I was on a neurology placement and decided to attend an OT session with my patient to get an idea of perceptual deficit assessment that is conducted for a stroke patient. Whilst at the session the OT team were teaching the patient to use an electric wheel chair and thus had to transfer the patient from his manual wheelchair to the electric. I watched while the two OTs allowed the patient to stand up in a maladaptive and unsafe way aka pull up from a table, they almost forgot to put the breaks on the chair until I reminded them and then struggled to control/facilitate the patient's balance in standing. This was a huge eye opener for me as I assumed that OTs have the same level or instruction and learn similar patient handling and transfer methods as physiotherapists do.
Throughout the treatment session I kept trying to stop myself from interferring with their patient handling as I felt it would be inappropriate for me, a student, to teach experienced OTs safe handling methods for the patient without appearing condescending. However at times I did step in for patient safety, i.e. wheelchair breaks and recorrecting the patient's affected LL alignment to prevent his foot slipping off the electric wheelchair while it was in motion. I also ended up doing a transfer with one of the OTs when the other OT was occupied showing her and stating/hinting that the patient usually transfers this way and it is the easiest for him.
As a qualified PT I think I will feel more comfortable teaching and sharing patient handling techniques to other health professionals. I have also now realised that contrary to my previous opinion not all OTs and maybe nurses etc. will know appropriate patient handling and that the baseline knowledge and safety precautions physiotherapists learn are not commonly known or taught to other health professionals. Thus it has highlighted to me how important and specialised the physiotherapy profession is.
Has anyone been in a position where they have witnessed poor manual handling and felt powerless to change it?
Did you step in or did you just struggle not to intervene and state, "but you should do it this way"?
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2 comments:
When I was on my neuro place, I was fortunate to be working with a very good team of allied health professionals. The OTs and nursing staff were all looking to the physio to suggest ways of transfers and not doing it their own way. We are also expected to write in the integrated notes as to how much assistance is needed and the type of transfer that was suitable for the particular patient.
However, if i were to be in your position, I would find time to speak to the OTs and ask why they did that particular transfer? I would not go in and expect answers, but more of a learning kind of attitude/approach. I am sure most of them would be glad to help a student out!
I have intervined before where I thought it was unsafe what was being carried out. I may have got the right people who let me go as they didn't fire up at me. But I could imagine sometimes some people would not like interference. If your watching the patient and they fall then you have to fill in an incident report. Better to intervene before that!
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