Hey all!
I’m currently on my musculo-outpatients clinic, so far no major dramas. But what I find extremely difficult at the moment is not being able to effectively palpate and assess the spine. I’ve had a range of Cx, Tx and Lx spine patients to treat, and I just find it frustrating not being able to feel the right thing when doing PPIVMs and PAIVMs assessment. To me, when assessing, all the segments feel stiff, I cant seem to differentiate when R1 comes on, or which segments have lots of movement. When the supervisors having a go at assessing my patient, to make sure I’ve picked up on the right affected segments, the difference in R1 between segments is literally 1mm. Though my supervisor tells me, I’m not wrong in saying that there are multiple levels affected, I need to narrow down to the most affected, in order to treat. So when the difference is only 1 mm, I’m slightly overwhelmed! I find that because I cant assess and feel as effectively, my treatment is being compromised, and I don’t seem to be able to think on my own and narrow down the affected segments. Similarily, I seem to manage with Tx and Lx regions, but Cx arrrghhhhhhh!! Its just so hard to figure out where my hands are, or if their even in the right place. I’ve been told that all this comes with practice, just frustrating that its a very slow and long process.
Rev
2 comments:
Yeah....
it can be frustrating.
But you might find that you could learn heaps from your rural clinic (if it has an outpatient department) where you are given a lot of independence and some guidance if you need.
I found this when I went to the rural clinic and got more hands-on experience with more backs and necks.
And you can keep practicing on your family members to get a better feel of the differences in movement in all of them.
Don't worry - it will come...."Patience is a lifetime's game".....
:)
Hi Rev,
I know exactly how you feel.. and I think the whole of fourth year does. Unless you have been gifted with the talent of identifying stiff spinal segments (highly unlikely) the only way we are going to learn is with practice..
So get as much practice as you can, and get people who are VERY GOOD at it to help confirm the segments.
Its better to feel silly now and get someone to tell you where the stiff segments are, than to make it up yourself.
I found I learned a lot quicker with the supervisor breathing down my neck and checking after evey time I did it :)
Good luck
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