On an acute ward there is a 24yo girl who presented with Gillian Barre Disease 9/7 ago. I had seen her in the past but today she was taken of sedation and awake and responding to commands. She is currently on a ventilator via an ETT and therefore cannot talk. After I treated her chest she started to make rapid head gestures and I asked her if there was something she wanted. She tried to talk but was unable and just had the movement of her mouth. I went through a few issues that she was trying to talk about until it was concluded that she was uncomfortable and wanted to move onto her back as she was positioned in side-lying. I informed her that the turning team was coming but she started to cry and kept attempting to talk which lead to her BP and RR increasing dramatically. I attempted to calm her down by stroking her hands.
I felt panicky and really sad as this girl was around age and so vulnerable. The nurses assisted my supervisor and myself to calm her down and we advised the turning team to turn her next. She calmed down once turned and went to sleep. This situation touched me as I kept thinking this could be one of my friends or even myself.
THIS SCENARIO HAS REINFORCED THAT THE LACK OF ABILITY TO COMMUNICATE, ESPECIALLY IN AN AREA WHERE THERE ARE CONSTANTLY NEW PEOPLE COMING AND GOING IS A SCARY THING. IT FURTHER TEACHES US TO DEAL WITH A VARIETY OF PATIENTS AND EMOTIONS THAT WE WILL FACE IN OUR PROFESSION.
I BELIEVE THAT AS YOUNG PROFESSIONALS, SOMETIMES WE CAN OFFER MORE TO YOUNG PT’S BY RELATING TO HOW THEY MAY BE FELLING AND BEING ABLE TO PROVIDE THE ADEQUATE LEVEL OF SENSITIVITY AND SUPPORT THAT IS REQUIRED. I DON’T THINK I WOULD HANDLE A SITUATION LIKE THIS DIFFERENTLY IN THE FUTURE, JUST HOPEFULLY BE MORE PREPARED.
Friday, September 26, 2008
Thursday, September 25, 2008
Surgery
On rural prac I was lucky enough to be exposed to various aspects of physiotherapy that I wouldnt normally in a perth based hospital. On final week of prac, with all going well my superivisor suggested I go in to see a TKR.
I didn't think seeing a TKR would be the best idea. I dont normally like blood and felt I wouldnt be able to survive seeing surgery. With much convincing I attended the surgery first think in the morning. I subsquently survived the experience and actually really enjoyed my experience.
This situation helped me push myself outside my comfort zone. See surgery made me more aware of what a patient goes through during a TKR and therefore allowed me to better manage my patients.
By pushing my limits I feel more comfortable around blood. I think in the future its important to continually expose yourself to situations outside your comfort zone as their are various benefits from experiences we sometimes fear. In the future, after seeing surgery I would feel more comfortable seeing a surgical patient day 1, trauma patients in ED and acutely sick patients in ICU. With this fear out of my system this better equips me to use my skills as a physiotherapist to help a patient in need.
I would suggest to all my peers to take up opportunities as a student in seeing things such as surgery, as I believe the experience was invaluable.
I didn't think seeing a TKR would be the best idea. I dont normally like blood and felt I wouldnt be able to survive seeing surgery. With much convincing I attended the surgery first think in the morning. I subsquently survived the experience and actually really enjoyed my experience.
This situation helped me push myself outside my comfort zone. See surgery made me more aware of what a patient goes through during a TKR and therefore allowed me to better manage my patients.
By pushing my limits I feel more comfortable around blood. I think in the future its important to continually expose yourself to situations outside your comfort zone as their are various benefits from experiences we sometimes fear. In the future, after seeing surgery I would feel more comfortable seeing a surgical patient day 1, trauma patients in ED and acutely sick patients in ICU. With this fear out of my system this better equips me to use my skills as a physiotherapist to help a patient in need.
I would suggest to all my peers to take up opportunities as a student in seeing things such as surgery, as I believe the experience was invaluable.
