Up until last Thursday, I was quiet certain that my uni days would be over within the week….how wrong I was! I had my final assessment with my CCT on Thursday, it didn’t go as well as I planned, to be honest I wasn’t expecting high praises, but the words “I’ve failed you” were the last thing I was expecting. As my CCT went through my assessment, I found quiet a few discrepancies, and some comments were completely wrong, but at this stage I was way too upset to be able to discuss this with her.
It only got worse from there, I approached my FCE right away, and wanted an indication of whether she was going to pass me, I had explained to her that I had PCR coming up in the next week, and that I needed to get in touch with the coordinators at uni to organize things. The FCE of course didn’t want to discuss things with me, and she said she’ll go through the assessment the next day. The final ax was left till Friday afternoon, so I had pretty much been a wreck for almost 2 days, on top of having to see all my patients.
What frustrated me, is that I was given absolutely no indication I was failing at the mid placement. My FCE said she had no concerns, and that I was doing fine 2 weeks into the prac. My CCT made no comments either regarding failing, she just told me to work on improving what I had already learned. Even at the end of the 3rd week, both supervisers had told me “your passing”, but they wanted me to set the bar higher, and keeping improving in certain areas. Not once did they indicate they were overly concerned, my FCE on the 2nd last Friday even said, “you did really well today, just keep doing this, and you’ll be fine”. For the next week, I found I had very little supervision, and I was left to be more independent to ax & rx my patients. I took this as a good sign, as most students would, when they are given more independence, and less intrusion by their supervisers. Hence my frustration and confusion when my FCE decided to fail me as well. I pointed out to my superviser she had left me to be independent, to which my superviser replied, “I noticed you weren’t coping very well”, if she really felt I was incompetent and struggling how could she leave me alone to see patients??!! She had told me that the patients were her main priority, I was finding this a bit hard to believe, considering she had left someone who she believed to be incompetent responsible for these patients. If I was really struggling, why wasn’t additional supervision provided, as is stated in the unit outline. Almost feels like they wanted me to fail. My FCE also said the only reason she outright failed me is because it was my last placement, had I been in this situation earlier in the year (like many students), she would have passed me with a ADF. I certainly drew the short straw there.
So currently I don’t know whats happening in terms of PCR/ supp placement etc. The coordinators have indicated I wont be able to sit the PCR until the deferred timeslot. I haven’t had a chance to explain to them my side of the story, and I’m really getting worried, considering PCR is only a few days away, and I’ve been stressed out and haven’t been able to concentrate on anything since last Thursday.
I feel I haven’t been given a fair go, by the supervisers on clinic, and also the uni, as my situation has been left hanging, and no-one else seems to be in a hurry to sort it out. I feel like I’m being ignored, except for all the students out there who have been very supportive and understanding.
All I want is to be able to sit the PCR this week like the rest of you, go through the same experience/emotion of finishing together with the people I’ve been with for the last 4 yrs.
Good luck to you all!
Monday, November 19, 2007
Patient confidentiality- rural
This is going to be just a short and simple blog about patient confidentitality.
After my rural prac I found out you have to be especially careful about what you say to people in town. Its so different in the city where you can say "i saw a lady with a hip replacement today"... In a small country town there's only a hand full of patients who would have had a hip replacement. So if you tell someone that, rumours start flying about who is seeing the physio- and before you know it the whole town knows it!
Thats the only negative about living in a small town is everyone knows everyone's business. And most people are pretty wary about not letting anyone else find out stuff about them (though they're not so fussed about spreading gossip about other people!).
So for people going to start work in a rural area keep this in mind :)
Also keep in mind what you tell people about yourself, because sure enough if you tell one person you are pretty much telling the whole town! hehe.
Just something for you to be careful with. I'm sure most of you figured that out by now after your rural pracs if you were in a small town. Big towns aren't too bad :)
Good luck with the PCR
Caris
After my rural prac I found out you have to be especially careful about what you say to people in town. Its so different in the city where you can say "i saw a lady with a hip replacement today"... In a small country town there's only a hand full of patients who would have had a hip replacement. So if you tell someone that, rumours start flying about who is seeing the physio- and before you know it the whole town knows it!
