I am currently on my rural placement, predominantly a musculoskeletal outpatient placement. I am finding it difficult to adhere to my supervisor's time-frames allocated to subjective (5-7 mins), objective (10 mins) and notes (5 mins) for an initial assessment.
My time management is an area of weakness for me and I am very grateful to have a supervisor who will help me overcome this problem. However I tend to need lots of time to think things through or need to write things down in order come up with a problem list and treatment plan. Just slow with my clinical reasoning I guess :p I feel that these time constraints are preventing me from furthering my learning as I'm tending to rush and I fear I will miss out important assessment areas.
So far I have addressed my time management issue the usual way: by being ultra prepared for my patients, i.e. planning what special questions that need to be asked for the patient's presenting complaint, evaluating possible assessments and treatments that need to be conducted and pre writing as much of my notes as I can. I have also tried to be more directive with my questions during the subjective.
Does anyone have any handy hints for improving time management, besides what I am currently doing?
My supervisor has also instructed me to cut off my patients if they begin to discuss irrelevant information during a subjective. While I appreciate that this is required for time management with some patients whom continue to talk, I don't feel comfortable doing this routinely as I feel it may come across as unsympathetic to a patient. Should I discuss my feelings with my supervisor if the issue is raised again so he understands my point of view, or should I just keep the feedback in mind and continue to conduct my subjective, modifying the flow of conversation as appropriate for each patient?
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1 comment:
I think we all understand the situation you are in. Unfortunately you go from having an hour and a half to Ax a patient in your musculo placement to only 20-30 minutes in rural/private practice. I also find it hard to cut off a patient mid way through a subjective but I guess it's necessary to make sure you help them in the time period you have. Most of the time you have an idea of their pathology from their subjective so the objective should focus on confirming this diagnosis. If all else fails, try something and see if it works.. if it does - keep doing it, if it doesn't - try something else.
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