Sunday, September 21, 2008
Changing your tone
On cardio placement at a large WA hospital I was referred a patient with dyscopia. During my interaction with this patient I learnt how I have to tailor my communication for each patient.
When doing my general check up prior to commencing treatment of the patient I only had access to an XL BP cuff. Not considering how my communication may affect the patient, as the cuff kept malfunctioning because the patients arm was too small for the cuff I told the patient "your arms a bit skinny for the cuff". This is resulted in the patient becoming extremely emotional. She explained to me how she wasnt coping at home and how once she was alot more fitter then her currently.
This interaction with this patient demonstrated how sometimes patients are emotional and distressed coming into hospital from home. The conversation I had with this patient obviously was found as rude and deeply upset the patient. In the future I think during initial assessment it is best to be cautious with your communication, as getting the patient off side on day 1 wouldn't be good for future physiotherapy. Once you better get to know a patient I think then your better equipped to get a feel what the patient is like, e.g. in distress with being hospitalised and dependent on nurses/doctors compared to a patient who is quite outgoing and comfortable with thier current situtation.
When doing my general check up prior to commencing treatment of the patient I only had access to an XL BP cuff. Not considering how my communication may affect the patient, as the cuff kept malfunctioning because the patients arm was too small for the cuff I told the patient "your arms a bit skinny for the cuff". This is resulted in the patient becoming extremely emotional. She explained to me how she wasnt coping at home and how once she was alot more fitter then her currently.
This interaction with this patient demonstrated how sometimes patients are emotional and distressed coming into hospital from home. The conversation I had with this patient obviously was found as rude and deeply upset the patient. In the future I think during initial assessment it is best to be cautious with your communication, as getting the patient off side on day 1 wouldn't be good for future physiotherapy. Once you better get to know a patient I think then your better equipped to get a feel what the patient is like, e.g. in distress with being hospitalised and dependent on nurses/doctors compared to a patient who is quite outgoing and comfortable with thier current situtation.
Thursday, September 18, 2008
Group classes
Whilst on a community physiotherapy placement, I was taking a class of 9 patients for multiple conditions such as general deconditioning, post CVA, post TKR/THR, and one lady with Parkinson’s. The class consisted of a warm up, strength exercises carried out in a circuit format, then a cool down and balance exercises. The class was going very nicely and I was up to taking the balance exercise component. I got all the patients to stand behind/beside a chair in a circle. After beginning moderate level balance exercises the Parkinson’s client lost her balance and toppled over! I got the class to stop the exercises, and my supervisor and I went over to help the lady up. Thankfully she hadn’t hurt herself! She was more embarrassed and did not want us to make a fuss over her. I felt terrible!
My supervisor sat with the client for a while, asked her questions, and told her she’ll ring her to check she is still ok tomorrow. The patient reports that she had had a busy morning and was more tired than usual. My supervisor and I had a talk about the situation, her first question was “do you think you did all you could to make the exercises safe for this class?” I told her I did and why. The supervisor totally agreed, and that on previous classes this client had never shown any signs of being at risk of a fall. The client was also the most active and independent client of the class.
From this situation it reinforced the importance of positioning yourself in a class amongst clients that are of a higher need of assistance. It also showed that in class situations even with all the setting up of the environment for a safe exercise, positioning yourself appropriately between clients, choosing appropriate exercises and being cautious, accidents can still happen. In future I would inform clients not to undertake any strenuous activity prior to the class. (The situation also showed me the large amounts of paper work that must be completed after a client falls!)
My supervisor sat with the client for a while, asked her questions, and told her she’ll ring her to check she is still ok tomorrow. The patient reports that she had had a busy morning and was more tired than usual. My supervisor and I had a talk about the situation, her first question was “do you think you did all you could to make the exercises safe for this class?” I told her I did and why. The supervisor totally agreed, and that on previous classes this client had never shown any signs of being at risk of a fall. The client was also the most active and independent client of the class.