Thats the only negative about living in a small town is everyone knows everyone's business. And most people are pretty wary about not letting anyone else find out stuff about them (though they're not so fussed about spreading gossip about other people!).
So for people going to start work in a rural area keep this in mind :)
Also keep in mind what you tell people about yourself, because sure enough if you tell one person you are pretty much telling the whole town! hehe.
Just something for you to be careful with. I'm sure most of you figured that out by now after your rural pracs if you were in a small town. Big towns aren't too bad :)
Good luck with the PCR
Caris
Sunday, November 18, 2007
Wrap up
Final blog! Just thought I'd use it to reflect on my last four weeks on 3K. Gerontology was a good prac for a last one, as I had patients with neurological, cardio/respiratory and orthopedic conditions - a real mix. I also found the prac to be pretty rewarding from the perspective that most of the patients were really appreciative of the things I was trying to do for them. Getting pretty sizeable changes in function over a short time as their health improved was good too.
I had spent alot of my time being concerned about the outcomes for all of my patients post discharge, as you have seen from my previous posts in the last couple of weeks. I'm still not sure that the health of our aging population is being managed as well as is really needed, but I have seen a lot of people working hard to provide the best care that they can. What the prac gave me that others didn't was an opportunity to develop a bit more of a holistic perspective on my patients and to think about their cases beyond the point where they ceased to be my patients. It was an eye opener that I enjoyed. One day I might even look at employment in the area.
Congrats to one and all on completeing their pracs and best of luck for the PCR
M
I had spent alot of my time being concerned about the outcomes for all of my patients post discharge, as you have seen from my previous posts in the last couple of weeks. I'm still not sure that the health of our aging population is being managed as well as is really needed, but I have seen a lot of people working hard to provide the best care that they can. What the prac gave me that others didn't was an opportunity to develop a bit more of a holistic perspective on my patients and to think about their cases beyond the point where they ceased to be my patients. It was an eye opener that I enjoyed. One day I might even look at employment in the area.
Congrats to one and all on completeing their pracs and best of luck for the PCR
M
Wednesday, November 14, 2007
Rural Experience
Last blog! On a cheerful note, I would like to blog about the really positive rural experience I have had. When coming to the town (a moderate-sized town of around 1800 ppl) I came with another physio student at the same facility, for which I was really grateful as I didnt picture that it would be easy to make friends in town. I had pictured that we would spend most nights quietly at the house together, as in most facilities I have been to although people are friendly enough at work there is never really an offer to extend that to after-hours. Not so here! As of the first day here we have been busy with barbecues, dinners, pub nights, playing netball/cricket/bowls and generally being very social most nights of the week. Everybody has made a huge effort to include us and make us feel welcome (whilst subtely suggesting that more physios are needed in the country!). My recommendation for other students would be to definately go rural for a different experience and also to say 'yes' to as many offers as possible, and not to be worried about not knowing people in town as friends are made really quickly and there is heaps of fun to be had.
Best of luck for the end of prac/PCR
Mel.
Best of luck for the end of prac/PCR
Mel.
Monday, November 12, 2007
Manual Handling Talk
Hi guys
Myself and the other student have been asked to give a few talks on our country prac, which is great, and one if them which we're doing tomorrow is a manual handling presentation to nursing staff. At first I felt a bit intimidated when asked as some of the nurses at the hospital have been there for at least 30 years and I felt that they would know more than I would about the topic, and may resent being 'taught' how to do what they have been doing for years. This was made more apparent when I had to ask one of the ENs to assist me with a standing hoist as I wasnt completely confident with using it. However, since first being asked I have noticed some staff doing transfers that look unsafe to the backs of both the nusring staff and the patients, such as prapping a belt around their backs/chest and literally yanking them from chair to chair. Since then I have realised that even if I dont have the experience that the staff do, because I know the theory and/or can look it up easily, and also have a greatly deeper knowledge of injury mechanisms, I still have something to offer them in terms of helping to prevent injuries. I now feel more confident going in to do the talk. Hopefully it goes well!
