On my last clinical placement I was assigned to a patient for twice daily chest clearance sessions. This particular patient had been in and out of hospital frequently for the past few years. During the last treatment session before she was discharged she picked up my note book and pen and proceeded to write me an extremely complimentary ‘report card’ to show my supervisor. She said that it was nice to have things explained to her so she could understand why we were doing a certain treatment technique.
I was extremely touched by this action, and was thrilled that as a student I was able to make such a difference to this lady. She said that she was very lonely whilst in hospital and was quite concerned about what the future held for her. Each day when I arrived for treatment at our prearranged time she was ready to go.
The situation highlighted to me the importance of a good therapist-patient relationship and how good rapport can increase compliance to treatment dramatically. It also highlighted to me how scared and alone patients can feel whilst in hospital. As students we don’t have a lot of exposure to patients prior to 4th year, so they can be quite a scary prospect. But put yourself in the patient’s shoes; I’m sure they find hospital staff scary!
My experience with this patient has reinforced the need for good communication skills in clinical practice. As therapists we need to be able to find a common thread with all of our patients, in order to build rapport and ensure that the patient receives the best possible standard of care. Simple explanations can make a world of difference. We need to use our hands to treat, but also our ears to listen. Sometimes our patients just need someone to talk to, and we’re often the ones who are there. As an aside to this, we also need to be aware of the appropriate avenues for referral if the need arises, and need to ensure that we do not take too much on, as this can be emotionally draining. Each patient is individual and should be treated as such.
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2 comments:
I think that's a really good point - although as physios we have a sizable case load in most settings, we still get to spend far more time with the patients than most of the other members of the team. So often the patient has a vague idea of what is going on but feels isolated in the hospital and with so many staff in and out all the time it is really important that someone takes the time to address their concerns fully.
Spot on about gaining compliance through a strong rapport - the extra time taken in the first couple of sessions can save a lot of time later! You can't always tell which patients really need that positive relationship so that they trust you and your interventions. It's important with every patient to try to build that rapport from the outset as it is tricky to do later in the piece..
More on rapport in my next blog - stay tuned!!
i agree, We are dealing with peoples lives here and each treatment needs to be tailor made to the individual. Another point to add is to give the patient a sense of control. Being in hospital can be very overwhelming as patients are relying on medical staff to look after them. Therefore establishing good rapport (even if talking to the patient is all you do in the first session), rationalising each intervention in laymens term and providing the patient with choice and control.
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