From this situation it reinforced the importance of positioning yourself in a class amongst clients that are of a higher need of assistance. It also showed that in class situations even with all the setting up of the environment for a safe exercise, positioning yourself appropriately between clients, choosing appropriate exercises and being cautious, accidents can still happen. In future I would inform clients not to undertake any strenuous activity prior to the class. (The situation also showed me the large amounts of paper work that must be completed after a client falls!)
Tuesday, September 9, 2008
Preparation
On my musculoskeletal placement, I had a new patient who made an appointment for back pain. When preparing for this patient, I noticed that her name sounded Arabic/Middle Eastern, and she was in her early teens. I was worried that this would be a problem, being a male therapist treating this young lady, especially for a condition like back pain, in order to gain an optimal assessment and treatment, a lot of physical contact is required and the area should be exposed.
I then made my supervisor aware of my concerns and asked my supervisor if I was able to trade patients with another student who was female, and my supervisor was more than happy to make the swap. Later that day, the student who treated this patient had told me that the patient's mother said that she was relieved to have a female therapist.
This experience confirmed the importance of preparing adequately for the patient, not just for the condition, but also other aspects such as age, gender and culture. I believe that this will help make the patient more comfortable, therefore make the treatment more effective. I feel that if I had not traded patients with a female student, or if i had treated this patient without being aware of the age, gender and cultural differences, the patient as well as her mother would have felt uncomfortable, and the treatment given would not have been very effective.
I then made my supervisor aware of my concerns and asked my supervisor if I was able to trade patients with another student who was female, and my supervisor was more than happy to make the swap. Later that day, the student who treated this patient had told me that the patient's mother said that she was relieved to have a female therapist.
This experience confirmed the importance of preparing adequately for the patient, not just for the condition, but also other aspects such as age, gender and culture. I believe that this will help make the patient more comfortable, therefore make the treatment more effective. I feel that if I had not traded patients with a female student, or if i had treated this patient without being aware of the age, gender and cultural differences, the patient as well as her mother would have felt uncomfortable, and the treatment given would not have been very effective.
Monday, September 8, 2008
Cancer
While on placement in a general medical ward I encountered a patient who had been admitted following a fall. This patient was later diagnosed with cancer with brain metastases. The medical team estimated only a short time before this patient would pass away. On the first day I saw this lady for a mobility assessment I was a bit apprehensive as I had never encountered a patient with terminal cancer before. On initial assessment the patient was cooperative but very withdrawn as the news of her prognosis was still fairly recent. However on subsequent visits through an exercise program, her mobility improved to the stage that she was able to walk a few metres independently. She began to enjoy our sessions and look forward to them.
I know the literature has proven that exercise is beneficial to patients with cancer, but this patient just highlighted the fact to me. Cancer patient should still be seen by physiotherapists on the ward as exercises can improve their mobility or prevent decline and benefit their mental well being. In future I will ensure I take time to explain the benefits of exercise to these patients and give them the option of physiotherapy treatment.
I know the literature has proven that exercise is beneficial to patients with cancer, but this patient just highlighted the fact to me. Cancer patient should still be seen by physiotherapists on the ward as exercises can improve their mobility or prevent decline and benefit their mental well being. In future I will ensure I take time to explain the benefits of exercise to these patients and give them the option of physiotherapy treatment.
Sunday, September 7, 2008
Stage of Healing
On rural prac doing musculoskeletal outpatients I was referred a patient for management of his broken ribs. As a result of the patient having a fracture it was important as I know now what the contraindications/precautions would be for someone following fracture.
The standard assessment form was used for all new patients. In the OE for spinal assessment the headings were - AROM, PAIVMS, PPIVMS etc etc. Without taking the underlying pahology into consideration I started doing AROM of the Thx spine. Following end range pain I decided I would do PAIVMS. Luckly I stopped and thought, if i PAIVM his thoracic spine will that to produce motion at his rib fracture.
I thought to myself, if the patient had a broke ankle would i mobilise it a week after fracture? Similarly I tailored my management of this patient taking a more prophylatic approach to his fracture, performing a cardio assessment and giving him DB exercises.
