Patient goals

While on my rural placement, there was a patient who had been transferred from a neighbouring town’s small hospital. His wife was also staying at the hospital. He had a discectomy at T11/12 and L4/5 with resulting weakness in the lower limbs. Whilst in hospital in Perth after the procedure the patient did not receive any physiotherapy and as a consequence was de-conditioned and unable to walk. The Physiotherapists organised for a transfer to our hospital for the sole purpose of physio rehab. I was seeing this patient twice a day and I had given him an exercise program to do independently. However, despite a strong desire to return home, this patient was not completing his exercises, therefore was not progressing as well as I had hoped.

Myself and my supervisor had decided that although the patient would have benefited from a longer stay in hospital, he wanted to be discharged and therefore we would use this goal to motivate him. Through using patient oriented goals we were able to motivate the patient. Together with the OTs we prepared him for returning home, but first he needed to stand independently. With a coordinated effort from the nursing staff and even the personal care assistants, the patient was reminded continually throughout the day to complete these exercises. This co-ordinated effort ensured the patient gained enough strength to stand independently to be able to be discharged.

This patient demonstrated the need to keep goals patient oriented, even if they don’t always match your own and that using these goals can be very motivating. This situation also demonstrated the benefit working as a multi disciplinary team to achieve patient outcomes.