Hi Guys, i'm on my inpatient cardio prac at the moment however i'm seeing a fairly diverse list of patients. This patient is a mobility patient who presented following a fall and I have seen him 5 times, 2 for assessment 3 for treatment. He is complicated by the fact he has severe L hip pain, currently managed R hip pain, some form of blood poisoning and he is undergoing chemotherapy at the moment. His Berg is within the range of requiring a walking frame.
There have been 2 days where I have been unable to treat him. The first time his hip pain had been aggravated by balance exercises we had been workin on. He didn't blame me, he blamed his hip and appeared to be quite down about it all. This was quite hard because one it appears that my treatment caused this man pain and no benefits and two he blamed himself. I will also mention that because of this patients cancer treatment he is not allowed to take pain medication above the strength of panadol. He says the panadol does nothing for his pain.
The most recent treatment refusal was due to the patient having had chemotherapy in the morning. His medical problems are interfering with his treatment for impaired balance. The doctor does not seem to be concerned with this L hip and is mainly concerned with the blood poisoning. However this patient was admitted d/t a fall caused by poor balance. This area is not able to be treated as well as needed and so he will be discharged using a frame but with no real balance improvement. I will talk to my supervisor about this but I was wondering what you guys would do in my situation. I am considering talking to his doctor about his hip. Other than that i'm not really sure what else I can do. Any advice would be appreciated.
Thanks, Anna
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Hello Anna ~
Blood poisoning certainly sounds critical; I was wondering how were the doctors managing that? I think that talking to the supervisor is definitely a great idea! Do let him/her know about your plan to speak to the doctor as well which I am sure he/she will agree! I believed the doctors will consider Physio’s opinions definitely prior to d/c as this constitutes overall patient care + welfare. It certainly wouldn’t be nice sending a patient home for another fall and subsequent admission again the next day. According to my supervisor when I was doing my cardio placement, if need be, we can ask to extend their hospital stay (so we have to assess carefully if they are safe/fit enough to be sent home with/without a walking aid; liaise with carers and other healthcare professionals such as OT if patient hasn’t been seen by him/her), refer to outpatient services if follow-up on eg: more balance training is needed or RITH (rehab in the home) if mobility/travel is really an issue. Hope this helps!!!
Cheers Peiying ~
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