This week a 55yo male was admitted with pneumonia to my ward after spending a week in ICU. I read the patients notes and the doctor had asked for chest physiotherapy. So with the doctor’s request in mind I went into see the patient and did a subjective and objective assessment, then took them for a walk. On returning the patient said they were tired from the session and did not want anymore chest physio that day. So I told the patient I would be back the next day to do more physio.
On returning the next morning the patient was in bed and said they were too tired and refused physio. I discussed this with my supervisor and they said next time I went into see the patient that they would come as well. The next day we both went to treat the patient however they had the same response and refused any physio. By this stage I was confused as the first day the patient had let me do some sort of physio treatment but now would not participate at all.
My supervisor suggested that I speak to the doctor and let them know that the patient was refusing physio. When I discussed the patient’s refusal to physio, the doctor said to ‘just get him up’, so I tried for a third time with no success. That afternoon the doctor came and told me they worked out the reason the patient was probably not compliant with physio was because they were in the down phase of bipolar. So bearing this in mind I understood why the patient wasn’t motivated to physio.
I HAVE LEARNT FROM THIS EXPERIENCE LIAISING WITH OTHER HEALTH PROFESSIONALS IN THIS CASE THE DOCTOR; CAN BE VERY IMPORTANT IN WORKING OUT WHAT IS CAUSING A PATIENT TO BEHAVE IN A PARTICULAR MANNER. IN THIS PARTICULAR CASE, I WILL CONTINUE TO SEE THE PATIENT EVERY MORNING AND TRY MY BEST TO MOTIVATE THEM TO JUST AMBULATE
2 comments:
Another good tip. I'll remember to consider the possibility of psychological issues if personality/attitude changes dramatically like that.
Important to note that if a patient is persistently refusing physio, even after the 'serious' conversation from the physio to patient/family, this can potentially influence the medical treatment plan from the doctors. For example, I had an oncology patient who refused physio input, so as a result the doctors told him he could not begin chemo/radiotherapy because he will not be physically fit for it. After being scared a little by the doctors he was as keen as mustard.
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