Final Entry – Placement 2 – 2013

I have recently completed a five-week placement on a gerontology rehabilitation ward. I found this placement to be highly rewarding and reaffirmed that this is the area I would like to work in. I felt I worked well with the physiotherapists, the staff and the patients and received good feedback highlighting my strong points and constructive criticism suggesting where I could improve. One of my biggest concerns was that I would not have developed greatly from my second year placement. I addressed a number of these inconsistencies and insufficiencies and feel I have emerged a much better therapist.

During my first week I endeavored to get familiar with the procedures and environment of the hospital. I found out that hospitals are not all the same and the forms and systems can be quite different. I was also off sick for two days in the first week so missed out on some valuable time.

In the weeks following I addressed the key areas that I felt were holding me back in my confidence as a gerontology physiotherapist.

Patient assessment – I have always struggled in this area, as it is a time when the most care with the patient is needed. You are unsure of their actual abilities and have to get a good understanding of where they are and where they are heading. A good mobility assessment is really critical as it is the cornerstone to nursing care and patient progression.

Team meetings – These take some getting used to and I am grateful that my supervisor took such care in ensuring I was on the right path when presenting to the multi-disciplinary team (MDT). Mobility status, rate of progression and discharge planning are all the consultants need to hear about from the physio. I enjoyed these meetings and felt I contributed well to the patients’ outcomes.

Time management – I improved slightly from my last placement in the amount of patients I was able to manage in a day. I feel the hold up in this area is being confident with any type of patient and knowing when to ask for assistance. I was reluctant to increase the patient load in fear of rushing and causing injury or not leaving enough time to complete documentation. I fell in to this trap at one point but made sure I stayed behind to complete what was needed.

Presentation – I was pleased to present to the physiotherapy group some background on Progressive Supranuclear Palsy (PSP) following a stroke patient I had treated with PSP as a previous condition. I identified some key treatment strategies that was supported in several research reports and highlighted the difference between PSP and Parkinson’s disease at diagnosis and progression.

One of the biggest hurdles to overcome in gerontology, I feel, is painting by the numbers. Create a problem list from the top six impairments and roll out the treatment plan. There is of course the risk of over thinking things as well, but each patient comes complete with their own set of diagnosis, co-morbidities and social history that needs to be considered during each session. All these factors make the area of gerontology physiotherapy interesting and rewarding and an area that I feel I could be successful in.