Stares 1 rotation 3

Stares 1 rotation 3

Situation:

I had been given a patient who was in her last three weeks of rehab. I was told to follow on from the previous therapist who had been in looking after Mrs R. According to her program plan Mrs R’s main problems were independent mobility and endurance with ambulation. The aim was to address these problems with the aim of discharge home. I had seen this patient twice at this stage, with her husband present. Mrs R was fairly obliging during these sessions although did complain of pain. Her husband was very supportive, providing Mrs R allot of encouragement.

Task:

Continue rehab of Mrs R with the goals of increasing independent mobility and ambulation.

Action:

Third day of therapy: Went into see Mrs R, her husband was not present as he had renovations to attend to at their house which would last two weeks. Mrs R she flatly refused to move from her room, saying she was in far too much pain to do anything. I accepted this planning to come back the next day.

Fourth day of therapy: I received much the same response as the third day. I sought advice from my supervisor who told me that Mrs R was very hard to get motivated at times, particularly when her husband was not present. She also told me that there was nothing physically wrong with her that could explain her reluctance to engage in rehab.

Fifth day of therapy: Mrs R refused again when asked if she would come to the gym for exercise or go for a walk, however after much encouragement agreed to do some work within her room. Once I was able to get Mrs R started on her exercises in her room, she then agreed to come for a walk and we were able to do a full session of rehab.

Result:

Two days of rehab had been wasted. It is more than likely that all the mobility Mrs R had done in the two days she was not seen was walk 10 m to the dining room and back for her meals. Though I do not think the patient regressed, she certainly didn’t progress in the two days with no therapy. On top of this, once she became engaged in the therapy she actually enjoyed it, asking if I could come by tomorrow.

Evaluation:

It is my opinion that I perhaps did not know enough about this patient in the first place to know how hard to push her. However, I should have sought advice from the start, rather than letting the patient go for two days without therapy. Reflecting on the type of patients the facility takes on, I think this will not be the only time I will come across this type of patient on this rotation. I think I need to be more firm with these types of patients in the future. In the end this lady actually enjoyed her session in the end, as well as bringing her a little closer to her goal of returning home.

Strategies:

· Invest more time communicating the importance behind the therapy.

· Tap into the goals of patients and use to engage them.

· Develop a clear plan with goals. Present the plan to the patient so that they can see what needs to be achieved to reach their goals.

· Invest in stakeholders – In this case I could have contacted the husband.