Through encoutering this patient it highlight to me how important was to keep clinically reasoning while your performing assessment and treatments. If I had mobilised his thoracic spine maybe it might have caused a puncture lung or something more serious. In future treatments it is important for me to take things slower, stop and think what is going here? what is the stage of healing? Is my treatment indicated for this patient?
The standard assessment form was used for all new patients. In the OE for spinal assessment the headings were - AROM, PAIVMS, PPIVMS etc etc. Without taking the underlying pahology into consideration I started doing AROM of the Thx spine. Following end range pain I decided I would do PAIVMS. Luckly I stopped and thought, if i PAIVM his thoracic spine will that to produce motion at his rib fracture.
I thought to myself, if the patient had a broke ankle would i mobilise it a week after fracture? Similarly I tailored my management of this patient taking a more prophylatic approach to his fracture, performing a cardio assessment and giving him DB exercises.
Through encoutering this patient it highlight to me how important was to keep clinically reasoning while your performing assessment and treatments. If I had mobilised his thoracic spine maybe it might have caused a puncture lung or something more serious. In future treatments it is important for me to take things slower, stop and think what is going here? what is the stage of healing? Is my treatment indicated for this patient?
Prioritisation
On cardio placement on a medical ward there are numourous very sick patients. Often patients who are at end stage of disease end up here as admitting these patients into high dependency or intensive care units is seen by the medical team as futile given the patients stage of disease. At first was very difficult for me to digest, a patient was not receiving optimal management for their disease. All patients had consent to this type of management, which puzzled me as to think why a patient would basically 'give up'. This demonstrated to me how patients are often prioritised depending on their presentation.
As this was a very large ward comprisied of over 60 beds I too had to prioritise who were high priority and who didnt need to be seen. Prior to prioritising who I would see I thought to check the status of the patient in terms of management. As a result I was able to identify patients who were seen as had rehabilitation potential and prioritise them to be seen first. As a result I felt that my physio management was too prioritised so I could provide more time for patients who had rehabilitation potential and still see other terminal patients if time permitted.
By encountering this situation, I learnt how it is important to gather a full picture of a patient - interms of what the docs see is there rehab potential and then prioristise to see patients who are seen as having potential, however still providing terminal patients with physio if time permitted and only a couple of times per week instead of everyday. This made the ward more manageable however at first was difficult for me to make such a decision.
As this was a very large ward comprisied of over 60 beds I too had to prioritise who were high priority and who didnt need to be seen. Prior to prioritising who I would see I thought to check the status of the patient in terms of management. As a result I was able to identify patients who were seen as had rehabilitation potential and prioritise them to be seen first. As a result I felt that my physio management was too prioritised so I could provide more time for patients who had rehabilitation potential and still see other terminal patients if time permitted.
By encountering this situation, I learnt how it is important to gather a full picture of a patient - interms of what the docs see is there rehab potential and then prioristise to see patients who are seen as having potential, however still providing terminal patients with physio if time permitted and only a couple of times per week instead of everyday. This made the ward more manageable however at first was difficult for me to make such a decision.
Thursday, September 4, 2008
It is not always about physio.
On my prac in the geriatric area, one of my patients was a 86 y/o man who had led a very active lifestyle all his life. He lives with his wife who is in her 70’s and is still physically active and independent. He came to see us because he felt that of late, his balance is deteriorating and that he sometimes feels unsteady during ambulation. As a result, he had a couple of falls in the past year. I then commenced assessment to identify his key problems and the reasons he’s been falling. During the subjective assessment, I found out that he had a fall 2 weeks ago which he blamed his wife for. He and his wife were rushing to catch a tram because she didn’t want to miss it. He then tripped over a high kerb and fell landing on his forehead. The patient then started expressing some issues he had been facing with his wife ever since this had happened. He feels as though she doesn’t understand that he is not able to do certain things that he used to be able to do. She thinks that his problems are not real and that he is just trying to avoid having to drive her down to the shopping mall when she wanted to go to the shops. All of these had made him so frustrated and depressed.
