Hello Guys!
The 3rd week passes really quickly! Do you agree?
This week I was down, sadly. I am in some form of ‘professional crisis’. The ward was relatively quiet this week so I had time to see the ‘lower priority’ cases for general mobility. But it turned out that these cases weren’t as easy to handle as I thought. It’s definitely more than a frame or a stick and ‘let’s go for a walk.’
How do you feel if
a cardiac surgery patient tells you he still has dull aching on his (L) upper chest and palpitations which the doctors have noted but still persisting?
a hemicolectomy patient with stage IV cancer tells you his large gapping abdominal wound hurts badly and on top of that, he’s going to the toilet many times due to loose stools?
a renal failure patient bumping into things tells you his vision is bad and glasses makes his vision worse?
I feel ‘helpless’. Because these aren’t the problems we as PTs can directly intervene to help them feel better quickly. But they are important to the patients. For some of them, walking and exercises although important, might not be their immediate concerns/worries and priorities. I just wished I could do more for them… So it really affected my mood. I was then told by a close friend “You are a PT, not God.” That’s when it dawned upon me that there’s only so much I can do within my abilities; that there’s only so much any professional can do within his/her abilities… I might not have the capabilities to solve those problems but I have the resources to perform referrals. This is why a multi-disciplinary team approach/communication is so essential. And also, after I have done what I can, I guessed I got to learn to just ‘let go’. I tend to ‘bring work home’ and this drains me out quickly…
2nd related issue I have is how much to push. I was told to rehab the patient in the 2nd case I mentioned above prior to d/c. I saw him a couple of times but a number of these he went “not today love…” He had issues with a poorly healed wound and loose stools. I noted he has been ambulant with a wheeled walker to and fro the toilet which he said totally drained him out (he’s big as well). So I let him have his way a few times. My thinking is that he is a palliative case, he’s ambulant and we have arranged for him to have follow-up rehab at home. He had a point when he said he didn’t want to over-exert himself because he’s for home soon and didn’t want anything to go wrong. I felt really scared/nervous when I had to report to the PT those times he said no as I think it reflected on my ability/competency… I just think that if I had insisted on a walk, compliance/cooperation would be even lower subsequently... Do you think the PT will see my point? Does anyone think I am wrong? Is there a better way to handle this kind of situation? And gauge how much to push?
Last lap guys!
Peiying ~
The 3rd week passes really quickly! Do you agree?
This week I was down, sadly. I am in some form of ‘professional crisis’. The ward was relatively quiet this week so I had time to see the ‘lower priority’ cases for general mobility. But it turned out that these cases weren’t as easy to handle as I thought. It’s definitely more than a frame or a stick and ‘let’s go for a walk.’
How do you feel if
a cardiac surgery patient tells you he still has dull aching on his (L) upper chest and palpitations which the doctors have noted but still persisting?
a hemicolectomy patient with stage IV cancer tells you his large gapping abdominal wound hurts badly and on top of that, he’s going to the toilet many times due to loose stools?
a renal failure patient bumping into things tells you his vision is bad and glasses makes his vision worse?
I feel ‘helpless’. Because these aren’t the problems we as PTs can directly intervene to help them feel better quickly. But they are important to the patients. For some of them, walking and exercises although important, might not be their immediate concerns/worries and priorities. I just wished I could do more for them… So it really affected my mood. I was then told by a close friend “You are a PT, not God.” That’s when it dawned upon me that there’s only so much I can do within my abilities; that there’s only so much any professional can do within his/her abilities… I might not have the capabilities to solve those problems but I have the resources to perform referrals. This is why a multi-disciplinary team approach/communication is so essential. And also, after I have done what I can, I guessed I got to learn to just ‘let go’. I tend to ‘bring work home’ and this drains me out quickly…
2nd related issue I have is how much to push. I was told to rehab the patient in the 2nd case I mentioned above prior to d/c. I saw him a couple of times but a number of these he went “not today love…” He had issues with a poorly healed wound and loose stools. I noted he has been ambulant with a wheeled walker to and fro the toilet which he said totally drained him out (he’s big as well). So I let him have his way a few times. My thinking is that he is a palliative case, he’s ambulant and we have arranged for him to have follow-up rehab at home. He had a point when he said he didn’t want to over-exert himself because he’s for home soon and didn’t want anything to go wrong. I felt really scared/nervous when I had to report to the PT those times he said no as I think it reflected on my ability/competency… I just think that if I had insisted on a walk, compliance/cooperation would be even lower subsequently... Do you think the PT will see my point? Does anyone think I am wrong? Is there a better way to handle this kind of situation? And gauge how much to push?
Last lap guys!
Peiying ~
1 comment:
hey there!
I understand what it feels like to have patients like that and that helpless feeling knowing that you can't do much for that patient. I think the important thing to realise is that even if the patient refuses treatment because they're having a bad day, just having you chatting to them about something completely random (sport, music, their hobbies) and giving them a smile can actually make the world of difference to their day, sometimes it can do more to them than your treatment.
As for the second case. You can try and persist but if the patient refuses then that's the final straw. Continuing to educate the patient as to why you want them up is the most we can do in this case. They then have to make that decision as to where to go from there. I think your right in saying that if you pushed too hard then patient compliance would decrease...I don't think you did the wrong thing
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