A pt I had had to wait for swelling to decrease before being operated on which was a number of days and during her wait she was ambulating independently with a WF NWB on the injured leg. After the surgery once she was allowed to start mobilizing we had to try get her onto using AC’s as she had a number of stairs to negotiate to get into her house. The first day I got her to use the AC’s she was a bit unsteady and so I told her to continue to use the WF within the room and around the ward unless she had someone to stand-by assist. The next day I had my CCT with me and I had read in the nursing notes that she had been amb to and from the toilet with the AC’s, so I explained to my CCT what I had told her the previous day and then what I had read in the notes that morning. My CCT asked me what I would say to the pt if it was true that she had been amb with the AC’s without any SB A. I knew I had to make a point to her that the reason I had told her to use the WF independently was for her own safety and what she had done was wrong, but I wasn’t quite sure how to make this point and I felt like it would seem a bit condescending being a student half the age of the pt reprimanding her for what she had done. When I went in to see the pt I made my point and she understood the reasoning and said the reason she had gone against my orders was because she wanted to improve her performance with the AC’s so she could go home sooner. During the Rx session she was still unsafe with her stand to sit transfer despite my constant reminders of the procedure needed to sit down safely. When giving me feedback after the Rx session my CCT told me I should have come down harder on the pt.
Although I feel uncomfortable being tough on pts when they don’t follow commands I know I’ve just got to learn to do it as its for the good of the pt. If I explain to the pt that it’s a safety concern and extremely important that they follow the instructions that I give them they should understand. I know its something that I really need to practice and work on but as I continue to gain experience through the year I’m sure my apprehension that I’ll offend the pt will lessen and hopefully eventually disappear.
2 comments:
Its hard but I think you really need to be confident about yourself and skills as a clinician. You have every right to be hard on a pt and tell them what is right and wrong. Thats our role as an allied health professional. We dont go through 3 years of hard study and 1500 exams to not be listened to!
:D
yeah i agree, if you hesitate or show a lack of confidence then the pt will loss confedence in your ability. In the long run the pt prob wont remember that their physio told them off anyway.
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