Hi guys!
This first entry is on my Dec placement doing neuro outpatient. Patients are allocated 1.5hours each and sometimes they are accompanied by their caregivers. I had the opportunity to work with this patient who has a very supportive spouse when it comes to rehab. I would like to share on this particular session which upset me. As part of my subjective, I asked if there were any new issues/concerns. The reply was ‘no, everything has been well!’ However, later during the session I noted that the spouse had gone to look for the Senior PT who then came along and addressed my patient’s sit to stand! Accordingly, the spouse was experiencing some difficulties facilitating STS at home. I could be too sensitive but at that moment I interpreted the look on the PT’s face as ‘Haven’t we gone through STS training during tutorial this morning? You mean you still don’t know what to do?’ (!!!) Eventually, I took over the session again but noted that the spouse had his arms folded and appeared to be rather inpatient, looking at his watch a couple of times. My immediate response was to explain to him what I was doing so as to engage him. That earned me serious ‘interrogation’, which I felt the component of ‘respect’ was lacking... All my confidence was swept away and that definitely affected the session... I chose to re-direct my full attention onto the patient then, who had been cooperative all along, pretending the spouse wasn’t there… My rationale at that point was if I couldn’t engage the caregiver then it’s alright as the main focus should be on the patient. Hopefully though, the spouse’s body language and attitude would not affect the patient negatively. (Not too sure if my rationale then was right? Any comments/opinions on this will be great!)
This got me thinking what will be the best way to manage caregivers who are present during a fairly long PT session. This is worth looking into as they are important people in patients’ lives and have the potential to influence rehab. I believe as students, it will definitely take some time for trust in our competency to be built up. Appropriate explanation of rationale + education to patients & caregivers and a display of confidence are absolutely critical during every session. I believe in engaging caregivers during a session so that they are empowered and feel involved, that they know they can help their loved ones get better. At the same time, they help to motivate/encourage patients and provide an additional pair of hands during treatment. I think the problem arises when the treatment doesn’t require an extra pair of hands. Then, it might be a good idea to ask if they would like to stay during the session or perhaps wait at the waiting area with a nice cup of tea and magazines if available! I believed what happened to me was partly due to the fact that I was ‘new’ to that caregiver and was feeling nervous. But I guessed this is normal at this stage and will improve as we gain more patient/caregiver contact experiences! Do let me know if there are any other suggestions on managing caregivers! All the best for 2nd week!
Peiying ~
This first entry is on my Dec placement doing neuro outpatient. Patients are allocated 1.5hours each and sometimes they are accompanied by their caregivers. I had the opportunity to work with this patient who has a very supportive spouse when it comes to rehab. I would like to share on this particular session which upset me. As part of my subjective, I asked if there were any new issues/concerns. The reply was ‘no, everything has been well!’ However, later during the session I noted that the spouse had gone to look for the Senior PT who then came along and addressed my patient’s sit to stand! Accordingly, the spouse was experiencing some difficulties facilitating STS at home. I could be too sensitive but at that moment I interpreted the look on the PT’s face as ‘Haven’t we gone through STS training during tutorial this morning? You mean you still don’t know what to do?’ (!!!) Eventually, I took over the session again but noted that the spouse had his arms folded and appeared to be rather inpatient, looking at his watch a couple of times. My immediate response was to explain to him what I was doing so as to engage him. That earned me serious ‘interrogation’, which I felt the component of ‘respect’ was lacking... All my confidence was swept away and that definitely affected the session... I chose to re-direct my full attention onto the patient then, who had been cooperative all along, pretending the spouse wasn’t there… My rationale at that point was if I couldn’t engage the caregiver then it’s alright as the main focus should be on the patient. Hopefully though, the spouse’s body language and attitude would not affect the patient negatively. (Not too sure if my rationale then was right? Any comments/opinions on this will be great!)
This got me thinking what will be the best way to manage caregivers who are present during a fairly long PT session. This is worth looking into as they are important people in patients’ lives and have the potential to influence rehab. I believe as students, it will definitely take some time for trust in our competency to be built up. Appropriate explanation of rationale + education to patients & caregivers and a display of confidence are absolutely critical during every session. I believe in engaging caregivers during a session so that they are empowered and feel involved, that they know they can help their loved ones get better. At the same time, they help to motivate/encourage patients and provide an additional pair of hands during treatment. I think the problem arises when the treatment doesn’t require an extra pair of hands. Then, it might be a good idea to ask if they would like to stay during the session or perhaps wait at the waiting area with a nice cup of tea and magazines if available! I believed what happened to me was partly due to the fact that I was ‘new’ to that caregiver and was feeling nervous. But I guessed this is normal at this stage and will improve as we gain more patient/caregiver contact experiences! Do let me know if there are any other suggestions on managing caregivers! All the best for 2nd week!
Peiying ~
1 comment:
(from LESLIE)
Hi Peiying,
It is a really difficult situation to be in, having a family member or caregiver observe your treatment, especially when we are students and still trying to gain confidence in our abilities. I always find I am
much more relaxed and confident and my treatment is more effective when I am not being observed. I agree with you that getting the caregiver involved in the treatment is beneficial, especially if they are going to be doing some of the things you will be working on in the session (eg. STS); however it seems you have to get a feel for the person and their personality before doing so. On my last placement, if the patient had a family member visiting when we went to do a session,
my supervisor would simply tell the family member how long we would be working with the patient and suggest they go get a cup of tea or coffee. She was very polite, but didn’t give much of a choice to stay
during the session. This seemed to work well and none of the family ever had a problem with it. I think it’s a matter of becoming confident and comfortable being assertive (in a polite manner) with the caregivers. This is something that will only come with experience, so until then we’ll just have to fake it till we make it!!!
PS…This is Leslie
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