Hi all
I've just had a week on my new placement on ward 3K at RPH WSC. It's a gerontology ward, but it has a focus on quickly returning patients to functional levels prior to discharge. So far it's going ok. My issue this week has to do with the family of one of my patients. This particular patient is always enthusiastic and keen to engage in the PT process. She still has a number of medical issues keeping her in hospital, but nevertheless she always tries hard with the rehab sessions we have with her. I was talking with one of her children the other day, who asked if physio was worth it, given that her mum is still ill (cardiac issues among others). This person actually became quite aggressive, accusing me of pushing her mum when she is sick, adding that her mother does nothing anyway. She seemed to feel that her mum was just waiting to die. I assured this person that the demands I place on her mother are minimal and quite safe. I also said that I had got quite the opposite impression from her mum, who is always keen to engage in PT. I was supported in my reply by the senior physio, who overheard the conversation. What made the biggest impression on me was the way this person spoke about her mother in such negative terms - she can't do this, won't do that. I listened to her for a while as she complained about the imposition her mothers health had made on her family and I realised that this person now thought of her mother only in terms of the burden that she had become over the last few years. What had started off as questioning the safety of what I was doing ended up in this person questioning why I bothered. Anyway, I felt that I had explained myself sufficiently so I moved on to my next patient. I guess it just shows the effect that chronic disease has on families.
Sunday, October 28, 2007
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Hey Martin,
I've come across families who are at the other end of the spectrum, where they've been demanding more physio. A particular pt on the neuro ward i'm on at the moment has been in hospital for 120days plus. His prognosis is really poor, he's been bed ridden for a long time, and there isnt much more physio can do for him. Initially he was seen 5 days a week, then cut down to 3, and now he's been seen once a week, for passive movements and chest/suctioning. On the ward the nurses have been encouraged to suction him as required. However his wife has put forward several complaints that he isnt getting any rehab. Which is true, but she fails to accept his state/condition, and that its come to a point that no amount of rehab can make a difference.
But its rather sad, seeing very unsupportive families, and also families that have difficulty accepting reality.
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