Don't come near me!

I am currently on my elective placement at King Edward's doing Women's Health. As I'm sure you all can imagine, this can be quite a confronting area to work in and the need to develop trust with your patients is very important as in many cases treatment involves performing ultrasound on perineums and haemorrhoids. The shock of performing such treatments subsides quite quickly as you kind of need to just get on with things however, it is not quite so easy for all patients.

Recently, one of my patients had been readmitted due to an area of hardness, perhaps a haematoma, developing around a scar that had resulted from the repair of a 3rd degree tear of her perineum. It was very uncomfortable and tender for the patient and she had been referred to the physios for ultrasound.

The first time I visited her, her boyfriend and his mother were there and she asked if I could come back later. Due to my busy schedule that day this was not an option. She then asked if it could wait until the next day and I explained it was important that the she received treatment as soon as was possible. Her visitors were happy to leave the room once I had reassured them that it wouldn't take longer than 15 minutes. 

Once they had left, my patient was still very reluctant to have ultrasound. She was asking me all sorts of questions such as "Will I have to have a needle?" and "will tis be at all painful?". I realised that a large reason for her reluctance to allow me to ultrasound was that I had provided her with very little explanation of what it was that I was going to be doing and how it would help her condition. A lot of patients readily accept that the physios know what they are doing and why they are doing it, which I had gotten used to. It is surprising really, considering the intrusive nature of the treatment. This was the first patient I had come across who had needed a reasonably in-depth explanation of the reason ultrasound would help.

Once I had provided this explanation, she was a little more willing to have the treatment but continued to ask questions throughout the treatment about how long it would take for it to have an effect and still seemed a bit skeptical. 

At the end of the treatment she said it felt a little better and the following day she couldn't kick her visitors out quick enough when I arrived.

This was a valuable experience for me as it has reminded me that not all patients are so trusting of health professionals and require a little more explanation than "It's Sarah the physio here, I have been told you need some ultrasound for you perineum tear. It will help!". I am happy with how I dealt with the situation in terms of being understanding of the patient's need to have more information provided and this helped me develop really good with a patient that wasn't necessarily an easy patient to develop good rapport with!