Bcoz people can get nasty

Hello everyone!

This week I have been experiencing a mixture of excitement, happiness, fear and anxiety – it being the last week of placement; not being 100% sure about passing it and also the upcoming PCR!

I would like to share with you my experience with a particular patient over the last four weeks of my musculo placement. It has been a roller coaster ride which I didn’t particularly enjoy, unfortunately. This lady has a # of the (R) head of humerus managed conservatively, coupled with a history of DM, obesity and being a current smoker (these certainly are factors which can contribute to delayed union of her # -about 10/52 post now). From week 1 through week 4, it has been a friendly-nasty-friendly again-nasty again encounter with this patient. What I found particularly difficult with this case is that although exercises given were demonstrated, practiced and prescribed accordingly with no pain, this patient tends to come in the next time complaining of more pain due to the exercise. The session became ‘challenging’ as she tends to be agitated and unhappy; it was made more difficult as I was totally ‘thrown off track’ when I recalled how successful the previous session supposedly went. It definitely hurts when patients direct their anger at you, especially when you have followed the correct procedures including telling them should any exercise cause pain, stop and let us know. What I learned from here is that firstly, I need to strengthen myself further mentally and emotionally to deal with such cases; secondly, it is very crucial to document what you have done, what you have explained during the session and what you have evaluated so as to protect yourself. I have also documented my experience with this patient in a more objective manner in the transfer summary so that the next student taking over knows what to emphasize and what ‘precautions’ to take.

I believed my experience with this patient did certainly contribute to professional development. I can see myself handling situations whereby patients reported being worse more confidently. When handling a not-so-friendly patient, I think it is really important to remain calm, confident and composed (including controlling emotions such as anger’ & ‘frustration’ which I really experienced!!!); acknowledged that they got worse and then direct their attention towards what is more important, and that is what can be done now to make them better. What I did with this patient was that I told her since the exercises gave her pain, then we have to modify accordingly and I would perform an assessment on the shoulder to ensure that no additional damage or problems have occurred. I suggested the usage of hotpack for the muscle soreness she also complained of and reinforced to her that she needs to be compliant towards the advice to stop any exercise which results in shoulder pain. Towards the end of the session, the storm has calmed, atmosphere was less tense and she was friendly again (but I was certainly and I still am, slightly overwhelmed…). It will be great learning experience if anyone can share with me your not-so-friendly experiences with any patients, the emotions you went through and how you deal with the situation!

Cheers, Peiying ~