Myself and the other student have been asked to give a few talks on our country prac, which is great, and one if them which we're doing tomorrow is a manual handling presentation to nursing staff. At first I felt a bit intimidated when asked as some of the nurses at the hospital have been there for at least 30 years and I felt that they would know more than I would about the topic, and may resent being 'taught' how to do what they have been doing for years. This was made more apparent when I had to ask one of the ENs to assist me with a standing hoist as I wasnt completely confident with using it. However, since first being asked I have noticed some staff doing transfers that look unsafe to the backs of both the nusring staff and the patients, such as prapping a belt around their backs/chest and literally yanking them from chair to chair. Since then I have realised that even if I dont have the experience that the staff do, because I know the theory and/or can look it up easily, and also have a greatly deeper knowledge of injury mechanisms, I still have something to offer them in terms of helping to prevent injuries. I now feel more confident going in to do the talk. Hopefully it goes well!
Sunday, November 11, 2007
Dry vs Moist cough
Hey All!
During the last 3 weeks, i've been seeing a patient mainly for chest and occassional SOOB, with 2 assist. During the first 2 weeks of this prac i saw the patient with my superviser, and we did the same thing each day - try to sit the pt out of bed, if unsuccessful then ROM for UL and suctioning.( at this stage i should mention, this is a 60 yr old gentleman, (R) hemi, drowsy, fully dependent with mobility, RIB majority of the time, weak cough, and bad chest).
At the beginning of last week, we had a new physio filling in temporarily for the next month. So now we see this patient together, and few times we've seen this patient in the last week, i've felt we havent done all that we can as physios. Treatment for this patient so far has consisted of SOOB for a few minutes, before we put him back down to rest. Everytime the patient cough, it sounded very moist and in definite need of suction. I've asked/mentioned whether she feels he needs a suction, and eachtime she's like no its sounds dry. Even though i completely disagree, i've just left it, and did as the physio wanted. I know this patient has a bad chest, given his history, ausc findings and cough, so i dont know if i'm jsut getting into a routine of suctioning him, because thats what my superviser did. But at the same time i'm left to wonder if the physio is right when she feels suctioning isnt indicated, because after all she has years of experience working as respiratory physio.
So i'm just a little confused about what i should do. Because when i'm in with the patient, i feel like were not doing enough for him, and beginning to doubt my own judgement, ie. is this cough moist or dry, and at the same time i dont want to create a fuss with the physio, where i feel she might think i'm undermining her experience.
Only 1 more week...
Rev
During the last 3 weeks, i've been seeing a patient mainly for chest and occassional SOOB, with 2 assist. During the first 2 weeks of this prac i saw the patient with my superviser, and we did the same thing each day - try to sit the pt out of bed, if unsuccessful then ROM for UL and suctioning.( at this stage i should mention, this is a 60 yr old gentleman, (R) hemi, drowsy, fully dependent with mobility, RIB majority of the time, weak cough, and bad chest).
At the beginning of last week, we had a new physio filling in temporarily for the next month. So now we see this patient together, and few times we've seen this patient in the last week, i've felt we havent done all that we can as physios. Treatment for this patient so far has consisted of SOOB for a few minutes, before we put him back down to rest. Everytime the patient cough, it sounded very moist and in definite need of suction. I've asked/mentioned whether she feels he needs a suction, and eachtime she's like no its sounds dry. Even though i completely disagree, i've just left it, and did as the physio wanted. I know this patient has a bad chest, given his history, ausc findings and cough, so i dont know if i'm jsut getting into a routine of suctioning him, because thats what my superviser did. But at the same time i'm left to wonder if the physio is right when she feels suctioning isnt indicated, because after all she has years of experience working as respiratory physio.
So i'm just a little confused about what i should do. Because when i'm in with the patient, i feel like were not doing enough for him, and beginning to doubt my own judgement, ie. is this cough moist or dry, and at the same time i dont want to create a fuss with the physio, where i feel she might think i'm undermining her experience.
Only 1 more week...
