On my womens health placement I initially had a bit of trouble getting my head around all the things we had to say and educate the patients on. Some of the things we had to teach were quite sensitive issues (e.g. perineal pain, bowel and bladders problems). I had sat in with the other physios when they were seeing patients and they seemed to go over these issues with no problems.
Eventually after I had done a few post natal educations of my own I realized that after birth patients are so used to people asking about their bowel and bladder habits and their perineum that it does not bother them anymore and they are more than happy to disclose the details to a physio student. Also as a result of all the antenatal edu pts get many of them know the technical terminology associated with womens health which makes it much easier. However some patients did not understand English very well and therefore did not understand what ‘Have you opened your bowels yet’ or ‘Did u have any constipation during your pregnancy’ meant. Initially this was difficult but I soon realized that if you didn’t get embarrassed or make a fuss about it the patients always thought it was funny if you re- phrased it and asked them ‘if they’d done a poo’.
This prac has show me that even if you are embarrassed about the things you are asking if you act confidently and are not immature then patients are less likely to be embarrassed and more likely to divulge important information to you.

Conversion Disorder

On my womens health placement I had a very interesting pt. This pt had had a home birth with a 5 page detailed birth plan, however everything did not go to plan when she retained her placenta and her and her newborn had to be rushed to hospital. When in hospital she lost sensation and power in her LL and pelvic pain. Within a few days of giving birth this pt was unable to walk without max assistance. She also AS and a number of other problems, all of which were self diagnosed. However with all these issues the pt was not phased at all and came across very cheerful, whereas the husband was very emotional and teary. The doctors had no idea what was wrong with this pt and blood tests and MRIs showed nothing.
Initially I found it difficult to see this pt as there was no apparent reason for her neuro symptoms and I cant help but think that maybe the patient is just being dramatic and making it up.

After talking to the other physios I learnt that this pt may have conversion disorder which is where the patients develops symptoms, such as this pt had, however there is no neuroligcal cause for these symptoms. It is thought to be brought on by psychological stress or trauma which would include childbirth, especially when the pt is rushed to hospital immediately after.
After learning this I found it easier to see this pt and it reinforced the (obvious) fact that diagnosis is not the be all and end all of physiotherapy and that we should not purely treat based on our Ax and not the diagnosis or lack there of.

Ortho pt on Cardio prac

When I was on my Cardio placement on a surgical ward all my Cardio patients were going well and then I was given an outlier pt who had had a TKR. The only orthopaedic placement id had were the 3 hours ones in second year when you were on placement with 5 other people and didn’t learn a lot because you spent the whole time doing subj and obj.
I knew basic things like ROM exercises and IRQ/SQ etc but other than that I didn’t have much idea what I was doing. To make it even more complicated the pt was so far behind on her pathway because she had had a PE post surgery. I had to see this pt twice a day for 3 days which took up a lot of my time when I should have been seeing cardio patients.
I did this until I my supervisor asked how I was going with everything and I told her that I felt like I had no idea what I was doing with this pt. Immediately after this she took the pt off me because it was my Cardio placement and I shouldn’t have had to see ortho patients.
This has shown me that if id just spoken up earlier then I could have saved myself 3 days of feeling useless and the pt would have prob got better treatment from a physio/ student who knew what they were doing