Thursday, February 15, 2007
Trying to be Superman
On my musculo clinic, I've been finding it hard to stick to the time limit for each patient. The main reason for this I think is that as a student I tend to assess everything, adn then in turn try to treat everything I can. Rather than doing the logical thing and assessing what's relevant to the patient's complaint, and then only doing one or two treatments that will have the greatest affect. When I teach tennis I always pick the one thing that I know that if I change it, it will create the greatest change in the persons performance. I guess I need to get over the immature idea that the best thing to do for a patient is treat every problem they present with, and start to think like a physio and now that the best thing to do for any patient is to focus on only a couple things at a time. What are your thoughts my fellow physios?
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3 comments:
Hi Calvin
I know exactly what you're struggling with. I think that's how we all feel when we first start assessing and treating patients. And you're spot on with the insight that focusing on one or two aspects per treatment session is enough and afterwards you're able to evaluate what actually helped and what not. Regarding the initial assessment though I think it's important to be as thorough as possible. The more pieces of the puzzle you can collect the better the picture will fit together. But hey, only a few weeks now and you'll be out there as a new grad, trying out what is going to work best for you...
Good luck and enjoy being a physiotherapist.
Edith
Magic words Calvin…I agree with you, because I had similar experience during my neuro prac. Let’s say observing the patient’s gait after stroke, there may be lots of deviations from normal. What I have learned is to look at the most visible deviation form normal (what patient is most having problem with), assess the contributing factors to determine the reasons for existing problem and treat it. I think it’s easy to get overwhelmed when you see so many different problems the patient may present with. Keeping it simple is the key to good quality treatment. That’s what I think anyway….
Hi Calvin, my comment below is indirectly related- I've had far more expereince in neuro than muslculo outpatients-but there is a lot of musculo skills needed in neuro OP so I thought I'd let you know a little about how I deal with my concern when I get a new complex patient. I look back on the difference between early professional days and one thng I see is that I have learned to trust myself that I can handle difficutl situations (I'm thinking from reading the blogs that you are all learning that you too can handle them) ie trust that I can use the assessment frameworks we have and prioritise prioritise prioritise. I liked the tennis and the gait analogies re pick the biggest deviation and work on that. Having said that I like to do the most thorough assessment I can, but none of us can in new learning situations handle all of the information infront of us.
For your interest I'll just jot down here what I do in Neruo OP.
I use my first neuro outpatient session to get a picture of what patients know.
I start my S and O assessment and as I do it I discover things that I know are contibuting to the problem reported by the patient. I try to teach the pt as I do the assessment just one or two things (behaviour changes) that i think will produce the biggest results and give them one exercise so I can see how good they are at motor learning at the time, how well they can do it when they come back (so see how compliant they are)I try to get as much assessment as I possible can but work to ensure that the patient has learned more about their condition and has some homework.
regards
Steph
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