week 3 - 2 posts

1. Last week I came across a bit of conflict with a patient! The patient felt that the exercises being done were not doing much in terms of strengthening and had unrealistic expectations about his recovery and how much we could do with him in terms of physio. As he has osteoporosis and many fractures, I had to explain to him the level of exercise we were doing is appropriate to the stage he is at in terms of bony healing,etc and because he is NWB, options for exercises have to be limited somewhat. I think when explaining this to him I could've communicated a lot better and made my explanation short and simple but instead did not explain it in terms that were clear, this resulted in the patient becoming slightly frustrated as I did not explain myself well. I spoke to my supervisor and shortly after went back to the patient and I found I explained everything much more effectively than I did before and this seemed to ease most of the patients concerns. I definately learnt from it as if I had communicated better the first time the situation would probably have not come about although I also learnt you have to be understanding of what a patient may be going through personally and to not always attribute it to something you may have done!

2. I met a 54 year old patient who had recently suffered a stroke and had quite severe expressive dysphasia but could understand everything being said to him (which I soon discovered after speaking to him a little too slowly and got a funny look back!). I found it difficult at first to establish signals or actions with the patient that he could use to communicate where pain was, etc. I found I had to ask very short, simple questions to communicate effectively and to get yes or no answers from the patient just to get a baseline for how the patient was feeling that day. So communicating with him was challenging! I also briefly went through a neurological assessment with my clinical tutor which we haven't covered yet so it was very interesting to go through but I also struggled to carry it out for this reason and did not feel very confident!
Overall I thought I could have developed a bit more of a rapport with the patient before conducting the assessment and am going to observe another physio with this pt to see how to go about communication.