Rev
New Conditions
Hi all, hope you're enjoying your last week of prac! I'm currently on my rural prac, and spending most of my time in the outpatients department. I am seeing a massive variety of patients, most of which have conditions I have never seen/treated before. At first this made me really nervous, becasue I couldn't follow a direct recipe about what i need to Ax and what I need to treat. After the first week or so I realised that I shouldn't be nervous just becasue "I havent seen that before". If there was something I was unsure about I look it up before the patient comes, and use the basic skills we have to problem solve what's needed in terms of Ax and Rx. Now I am really enjoying the challenge of such a variety in the patient case load, and have learnt a great deal on thsi prac, now that I have got over the anxiety of seeing something new, in case I didnt know what to do. Like I suggested in my last blog, I think all we need (well what I needed anyway) is confidence in ourselves, and confidence in the skills we have learnt. We will graduate soon and surely enough come across many challenges, and uncertainties, and what i have learnt from this prac is that all we need is confidence in our abilities.
Return patients
Hi all
Another week on the gerontology ward and another lesson for me about just how difficult life can be for some of my patients. Last friday i discharged three patients. They had a number of different issues, some of them still with medical rather than mobility issues. I'm pretty conservative, so no patient gets my ok to discharge without me being well and truly satisfied that they are safe to go. Anyway, two of these patients were re-admitted (one through ED) the very next day. It was reported that one of them had suffered another fall. The other had another cardiac event. Obviously, to hear that one had fallen again so soon after DC left questions as to her safety for DC in the first place. Questions were asked. This patient was admitted to another ward, but my supervisor (who is very supportive) went and did some investigating. The truth of the matter was that the patient was re-admitted with a UTI, and in fact the hostel that she had returned to (she has been a resident there for 10 years) had decided that they were unable to provide the level of care she requires, so had her sent back to RPH. There had been no fall. This is not just a story about me being in the clear regarding discharging a patient. What was annoying was that we had done alot of rehab with this person, so much so that her mobility on DC was better than her pre-morbid status. Also, her mobility was much better than that required by the hostel as part of the criteria to return to their facility. But, somehow the facility must have changed their criteria overnight.
I think you can see a theme running through my last few posts. It has to do with the fact that gerontology is so much about finding somewhere to put someone. Sadly, it is not a very consultative process, and the wishes of the patients seem rarely to be taken into account. While this is in some ways unavoidable, the attitude of the hostel in question takes the cake. I hope bureaucracy has something sorted by the time I get old(er). Am I getting a warped view of the way our aging population is (mis?)managed? or have some of you felt the same way on your gero clinics
M
M
Another week on the gerontology ward and another lesson for me about just how difficult life can be for some of my patients. Last friday i discharged three patients. They had a number of different issues, some of them still with medical rather than mobility issues. I'm pretty conservative, so no patient gets my ok to discharge without me being well and truly satisfied that they are safe to go. Anyway, two of these patients were re-admitted (one through ED) the very next day. It was reported that one of them had suffered another fall. The other had another cardiac event. Obviously, to hear that one had fallen again so soon after DC left questions as to her safety for DC in the first place. Questions were asked. This patient was admitted to another ward, but my supervisor (who is very supportive) went and did some investigating. The truth of the matter was that the patient was re-admitted with a UTI, and in fact the hostel that she had returned to (she has been a resident there for 10 years) had decided that they were unable to provide the level of care she requires, so had her sent back to RPH. There had been no fall. This is not just a story about me being in the clear regarding discharging a patient. What was annoying was that we had done alot of rehab with this person, so much so that her mobility on DC was better than her pre-morbid status. Also, her mobility was much better than that required by the hostel as part of the criteria to return to their facility. But, somehow the facility must have changed their criteria overnight.
I think you can see a theme running through my last few posts. It has to do with the fact that gerontology is so much about finding somewhere to put someone. Sadly, it is not a very consultative process, and the wishes of the patients seem rarely to be taken into account. While this is in some ways unavoidable, the attitude of the hostel in question takes the cake. I hope bureaucracy has something sorted by the time I get old(er). Am I getting a warped view of the way our aging population is (mis?)managed? or have some of you felt the same way on your gero clinics
M
M
Friday, November 9, 2007
Go hard or go home...
Hey guys, I think this is my last blog (Peter??)
