Fast-paced musculo?

Hello everyone!

Staying +ve has helped me got through the 1st week of my musculo placement! (Though I almost cried in front of my FCE today…!) Hope everyone’s doing well!

One patient after another really wasn’t easy. I was trying very very hard to keep to the time limit so that the next patient did not have to wait too long. To me, outpatient musculo is really fast-paced, you got to work fast, think fast and treat fast (+ effectively)! Today, I realized this ‘pace’ is not always possible, at least for me at this stage as a baby physio… I saw a 90 year old (!!!) patient whom besides having a musculoskeletal problem, also has a balance problem described as ‘horrible’. I tried to ‘rush’ still, but it’s just not possible. Considering the age and balance issue, the session warranted more considerations and precautions. Things I tried to do included - keeping the time in standing for observation to a minimal - minimize change in position and providing adequate supervision (but I found minimizing change is really hard as I still couldn’t organize in my head all the different assessments to be done in the different positions) - frequently checked if patient is feeling well – specifically instructed not to move about when I left the cubicle - spent more time in education and practice of posture correction & exercises, as I noted this would help the patient remember better. I tried to be very cautious with hands-on as well as the skin was so fragile!!! I also learned from this case that I made a very serious mistake the last few days! Apparently I was just literally ‘reading through’ and not absorbing important information... Because I couldn’t recall at all what’s the patient’s medical history and surgical history during the session. This happened to another patient as well who reported dizziness after every change in position and I couldn’t recall the relevant medical history. Perhaps I was rushing through so that I can be on time… Also, part of me could have subconsciously assumed these were not as important in a musculo outpatient setting which is very wrong! My perception of musculo involving younger, 'healthier' patients really needs correction. There were just so many other things patients brought in with them, like their fall history, stroke history, social circumstances (eg: how husband could not be depended on to help with chores because he's cheating on her), anxiety, depression etc. Once again, I learned that it’s always about a holistic approach when it comes to patient care; it doesn’t matter whether it is inpatient or outpatient! I need to spend the time to look at the whole / bigger picture! Hopefully I will get more efficient over time and find the right ‘balance’ in a more fast-paced musculo setting! :)

All the best to myself n everyone for next week! :D

Cheers Peiying ~