Treat them all the same.

During my neuro placement, I had a new patient and the handover notes was that the patient was a prisoner in shackles, he had two prison guards with him 24/7 and was a left hemiplegia with no sitting balance. The notes also did mention about him having a psych review and that he was diagnosed with bipolar disorder and mild psychosis.

This is my first time having to treat a prisoner in shackles and that really made me worried. We had to get permission from the prison authorities to unshackle the patient for rehabilitation and that made me worried as I had all the “what if’s” running through my head. Well, I tried to calm myself down and felt that if I treated him just like any other patient I will do fine and besides, if anything happens there is two guards to help restrain him. When I met him, I introduced myself and gave him a brief explanation of what the treatment is going to consist of. He did not respond much to what I had said and just looked away. Then I asked him, if he had anything bothering him and his reply was, “like you care”. That is the first time I had met a patient who spoke that way. I then just said politely to him, I’m only here to help and I need him to allow me to. So I asked him again, if he has any concerns? Then he said that his neck been hurting for a week now and it disturbs his sleep at night. I then decided to assess and treat his neck before looking at his sitting balance. He then became more interactive and looked pleased that I actually listened to his concerns and acted upon them. He then appeared more compliant to the treatment session which I thought was impossible at the beginning of the treatment just by the way he appeared to me. He then became a patient in my caseload for the next two weeks I was there. He became more and more compliant each session and this helped his rehabilitation progress smoothly. By the end of the two weeks we achieved sitting balance and I started working on standing balance.

This was an invaluable experience. It had thought me the importance of treating each patient with dignity and respect regardless of what their background is in order to have a positive contribution to the rehab process. Just by listening to him and making him feel that his concerns were important, he became a more compliant patient.