Im on a neurosurg ward and ive found that it can be a little difficult at times to work with the patients, as im used to working with people who dont have any cognitive issues. As it is an acute ward with traumatic head injury patients, my eyes have really been opened to the cognitive/behavioural problems these patients have.
One of the biggest ways ive found it impacts my treatment is trying to get the patients attention to begin with, and then trying to maintain their attention and find a task that interests them. Most of the patients have been all over the place in terms of attention spans and the slightest thing will seem to distract them. One particular patient will pretty much not stop talking! He will repeat everything you say over and over again and call me all sorts of names (not rude ones just different girls names, eg, tara, lisa, jessica, kate). So for him trying to get him to be quiet and listen for even a minute is a real struggle!
The other struggle is trying to find a task that interests him and keep him interested in it for more than one repetition. Ive learnt that the key to tackling this is to be really really overprepared for all your treatments! As long as you have heaps of treatment ideas to choose from you can keep switching from one to the other to keep the patient interested. If you persist with something the patient clearly isnt interested in it can make them quite aggressive. and if you cant think of anything to do next the patient will get distracted again.
So the moral of the story is always have lots of treatment ideas to choose from so you never run out!
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I couldnt agree with this more Brooke. I am also on a neuro placment and find that you need to have a huge amount of treatment ideas because the patients will often not respond well to a treatment that you may have planned on doing with them.
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