Social Situation

During my ortho inpatient prac my Curtin supervisor and I had an appointment to see a 21 year old female who had fractured her (R) ankle at the pub skylarking with friends. She was a student and lived with her father. There were some social issues regarding her situation which became apparent as the subjective examination was being conducted. As I asked her some questions regarding ‘home care’ and ‘mobility’ she continually appeared to become upset . My supervisor at this point asked her if she was ok and with this she broke down and cried.
The issues being brought up from my questioning she had not thought about and the uncertainty of not knowing the answers to my questions caused her this distress. I told her I would refer a Social Worker and Occupational Therapist to see her. She calmed down thanks to my Supervisor and I went and paged the SW and OT.
During the second part of my assessment the Supervising Nurse on the Ward called out to my Supervisor who attended to her. I continued my assessment. Later it was explained to me that the SW was not happy regarding my referral to him for this patient. He didn’t consider it necessary to see the aforementioned patient. My supervisor explained to the nurse why it was appropriate and subsequently this was relayed to the SW. He did end up seeing her prior to discharge.
I understand as physio’s we need to ask the questions regarding Social Hx, Mobility etc not only for our benefit but also so we can decide whether we need to refer other allied health care workers to our patient’s.
This experience highlighted to me the importance of conducting a thorough subjective assessment. From this a holistic approach to health care is delivered. The patient in question required the services of a SW and an OT and thankfully they were forthcoming to her. Where we deem it necessary for other allied health care workers to intervene we may need to put out case across as not everyone may agree on why there services are required. At the end of the day it is all about adequate patient care and appropriate discharge.