Hi everyone,
I was in a neurosurge ward and had to treat a patient who was very demotivated about her recovery. At first when i met her, she seemed to be a very enthusiastic and motivated patient. I found that she was very compliant.
At closer look, she seemed to get quite distracted easily. She would start commenting on what the patient is doing next to her bed that she was in, etc.
Treatment also became quite difficult when I found that she seemed to get slightly agitated when i tried to bring her attention back to what I wanted her to do. My supervisor warned me that she does get very distracted and sometimes even agitated. Walking became even more difficult with her. The patient seemed to just want to stay in the bed and listen to others' conversations.
But one day I found out what was really happening in her house that she goes to during weekends. Her daughter is the carer for her mother. And currently - she can transfer with s/b * 1. But the daughter reported that she was needing two people to transfer her to the wheelchair. The daughter became frustrated and said that the mother may need to be put in a hostel.
This time, my supervisor advised me to be a little "hard" on the patient. Being a "softy" i found this actually quite difficult at first. But i learnt to tell the patient of the consequences of what happens if she regresses back to becoming dependent.
I realised that one of the biggest roles of the physiotherapists is to use their voices to motivate the patient to get out of their established comfort zones. I started to tell her how well she was doing and what will happen if she doesn't do well. Everyday - she was in tears because of this. But as my supervisor told me - i found it rewarding in the end - when i said to my patient that her STS took 1:35s - compared to 10:45 s one week before.
My patient felt happy and i found that being a great way of motivating her. In this way - the moral of my story is this - u may think u are being mean to a patient when u are hard - but one will do more favour if they help the patient get out of their comfort zones and help them achieve a goal.
sashi.
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2 comments:
Hey Sashi,
I agree that often the physiotherapist has to be the prime motivator! It is often a shame to see people like this as others are the opposite and try so hard, but I think it is a great point that you raise that the physio has to motivate the patient, and if this is less cheerleaderish and more bullying/cajoling/threatening it is not so bad is it really helps the patient in the long run. I agree that it can be hard though! Sounds like you are doing fine keep up the good work. X
Hi Sashi,
Being hard on patients sometimes is the only thing we have left to do. Sometimes, we just have to be honest and tell them the reality of the situation. I know it's a very hard thing to do, but in everyone's best interest - this patient does not have much time for rehab, and whatever rehab she can get, is probably all that she will ever get. Let's say if you could change her transfer from a two assist to 1 moderate assist in the end, and in order to do that, you had to be a little hard - You've made a huge difference for this patient's life! So keep up the good work and don't feel obliged to make someone happy in the short term, but lose out in the end! ;)
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