Never run away..

In my neuro prac, I worked with acquired brain injury patients. Most of them have problems communicating as a result of their brain injury. The most challenging part about being able to treat this group of patients is to be able to communicate what we want of them during therapy sessions. One of my patients, a 19 year old male was assaulted and sustained a sub-dural hematoma that had left him with drastic impairments including an inability to verbalise speech. Apart from that, he sustained cranial nerve deficits (minimal eye movement), only able to have a fixed gaze and does not have the control for neck and head movement. He was the most challenging patient that I have had to date. I thought to myself, it’s hard enough to treat someone with brain injury but now I have someone with brain injury and can’t communicate. I was just about to give up as I really felt that it wouldn’t be fair for me to treat him if I was not confident enough. I went to my supervisor and I had a word with her and she told me not to give up so soon without a try, she guided me along for the 1st session with him. That really helped build courage to take him on as a patient.

I then went on to see his speech pathologist and ask for a bit more insight as to how I can communicate more effectively with him. She gave me some really good ways to communicate with him (non-verbally) and also how to judge his way of saying yes or no. Some of which was, yes = one blink, no= two blinks and how much he lifted his leg up in the air correlates with pain levels. Every session was a learning curve for me, I got better each day and that helped me achieve good rehabilitation outcomes with him. Then there came a day when we were partly through therapy, the patient suddenly became very distress, his UL and LL tone started kicking in terribly and it panicked me. I tried to keep things together and calmly verbalised each body part for him to identify which part was giving him the problem. As it turned out he was getting uncomfortable with his secretions in the mouth due to his inability to swallow. I then organised for suctioning. After that, he looked a lot more settled and was able to continue with therapy. I am glad that I took the initiative to learn the language he spoke which has helped me tremendously in his rehabilitation during my four weeks there.

From this experience, I have learnt that I must embrace every challenging patient and treat it as an opportunity to better myself so that it sets me up to become a better physio one day. In the future when I have a challenging patient like that, I will try my best to gain as much insight I can about the patient by liaising with staff that had worked with the patient. This will help me utilise what works best for the patient to help facilitate patients’ rehabilitation more effectively.