Listening to this, I had to take a moment to try and see how I can help with the situation as it was really obvious it is affecting him terribly. They needed to get help before the situation gets too complicated. I then offered to refer him and his wife to a counsellor but he refused. At the same time I felt that if we did not find a way to deal with the issue, it is not going to help his rehabilitation process. I then decided to continue with objectively assessing his condition so that I was able to tailor and exercise program to help facilitate his rehabilitation. At the end I discovered that he had genuine balance issues as well as some weakness in his lower limbs which needed to be addressed promptly. I prescribed a home exercise program to help with his balance and improve his strength after the first session. Then, I realised that I have only addressed half his problems and I disregarded the problems he had with his wife as soon as he refused counselling. I was sceptical of his compliance to the home exercise program because to him, having a wife that does not understand his condition is a “bigger” problem. So I really thought that in order to achieve anything with him I must address his “bigger” problem.
So for the next session, I asked him if he was happy for me to talk to his wife about my assessment findings. He said I could try but he wasn’t sure if that was going to make things any different. I decided anyway to try and explain some of what I found with his balance. She was surprised at what I had commented about her husband’s condition but looked accepting. I also explained that he may improve if he kept to his home exercises and that she should play an active role in reminding him if he forgets. She seemed eager to be a part of his rehab. And after that session, I realised how much difference that had made to his motivation. He seemed a lot more compliant to physiotherapy which resulted in a difference to his balance score.
From this encounter, I’ve learnt the importance of dealing first with the patients primary problems regardless of whether it is physiotherapy related or not as this is one step closer towards achieving patients’ goals. Besides that, addressing patients’ specific concerns will help enhance motivation and compliance towards rehabilitation.
Listening to this, I had to take a moment to try and see how I can help with the situation as it was really obvious it is affecting him terribly. They needed to get help before the situation gets too complicated. I then offered to refer him and his wife to a counsellor but he refused. At the same time I felt that if we did not find a way to deal with the issue, it is not going to help his rehabilitation process. I then decided to continue with objectively assessing his condition so that I was able to tailor and exercise program to help facilitate his rehabilitation. At the end I discovered that he had genuine balance issues as well as some weakness in his lower limbs which needed to be addressed promptly. I prescribed a home exercise program to help with his balance and improve his strength after the first session. Then, I realised that I have only addressed half his problems and I disregarded the problems he had with his wife as soon as he refused counselling. I was sceptical of his compliance to the home exercise program because to him, having a wife that does not understand his condition is a “bigger” problem. So I really thought that in order to achieve anything with him I must address his “bigger” problem.
So for the next session, I asked him if he was happy for me to talk to his wife about my assessment findings. He said I could try but he wasn’t sure if that was going to make things any different. I decided anyway to try and explain some of what I found with his balance. She was surprised at what I had commented about her husband’s condition but looked accepting. I also explained that he may improve if he kept to his home exercises and that she should play an active role in reminding him if he forgets. She seemed eager to be a part of his rehab. And after that session, I realised how much difference that had made to his motivation. He seemed a lot more compliant to physiotherapy which resulted in a difference to his balance score.
From this encounter, I’ve learnt the importance of dealing first with the patients primary problems regardless of whether it is physiotherapy related or not as this is one step closer towards achieving patients’ goals. Besides that, addressing patients’ specific concerns will help enhance motivation and compliance towards rehabilitation.
Wednesday, September 3, 2008
Making mistakes
While on cardiopulmonary placement I encountered a patient who was identified as a intravenous drug user. The patient had experienced a perforated bowel, which was subsequently repaired, however subsequent complications required an ICU admission. During the patient’s stay on the ward it drugs had been discovered in her room and she had crushed painkillers which she tried to insert into her IV. The patient was keen to return home to care for her children.
