Hi everyone,
I recently had my rural prac and I was given some good advice from my supervisor that I thought I might share with you all.
I was in outpatients one afternoon when the patient I was expecting didn't turn up. So my supervisor told me I could sit in on her new patient who was due in about 5 minutes. She told me it was a stroke patient and asked me to perform the subjective and objective assessment. Seeings as though I havent had my neuro prac yet, I had a mini freak-out as I realised I had no idea what to do!
I spoke to my supervisor about the fact that I wasn't confident with neuro which was when she gave me the advice which was that if you are in this sort of setting and I patient comes in with a condition that you know very little or nothing about, or arent overly confident in that area, it is best to simply ask the patient what their problem is. If you look at the patient from a hollistic and more functional approach, and find out what they are having trouble with, and what they would like out of physio (goals and expectations), you can use this to guide your treatment. Therefore, you dont need to always do a specific assessment, but guide your assessment and treatment by the patients problems.
I have learnt from this that as long as you can find out what the patients problems are, and provide an effective treatment based on this, you dont need to be an expert in every area. I think this will help in the future if I am faced with a patient im not sure about.
Overall if you follow what the patient says and improve their perceived problems, they will be happy and satisfied with the treatment you have provided. So pretty much you cant go wrong!!
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2 comments:
I had a freak out on my first placement when a post op patient I was visiting at their home reported that they had been getting pins and needles and burning sensations around the surgery site as well as eccessive swelling at a distal joint and some other related acute problems. This went froma simple mobility and strength assessment to something more complicated. After taking the subjective I came to a stop as I almost felt as though I had to have a diagnosis for all of these problems and answers to every question. I freaked out and didnt know where to start the assessment.
This is when my supervisor helped by explaining that although I didnt know why all of these neuro signs were occurring I still needed to at least clear all major surgical complication (DVT, nerve sensitisation etc) and use the objective to make a clear picture of the symptoms. I find if often helps to have some basic questions and plans behind you so if all else fails it can lead in the right direction.
I totally agree with this one. We often have our own subjective/objective asterisk signs with our patients but the things that are important to them are their functional problems and how they improve with treatment. If we focus on our simple S/O outcomes then were not dealing with the real problem.
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