Hi Everyone,
Hope you have enjoyed the start of our final semester!! I am writing today to discuss my fustration with patients who refuse treatment in an inappropriate manner. I am currently on the oncology ward at RPH whereby it is one of my roles to maintain the patient's fitness while they are recieveing chemo treatment. On Friday however, I went to conduct an initial mobility assessment on a new patient to the ward and after conducting my assessment, the patient refused to get out of bed for me. He would not turn down the radio when asked and did not want to explain the reason for him declining treatment. I proceeded to provide some eduction on the benefits of exercise for people recieving chemo and explained the problmes associated with remainig bed-bound while in hospital. The patient was unreceptive to the information provided and was quite happy to see the back of me when I left the room.
After this encounter, I really felt like my time was wasted. Not only had I not been able to complete an assessment that was requested by both my supervisior and the doctors but the level of assistance that the patient would require whilst in hospital to assist the nursing staff was still not determined. I understand that the patient was probably feeling very unwell and so I told him that I plan to return at a later date to complete the assessment, however I am not optimistic that the patient will be compliant even then.
So my question to anyone that has as opinion on this issue, is that do I continue to push, plead and prod this patient into complying with my treatment goals or would my time be better spent on patients who are euqally in need of and receptive of, physiohterapy treatment?
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2 comments:
I've also been on pracs where patients refuse any form of treatment from physio, not just us students, but from senior therapist as well! On most occassions i've gone back to the patient a few more times, trying to make progress. What i've found that helps is just letting the junior Dr in charge know of the situation, or even bring it up in team meetings. In all these situations the Drs have been really helpful and influential, and they'll just tell the patient "you have to do physio!". Even though the next time your in to see the patient, they may not be putting in a 100%, some effort is better than nothing.
Likewise, being an ocology patient, they have a lot of issues and things to deal with, so perhaps you just caught them on a bad day. But i'd definitely go back and give it another shot.
Rev
We can only do as much as we can. If a patient refuses treatment, we cannot impose it onto them. But that does not mean we do not do our jobs. I think you've done the right thing in explaining the benefits of exercise, and tried to persuade him into performing the exercise. But in the end, if the patient refuses, we cannot do anything more. So don't put yourself down - you've done all you could.
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