As the patient had been desaturating on oxygen, this needed to be tested to ensure her oxygen did not drop too low when ambulating. Initially the patient’s oxygen was 94%, but she refused oxygen as she was intent on going home, during ambulation her oxygen dropped to 88% at this stage I tried to apply oxygen to the patient, she refused, so I asked her to stop and take deep breaths prior to recommencing oxygen. However the patient did not listen to me as we were close to her room. During the last few metres to her bed, her oxygen sats dropped to 71%. Once again the patient refused oxygen despite warnings and education. With deep breaths her oxygen recovered to pre ambulation levels within 2-3 minutes. I promptly informed the my supervisor, the nursing coordinator and the medical team. A chest X Ray was performed and she was found to have significant bilateral atelectasis.
I felt I had lost control of the situation with this patient and I should have been more firm. Patient education is even more important with difficult patients to ensure they are aware of your reasoning behind your assessment and treatment to improve compliance.
I have learnt a few things from this experience
· ENSURE I AM IN CONTROL OF ALL TREATMENT SESSIONS
· BE FIRM WITH PATIENTS IF THE SITUATION BECOMES DANGEROUS
· EVEN IF I MAKE A MISTAKE, ENSURE I INFORM THE APPROPRIATE STAFF AS IT MAY INDICATE A SERIOUS PROBLEM THAT REQUIRES FURTHER INVESTIGATION
As the patient had been desaturating on oxygen, this needed to be tested to ensure her oxygen did not drop too low when ambulating. Initially the patient’s oxygen was 94%, but she refused oxygen as she was intent on going home, during ambulation her oxygen dropped to 88% at this stage I tried to apply oxygen to the patient, she refused, so I asked her to stop and take deep breaths prior to recommencing oxygen. However the patient did not listen to me as we were close to her room. During the last few metres to her bed, her oxygen sats dropped to 71%. Once again the patient refused oxygen despite warnings and education. With deep breaths her oxygen recovered to pre ambulation levels within 2-3 minutes. I promptly informed the my supervisor, the nursing coordinator and the medical team. A chest X Ray was performed and she was found to have significant bilateral atelectasis.
I felt I had lost control of the situation with this patient and I should have been more firm. Patient education is even more important with difficult patients to ensure they are aware of your reasoning behind your assessment and treatment to improve compliance.
I have learnt a few things from this experience
· ENSURE I AM IN CONTROL OF ALL TREATMENT SESSIONS
· BE FIRM WITH PATIENTS IF THE SITUATION BECOMES DANGEROUS
· EVEN IF I MAKE A MISTAKE, ENSURE I INFORM THE APPROPRIATE STAFF AS IT MAY INDICATE A SERIOUS PROBLEM THAT REQUIRES FURTHER INVESTIGATION
Tuesday, September 2, 2008
Sometimes patients don't realise what they can do
On my rural placement, a patient was admitted after having a CVA. On first impression, this patient seemed very unmotivated, and convinced my supervisor and I that she "couldn't do anything". She would continuously compare how she is now with her premorbid status, and was very fixed on the fact that she had movement on her affected side.
For the first few sessions, everytime my supervisor and I would attempt to stand her up and walk her, she would state that she can't, and would just sit straight down. After setting the goal of walking to the toilet, we were able to stand her up and walk her with 2 assist, however, the more steps she took, the more she would actually contribute, needing less assistance.
The next session, she still refused saying that she was unable, until I reminded her of her performance the day before. This seemed to have improved her confidence, and she was able to walk a greater distance with less assistance.
I FEEL THAT SOMETIMES PATIENTS THAT HAVE DISABLING CONDITIONS SUCH AS STROKES, WILL TEND TO COMPARE THERE CURRENT STATE WITH THERE PREMORBID STATE, AND WILL ASSUME THEY ARE UNABLE TO DO CERTAIN TASKS. I THINK THAT A GOOD WAY TO TREAT THESE PATIENTS IS TO SET REALISTIC SHORT TERM GOALS, AND USE THAT GOAL AS MOTIVATION FOR THE NEXT SESSIONS.
