In my first week in an out pt setting I received a pt that had been coming to physio for 4 months and had been seen by other physio students. She presented with a neck strain after turning too quickly while driving. Former students had also begun a walking program with her as she had a BMI of 37. When I asked her how her neck was progressing all she could talk about was her sick father who was in a nursing home. She told me some disturbing issues and the conversation was getting very personal. Whenever I asked her a question she always responded about her father and she argued that she was unable to complete any exercise or the walking program as her father would not cope without her there. I responded by discussing with her that her health was very important and that she needed to commence her walking program. I was unsure what I could achieve with this pt and felt like that she needed to discuss her personal issues with someone who was more qualified in that area. After talking to my supervisor, I decided to refer the pt on to the clinical psychologist. I was hesitant on how I was going to tell the pt by being professional as well as not being harsh. I told her that I believed that she could improve her level of physical activity and her neck pain if she tried to off load her personal issues and speak to someone with more experience than myself. The pt begun to cry but took it well and agreed to the referral.
This was an interesting yet new situation for me. Afterwards I started to feel guilty for referring her on simply because the stigma that is related to a psychologist. However I then realized that I was just more overwhelmed by my role and responsibility as PT student. I now understand how someone’s physical ability can be so affected by personal issues. I wouldn’t change how I treated the situation, next time I will have more confidence in myself as a professional. Do not be afraid to refer on!
2 comments:
I have also had many situations where people have started discussing very personal issues with me. I think it is important to refer these people on to a psychologist (or at least give them the option). This is because we aren't trained in counselling and we may actually being doing a disservice to the patient if we don't refer onwards.
I think this is a great example of how psychological factors can affect the prognosis of a patients problem, as for example if the patient did not have the other issues to deal with she may have been more compliant with her management. it just goes to show we do have a role and shouldn't try to burden ourselves with something that may be out of our league.
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