Whilst on a placement recently in cardiopulmonary area there was a patient who had come in from a nursing home with shortness of breath and chest pain. On reading the patients notes I found out that the patient usually uses a stick and requires minimal assistance at the nursing home. It turned out the pt had empyema this was dealt with and the pt's lung function improved. When it came closer to the time when the pt was to be discharged i was to do a mobility review to determine what the patients previous level of function was and also what he was capable of now. The patient was very agitated and seemed like he wanted very much to leave the hospital, he refused to do anything and even with trying to motivate the patient to get up and moving he still wouldn't budge or comply with any request. I was not the only one to experience this either as the OT also had the same issues the patient was becoming quite the problem and was getting a reputation on the ward.
This lasted for a few sessions and after trying various things to get the patient motivated with no result i was beginning to become frustrated myself and thought if the patient wasn't going to move then how could i help.
On discussion with my supervisor we tried to think of ways in which we could get the patient to comply with our requests, i told the supervisor that the pt was just becomming more and more frustrated with his stay in hospital and then it clicked, we could use him going home as his motivation for completing the mobility review. On implementing this with the patient it worked and the patient although still agitated performed the review and could be dischared from a physio point of view.
For me this outlined how sometimes you must use anything you can in your disposal to get a patient motivated and i think by showing the patient that there was light at the end of the tunnel so to speak or by dangling a carrot in front of them (not saying that patients are donkeys) you can sometimes get a better outcome than with normal methods of trying to get a patient to comply to your requests. In future I think I will now be aware of this more and with the more stubborn patients i encounter i have a few more methods up my sleeve which i can use.
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2 comments:
Patients like yours are very hard to motivate. I have also come across a few patients who are quite similar. For me discussing with the patients their goals and then explaining exactly how your goals fit into theirs really helps. However the elderly seem to be very hard to motivate so I think in your case the way you dealt with the situation was very good.
I think you handled the situation well. I also find that explaining to the uncompliant patient that you just want to make sure they're fully safe after discharge can also help.
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