Discharging DNA patients

Hi Everyone,

I hope you are all enjoying your final week of this placament. I am writing this week about a new patient given to me in my first week here in the outpatient department and of which I have still not managed to actaully assess. This particular patient was referred to me by an surgeon for rehabilitation after he performed a laminectomy on her 2 months previously. The patient did not attend three times in a row, each time stating that she got her appointment times confused. On speaking with her after the initial DNA, I was fustrated bacuase she was not very apologetic and lacked concern about the hassle it had caused but yet still wanted to make anoother time to see me. On the third DNA I rang the patient to find out what had happened and to discuss the problems associated with continually DNA'ing (i.e. three DNA's and your out policy) and came across a difficult situation. (NOTE: I had discussed the events with my supervisor and he said if, after speaking with her, she agreed to show up for another final appointment genuingly, it was my call whether or not I agreed to try and see her again). The woman sounded very upset about her lack of organisation and when I asked her about her motivation for physio, she was very keen to make another appointment.

Weak as it might have been, I told the patient that yes, I would make another appointment with her and she was very grateful. I discussed with her that this was her final opportunity for physio and she agreed to my terms. I feel that in this situation I appeared weak and that through my actions, I was disadvantaging other patients who are on our waitlist and are not being seen due to lack of availability of physio's. My problem was that I felt that this patient would benefit from physio and I don't feel comfortable turning people in need away from our profession. Perhaps if she doesn't show up for the final appointment, I will know that I made the wrong decision. Would any of you guys have handled this situation differently? Do you think that in order to get respect from patients we have to portray a tougher policy approach in regard to the consequences of DNA'ing?

Thanks for your input,
Kate.