Sunday, 9 September 2012

2012 - Final Entry - I'm Still Standing


It seems like a really long time since I wrote the initial entry. The routine of work can become a bit of a grind at times. Although I am sad to be leaving the placement, the patients and the staff, I am satisfied with my efforts and the confidence that grew in me. The daunting nature of a neurological placement seems distant as well – although not nearly mastered, certainly well apprenticed.

As always I made communication my first goal. I feel it is an imperative part of being a therapist and all situations are improved if used effectively. Poor communication can lead to countless errors, poor safety and resource wastage. On this placement I was exposed to direct communication with patients, allied health professionals, family members and the general public. There is a great art in being able to slide into different roles. Health professionals need succinct information that is relevant without the chit-chat. Family members require a more friendly, approachable professional who is also able to deliver top-notch service. The level of communication then varies greatly when it comes to patients who have suffered a stoke. Some patients are able to comprehend their condition and are either fully communicative or have a flat effect. Others have a vague awareness of what is going on and can only follow one stage commands. Some can become emotional if given too much praise while others depend on the positive feedback. Being able to cover all these bases within a morning can be exhausting but becomes easier with time and reflection. Starting each day with a warm, friendly and humble attitude seems to go a long way in the right direction. Another important aspect of this is good written documentation from other professionals in contributing to the understanding of the patients communication needs. It keeps everyone on the same page, as it were. When you read in the integrated notes that a patient becomes emotional when speaking about their condition but calms if distracted by the footy, this can save much needed therapy time. Recorded conversations with family members or consultants can piece together the structure of how this patient is being supported.

This placement has gone a long way to showing me what a physiotherapist can be to a patient and how fragile that relationship is. Working so hard with someone and finding out their medical and social history, meeting their families and getting them to place their trust in you and your colleagues – and then having to leave – it almost seems neglectful to assume that others can fill the void. A good hand-over needs to include a social aspect that may get lost in the medical jargon and it is why the S in SOAPIER is so important. It can be used for more then “Valid verbal consent”. It should express the patients mood, their feelings and their complaints as these really are the ultimate goals – improve their mood (and health), improve their feelings, minimize their complaints.

I was going to write a whole bit on time management and safety awareness but these seem to have taken care of themselves. My shoes held up, thanks for asking. Good form, good function. Building a great physiotherapist from the ground up.
  

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