Ok I'm still on my rural prac... there are 2 physios working up here and both are taking 2 weeks leave while I am here so I have spent my first 2 weeks with one physio, and now the next two with another physio. Both have VERY different ways of treating patients in the acute stages. Lets take an acute ankle injury for example- the first likes to go in quite easy for the first one or two sessions ie. treat the swelling (ice, US, compression etc), and start gentle active movements etc, while the second likes to get straight in there and mobilise to get as much ROM as possible as early as possible. Considering I have just spent 2 weeks with the 'gentle' physio its a bit of a shock to the system to now be with the second physio!! I tend to agree more with the way the first physio deals with acute injuries, so I am quite reluctant to go against the grain with the second physio... this close to the end of uni and I am pretty content not to rock the boat so basically I'm just going along with how she does things (afterall she is marking my final assessment)... When I reflect on it later I think I should treat the patient as I see fit (ultimately making the patients progress more my responsibility), but at the same time I'm happy to take advice from either supervisor. Does anyone else out there modify what you would normally do to please a supervisor, or am I the only one who just wants to get through the year without rocking too many boats??
Cheers,
Ezza
Ok I'm still on my rural prac... there are 2 physios working up here and both are taking 2 weeks leave while I am here so I have spent my first 2 weeks with one physio, and now the next two with another physio. Both have VERY different ways of treating patients in the acute stages. Lets take an acute ankle injury for example- the first likes to go in quite easy for the first one or two sessions ie. treat the swelling (ice, US, compression etc), and start gentle active movements etc, while the second likes to get straight in there and mobilise to get as much ROM as possible as early as possible. Considering I have just spent 2 weeks with the 'gentle' physio its a bit of a shock to the system to now be with the second physio!! I tend to agree more with the way the first physio deals with acute injuries, so I am quite reluctant to go against the grain with the second physio... this close to the end of uni and I am pretty content not to rock the boat so basically I'm just going along with how she does things (afterall she is marking my final assessment)... When I reflect on it later I think I should treat the patient as I see fit (ultimately making the patients progress more my responsibility), but at the same time I'm happy to take advice from either supervisor. Does anyone else out there modify what you would normally do to please a supervisor, or am I the only one who just wants to get through the year without rocking too many boats??
Cheers,
Ezza
Wednesday, November 7, 2007
Hi everyone
My post is about difficult musculoskeletal presentations. I had a patient present to me with a 14yr history of longstanding hip pain (since she was 11) that begun insidiously. Her presentation is that after playing sport (netball/hockey) she will feel her (R) knee turning in, and then for the next few days she will have intermittant stabbing sharp hip pain deep within her joint with certain mvmnts eg. crossing her legs. After a few days it will disappear again, and it is only in the few days post sport that this pain appears. Objectively she had decreased ER ROM actively and passively on the (R) side, and no other findings. The pain could not be reproduced as it is the 'off-season' and she only gets the pain after playing sport.
So I was pretty confused with this lady... the best diagnoses I could vaguely come up with was perhaps an old labral tear from whe she used to play gymnastics when she was young, which gets aggravated with sport (+/- synovitis?) and catches in the hip joint. Perhaps also related to poor glut med pelvic control making her knee turn in after sport? But I really wasnt too sure and neither was my supervisor. Treatment over 2 Rx sessions consisted of some ER mobs at 90 degrees flexion, ER self-stretches for home and a program to strengthen glut med (although (R)glut med was G4+ on testing, probably stronger than me).
The outcome was that we decided to wait until she was playing sport again and could monitor response to treatment more accurately and told her to come see us again then, bypassing the 5 month waiting list. We sent a letter to the doctor about our findings and suggesting that imaging could be the only was to conclusively diagnose her hip pain. We also suggested to her that if it was a problem within the hip joint capsule as it seemed, physio perhaps wouldnt really help too much.
What I learnt from this is that there are still so many musculoskeletal dysfunctions out there that I still have no idea about, and this will still probably happen for some time. Referring back to the doctor saying 'I dont really know whats going on' and requesting imaging is sometimes all that can be done.
Any ideas about what the pathologycould be would be greatly welcome!
Hope the tail end of everyone's last prac goes well.