For the first few sessions, everytime my supervisor and I would attempt to stand her up and walk her, she would state that she can't, and would just sit straight down. After setting the goal of walking to the toilet, we were able to stand her up and walk her with 2 assist, however, the more steps she took, the more she would actually contribute, needing less assistance.
The next session, she still refused saying that she was unable, until I reminded her of her performance the day before. This seemed to have improved her confidence, and she was able to walk a greater distance with less assistance.
I FEEL THAT SOMETIMES PATIENTS THAT HAVE DISABLING CONDITIONS SUCH AS STROKES, WILL TEND TO COMPARE THERE CURRENT STATE WITH THERE PREMORBID STATE, AND WILL ASSUME THEY ARE UNABLE TO DO CERTAIN TASKS. I THINK THAT A GOOD WAY TO TREAT THESE PATIENTS IS TO SET REALISTIC SHORT TERM GOALS, AND USE THAT GOAL AS MOTIVATION FOR THE NEXT SESSIONS.
Monday, September 1, 2008
I've broken my hip
I am currently on a musculoskeletal outpatient placement in which I am treating a lady diagnosed with traumatic trochanteric bursitis after a fall onto her side of her hip. During the initial session the patient explained that she felt she had pulled some ligaments or broken her hip. She has ideas regarding the basic anatomy of the hip in general saying she felt the “ball and socket isn’t rotating properly”. After doing the physical examination I was confident she hadn’t broken her hip nor pulled any ligaments.
I explained to the patient some of the reasons she was having the pain in the hip and thigh and our plan for treatment. I reassured her she hadn’t broken her hip and that I had tested for ligament problems and found them all good. On the second time seeing this patient she had noticeable improvement in pain, ROM and function. However she still felt she had a broken hip (even though she had nil pain, able to walk/run, all ADL’s). Once again I reassured her hip wasn’t broken and explained to her the healing that takes place and the muscles running over her G.T., bursa etc etc. She felt better and understood. At the very end of the session I showed and explained a picture of the hip, muscles and bones. She sighed of relief.
With this patient I focused a lot of the treatment session on education and getting the patient to understand the problem. But while understanding the problem the patient did not entirely exclude their own conception. This suggests the patient had not entirely understood what I had explained on the initial treatment. The patient finally understood when a picture was used that separated the area of interest (G.T) to the ball and socket joint (in which she thought she had broken/damaged ligaments).
From this patient I have acknowledged the importance of readdressing education regarding the cause of a problem. It also illustrated the benefit of using diagrams/visual aids to help in explaining mechanics and anatomy. In future I will try to use diagrams or visual aids in an initial treatment session. I have learnt the importance of ensuring patients understand the problem, but also reassuring and explaining any misconceptions.
I explained to the patient some of the reasons she was having the pain in the hip and thigh and our plan for treatment. I reassured her she hadn’t broken her hip and that I had tested for ligament problems and found them all good. On the second time seeing this patient she had noticeable improvement in pain, ROM and function. However she still felt she had a broken hip (even though she had nil pain, able to walk/run, all ADL’s). Once again I reassured her hip wasn’t broken and explained to her the healing that takes place and the muscles running over her G.T., bursa etc etc. She felt better and understood. At the very end of the session I showed and explained a picture of the hip, muscles and bones. She sighed of relief.
With this patient I focused a lot of the treatment session on education and getting the patient to understand the problem. But while understanding the problem the patient did not entirely exclude their own conception. This suggests the patient had not entirely understood what I had explained on the initial treatment. The patient finally understood when a picture was used that separated the area of interest (G.T) to the ball and socket joint (in which she thought she had broken/damaged ligaments).
From this patient I have acknowledged the importance of readdressing education regarding the cause of a problem. It also illustrated the benefit of using diagrams/visual aids to help in explaining mechanics and anatomy. In future I will try to use diagrams or visual aids in an initial treatment session. I have learnt the importance of ensuring patients understand the problem, but also reassuring and explaining any misconceptions.
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