I am currently on my rural prac where I’ve been seeing patients on an aged care rehab ward. One of my patients was admitted to the ward with lumbar, sacral and rib fractures following a fall at home. These fractures are stable, and my treatment thus far has been mobilising her around the ward with a WZF. As I have been treating her, she has started to tell me bits and pieces about what happened the night of her fall, but also the weeks leading up to it. To cut a long story short, her husband of 62 years had passed away 8 weeks before her fall, and she had cared for him for 3 years before he died. She also said she hadn’t been taking care of herself and wasn’t eating enough because she felt so lonely and grief stricken. She has cried during several Rx sessions with me, and has stated she wishes she’d ‘died with her husband.’ During the Rx session, I’ve asked her about how she had been coping with her loss and about her husband (only if she felt comfortable with it) because I felt that if she could talk about her loss, then maybe it may alleviate some of her pain, but also assist in her compliance with PT Rx.
My concern now is that she has become reliant on me to talk about what has happened, but also she has been asking me advice on issues that I don’t feel qualified about. Her doctors have asked her about taking antidepressants, which she has refused, but she almost constantly asks me whether or not she can be forced into taking them. My reply is always that she should discuss it with her doctor, but she keeps asking me as she says she isn’t comfortable speaking to him.
My current plan for this situation is to speak to my supervisor to see how I could change my tack with the patient without hurting her feelings, and asking whether a referral to a counsellor/ clinical psychologist would be beneficial (mainly to find someone who is qualified and can give her appropriate advice). I also plan on speaking to her doctor about what the patient has been telling me.
I feel as though I’ve bitten off more than I can chew here, as I didn’t expect that my input to her would mean as much as I thought. Has anyone else dealt with a situation like this before?
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1 comment:
It's great that the patient can feel so comfortable talking to you about her issues. I think its imporant to remember that we are not qaulified to discuss things such as medications and the patient needs to reminded of this. I guess the other option is to talk to her doctor and ask what amount of information he would like you to tell the patient.
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