Optimal Patient Care?????

In the first week of my neurology placement there was a 35 year old pt was admitted with a R MCA CVA(TACS) rendering only about half his brain function intact. The patient’s hospital stay had been complicated by seizures, pneumonias, cardiomyopathy and a number of urgent and elective cranial surgeries resulting in osteomyelitis etc. Basically the patient was still quite unwell as he was on ABs, had a lung infection/atelectasis and experiencing frequent residual HA/migraines. I was going to take over this patient’s rehab, so for the first few days while treating other patients I observed his treatment sessions.

The patient’s concentration level was only a few seconds at a time and the treating physio tended to scream at him to get his attention. A couple of other stroke patients commented at the time at they disapproved of the way she was handling the patient. The patient on a number of occasions also told the physio that her loud voice was making his HA worse yet this didn’t deter her from yelling at him. I was extremely upset by this as I thought it to be a disrespectful and unethical approach for this patient, especially as her management was aggravating his symptoms. However as a student I didn’t feel that I could broach the subject with her or any other physiotherapists working in the gym. I witnessed other physios treating this patient and they were able to have effective results without yelling. I was actually glad that I was taking over the patient’s rehab, so I could prevent him from being treated by this physiotherapist.

I think in the future if a come across a similar situation as a qualified physio, I will talk to the physio and try to emphasis the detrimental effect their behaviour/ management is having on the patient and suggest other methods that can be employed with the patient to maintain his attention.

Has anyone come across another physiotherapists behaviour during a treatment session that they thought was not respectful to the patient or not optimal patient care?