My post is about difficult musculoskeletal presentations. I had a patient present to me with a 14yr history of longstanding hip pain (since she was 11) that begun insidiously. Her presentation is that after playing sport (netball/hockey) she will feel her (R) knee turning in, and then for the next few days she will have intermittant stabbing sharp hip pain deep within her joint with certain mvmnts eg. crossing her legs. After a few days it will disappear again, and it is only in the few days post sport that this pain appears. Objectively she had decreased ER ROM actively and passively on the (R) side, and no other findings. The pain could not be reproduced as it is the 'off-season' and she only gets the pain after playing sport.
So I was pretty confused with this lady... the best diagnoses I could vaguely come up with was perhaps an old labral tear from whe she used to play gymnastics when she was young, which gets aggravated with sport (+/- synovitis?) and catches in the hip joint. Perhaps also related to poor glut med pelvic control making her knee turn in after sport? But I really wasnt too sure and neither was my supervisor. Treatment over 2 Rx sessions consisted of some ER mobs at 90 degrees flexion, ER self-stretches for home and a program to strengthen glut med (although (R)glut med was G4+ on testing, probably stronger than me).
The outcome was that we decided to wait until she was playing sport again and could monitor response to treatment more accurately and told her to come see us again then, bypassing the 5 month waiting list. We sent a letter to the doctor about our findings and suggesting that imaging could be the only was to conclusively diagnose her hip pain. We also suggested to her that if it was a problem within the hip joint capsule as it seemed, physio perhaps wouldnt really help too much.
What I learnt from this is that there are still so many musculoskeletal dysfunctions out there that I still have no idea about, and this will still probably happen for some time. Referring back to the doctor saying 'I dont really know whats going on' and requesting imaging is sometimes all that can be done.
Any ideas about what the pathologycould be would be greatly welcome!
Hope the tail end of everyone's last prac goes well.
Monday, November 5, 2007
Frozen Shoulder??
The other day a patient presented to the hospital outpatients with a referral from the Doctor for treatment of her frozen shoulder. Upon Ax the patient had full shoulder AROM - with a apinful arc, and full PROM of GHJ (90 degrees flexion, 90 degrees abduction, 70 degrees ER). At this stage I was confused.. The pt wasn't presenting like she had adhesive capsulitis. Upon completing my Subjective and Objective Ax, I presented my findings to my supervisor because I was confused how the Dr could think it was froen shoulder, but assuming that it must be, even though I thought it was biceps tendinopathy resulting in secondary subacromial impingement. My supervisor questioned me about what a frozen shoulder presented like? what this patient was presenting like? and did I think this was frozen shoulder? If not, what do I think it is? Feeling silly that I needed his confirmation I answered all these questions then he said GOOD, now go treat her. I shouldn't have needed my supervisor to confirm what I thought, I should have just trusted myself. Moral of the story... Don't always trust what the Doctor has written on the refferal and trust your instincts, we know more than we think we do :) This is not the only time on this prac where I have had a referral from a Doctor with a wrong diagnosis. Has anyone else been in a simialr situation?
Sunday, November 4, 2007
Neuro
Hey all!
So only 2 more weeks to go, till we finish our very last pracs ever YAY!! Lucky for me I get to finish off with neuro. Compared to all my other pracs, neuros definitely the most challenging, I’m sure most of you agree. Towards the end of last week, I had to do an initial assessment on a patient. My superviser told me to do a quick mobility the check (for the nurses), and then do a more detailed assessment later. So that’s exactly what I did, a “quick” mobility check, ie. Rolling, supine à sit, sitting balance, sit to stand, standing balance and ambulation. I went back to the superviser who then asked me questions like, is the patient equal wt bearing, sitting posture, standing posture, what happening at the ankle, knee, hip, trunk during gait, what are voluntary movements at the arm like, any perceptual deficits – how did you test these, the list went on. Of course my answer to a majority of these questions was, “umm didn’t look that closely into it, was leaving it for later”. I was told that I’m 2 weeks away from being qualified, and that at this stage of the year, my skills were at a 1st/2nd year level. OUCH.
