Last week during my cardiopulmonary placement, I was reading a set of patient notes whom I had never seen before, to try and get an idea of what to expect when I went to do a subjective and objective assessment. From the notes I got that this 50yo male who had pneumonia and had been in ICU for quite a few days, they also had some mental health issues which included not being compliant with any treatment. From these notes I got the impression that this patient was going to be difficult to mobilise and treat due to the above issues.
On meeting the patient I was shocked to find he was up walking and talking, not at all what I had expected. However once I began a subjective assessment I found that his mental health issues were going to hinder my normal assessment. This occurred as I couldn’t seem to get the patient to stop talking about random topics that had nothing at all to with the questions I was asking. After 10min of trying to get a subjective assessment done, I decided to go walking with the patient to try and get some objective measures done. He was compliant with this part of the session, however when we came back to the patients room I asked if I could do some auscultation and he refused and said he had enough.
I came out of this treatment session feeling like I had hardly achieved anything, but didn’t really know what else I could have done to help this particular patient. However after speaking with my supervisor they assured me that in this particular situation I just had to record the findings that I did find out and try to get more information during the next session.
I HAVE LEARNT THAT SOMETIMES WE HAVE TO BE VERY CREATIVE WHEN TRYING TO DO A SUBJECTIVE AND OBJECTIVE ASSESSMENT ON PATIENTS. IN THIS PARTICULAR CASE I WORKED OUT THAT THE PATIENT ENJOYED WALKING, SO IN FUTURE SESSIONS I WOULD TAKE THE PATIENT WALKING AND TRY TO DO MOST OF MY SUBJECTIVE ASSESSMENT AND OBJECTIVE ASSESSMENT WHILST THEY WERE DOING SOMETHING THEY ENJOY. SOMETIMES THE FIRST SESSION WITH A PATIENT IS JUST ASSESSING THEIR PERSONALITY, SO THEN YOU CAN WORK OUT HOW BEST TO GET THE INFORMATION REQUIRED.
Subscribe to:
Post Comments (Atom)
1 comment:
Rather than asking if you can auscultate a patient you could say something along the lines of " I Need to auscultate/listen to your chest now", rather than a question. Your patient still benefited from your treatment session because you got them up walking! don't be so hard on yourself Amy! :P
Post a Comment