Hey bloggers. On one of my previous placements there was a particular patient that i learned plenty from. It wasn't so much the condition which was a left supraspinatus tendinopathy but understanding the patient as a whole. I was casually going through my subjective and rattling off all these questions and my patient seemed reluctant to answer and quite withdrawn in general. I was getting quite frustrated (trying not to show it) as i was asking pretty simple questions i thought but was getting poor responses and sometimes not much at all.
Going through the social history i realised why my patient was reacting in the way they were. A close family member had passed away in the previous week and the last thing they were really worried about was their shoulder.
Consequently, i felt quite bad because i hadn't been very empathetic prior to this during my assessment but consciously tried after this to try and change my manner and adjust and ask only the essential questions relevant to their condition and only the relevant objective assessment. Treatment was some hands on therapy and exercises the patient had to do along with some education. I tried to keep it all nice and succint as too much information would go in one ear and out the other with this patient.
This situation made me think about in the future if i come across another patient in grief as i most likely will what the best way would be to approach the patient as they still have a condition that needs to be treated to improve but also has to deal with other more important issues in their life. It also made me realise how someone being in such a state can affect your assessment and treatment.
In the future if someone is displaying the same signs as this patient i might even ask early on whether the patient is ok but it obviously has to be the right patient as some people are naturally quite shy and withdrawn. If i know their is something going on in their life earlier in the assessment i can tailor it and my manner acordingly and display a more understanding approach.
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4 comments:
I also experienced a similar siuation on my last placement. I had been treating a patient and about a week later saw the her again. This other time was the day after she was told that her husband had died. From what I remember his death wasn't a suprise but had come faster than expected (while she was stuck in hospital). All I could was similar to what you have mentioned in your blog - do what needed to be done while respecting the patients emotional state.
The last paragraph in your post reminded me of those subjective examination video's we did for Penny in Y2 and that we need to treat the whole patient, or at least acknowledge that there may be more to someone's condition that the physical signs. Perhaps it just boils down to having good people skills and a caring nature too.
This is a very good example of treating the patient as a whole and not just treating the problem they are presenting with. Even though we have been told this regularly throughout our course I feel that it is not until you are faced with a situation such as this that you really recognise the importance of knowing what social issues are impacting on the patients life.
I have also been in a similar situation on a previous placement at PMH where the patient’s father had recently passed away. I was told about the situation at hand before seeing the patient and during the session was obvious that it was impacting on both the patient and his mother. I was lucky to be aware of this before seeing the patient otherwise I would have been puzzled by their behaviour and I was able to adjust my communication appropriately and be empathetic and understanding.
I had a similar situation in my last placement which was musculoskeletal outpatients. A women presented 3 months post fractured ankle which was managed conservatively. On social history questioning she revealed that her husband had passed away in december. She also mentioned that her husband had been in a wheelchair and she cared for him which suggests that he may have been ill for quite some time before his death. She was also taking Zoloft, which is a medication for depression. During treatment I kept this in mind and tried to be as encouraging and enthusiastic as possible to keep her motivated.
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