I’m not sure if that was a fair call, yes I’ve gone through 6 other pracs prior to this, but this is the first and only neuro prac I’ve done, and in an area as specialized as neuro, it shouldn’t matter if it was my very first prac for 4th yr or the very last one, because the level of competence would be the same.
But saying that, the fault on my behalf is that I wasn’t using my observation skills, it doesn’t matter what area of physio your working in, I should have been paying more attention to my patient, and picking up on things as I was doing the mobility assessment.
As a result of this, I feel that I’ll be better prepared for the next new patient I get, and will save a lot of time on assessment, rather than having to repeat things. Also I want to put forward the question, will students benefit more from having a neuro prac for 5 weeks, rather than 4?
Rev
So only 2 more weeks to go, till we finish our very last pracs ever YAY!! Lucky for me I get to finish off with neuro. Compared to all my other pracs, neuros definitely the most challenging, I’m sure most of you agree. Towards the end of last week, I had to do an initial assessment on a patient. My superviser told me to do a quick mobility the check (for the nurses), and then do a more detailed assessment later. So that’s exactly what I did, a “quick” mobility check, ie. Rolling, supine à sit, sitting balance, sit to stand, standing balance and ambulation. I went back to the superviser who then asked me questions like, is the patient equal wt bearing, sitting posture, standing posture, what happening at the ankle, knee, hip, trunk during gait, what are voluntary movements at the arm like, any perceptual deficits – how did you test these, the list went on. Of course my answer to a majority of these questions was, “umm didn’t look that closely into it, was leaving it for later”. I was told that I’m 2 weeks away from being qualified, and that at this stage of the year, my skills were at a 1st/2nd year level. OUCH.
I’m not sure if that was a fair call, yes I’ve gone through 6 other pracs prior to this, but this is the first and only neuro prac I’ve done, and in an area as specialized as neuro, it shouldn’t matter if it was my very first prac for 4th yr or the very last one, because the level of competence would be the same.
But saying that, the fault on my behalf is that I wasn’t using my observation skills, it doesn’t matter what area of physio your working in, I should have been paying more attention to my patient, and picking up on things as I was doing the mobility assessment.
As a result of this, I feel that I’ll be better prepared for the next new patient I get, and will save a lot of time on assessment, rather than having to repeat things. Also I want to put forward the question, will students benefit more from having a neuro prac for 5 weeks, rather than 4?
Rev
Community Services
Hi all.
Regarding my patient from last week... Discharged with a functional ability better than her pre-morbid status so well pleased.
This has been an interesting week on 3K. Things are going pretty well. One of the most interesting parts of the week was a visit to Mercy Hospital Restorative Unit. I spent Wednesday morning doing home visits with the ACAT nurse and social worker. It was a bit of an eye opener to get into the homes of the sort of people I might otherwise be treating on the ward. The people we visited all had different issues ranging from dementia to repeated falls to parkinsons. I found it interesting the amount of assistance that can be made available to people in the community, and moreso the huge amount of assistance that so many people need. Alot of the people we visited were frustrated by having to seek assistance in the first place and then more frustrated by the "you can have this, but not that" sort of system that seems to be in place. I understand that there are limited resources in the community, and I think that the ACAT workers I was with do a great job. I just couldn't shake the impression that there were so many needs going un met. A tough one
M
Regarding my patient from last week... Discharged with a functional ability better than her pre-morbid status so well pleased.
This has been an interesting week on 3K. Things are going pretty well. One of the most interesting parts of the week was a visit to Mercy Hospital Restorative Unit. I spent Wednesday morning doing home visits with the ACAT nurse and social worker. It was a bit of an eye opener to get into the homes of the sort of people I might otherwise be treating on the ward. The people we visited all had different issues ranging from dementia to repeated falls to parkinsons. I found it interesting the amount of assistance that can be made available to people in the community, and moreso the huge amount of assistance that so many people need. Alot of the people we visited were frustrated by having to seek assistance in the first place and then more frustrated by the "you can have this, but not that" sort of system that seems to be in place. I understand that there are limited resources in the community, and I think that the ACAT workers I was with do a great job. I just couldn't shake the impression that there were so many needs going un met. A tough one
M
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