I am currently undertaking my neurology outpatients (NOP) placement and last week met all my patients for the 5 week duration I will be in attendance there. One patient sustained a CVA in November 07 and has been attending NOP’s now for 16 weeks. Prior to meeting this patient I was informed by my supervisor that he would be referred onwards to ‘Community Physiotherapy’ or a similar organisation after my tenure with him.
The supervisor told the patient soon after we met and it was obvious from this the patient was upset and immediately anxious about what the future held for him in terms of rehab. The patient has since expressed his concerns to me during the 2 Rx sessions he has attended. It seems apparent to me however that it is the obligation and the social aspects of his physio appointments that are more important to him. This can be backed up by his less than enthusiastic approach to his HEP.
I have tried to rely the importance of finishing this 5 weeks with me as a NOP with a commitment to his HEP to gain as much as he can so he is better prepared to undertake future rehab. He also mentions, at least three times per session, how much he will miss attending PT Rx because of the above reasons. I have tried to re-assure him that he won’t be left with no options at the end of his NOP programme and new social opportunities will eventuate with further rehab.
I understand the holistic aspects of our position a little clearer now. Most people value what we do for them immensely and are appreciative of us helping them re-gain function and the like. We need to acknowledge this but we also need our patients to gain ownership of their functional limitations and utilise their HEP. We are also required to counsel patients as I have learnt from this experience. This I will continue, with this patient, for the following 4 weeks and perhaps this may be as important as the Rx session(s).
1 comment:
I think this situation is one which will arise all the time, especially when we as physios provide too "good" a service to our patients. Patients may grow attached to us but it is important to stress that the patient has to take ownership of their own progress and well-being. PT Rx is just a stepping stone to helping them regain independence or back to their pre-admission status. We have to let them know that there are other forms of Rx in the community that can help them maintain their functional status.
I guess you should continue to do your best for your patient, and prepare him/her for independence in the community. Explain to the patient that being in the community would be a better solution for them to recover sooner. I believe it is true that just spending some time talking and understanding the patient, may be more important than physically treating the patient. Hope your patient will understand what's best for him/her soon and not feel dejected that he/she will be progressed to another level of Rx.
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