similar experience with a 17yo female in an inpatient ward. I found that whilst remaining professional, joking with the patient helped them to relax and tell me exactly what happened and how they were feeling. I think you did the right thing in that senario, just remaining professional and not showing your frustration is definitely important.
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