dfferences in technique

On my new prac, we are required to have a physiotherapist and a nurse at the bed side whilst we treat every patient. Normally our clinical tutor supervises us and therefore we have adopted her method of treating patients. The other day however I was suctioning a patient with a tracheotomy and a different physio from the department was with me.

The patient was fully sedated and had enormous amounts of secretions. After manually hyperinflating the patient for a few minutes, we needed to suction her twice until her chest was clear. There was large amounts of M2P3 sputum and the patient did not tolerate the suctioning well as it sent her into fits of coughing. Having suctioned many patients on the same prac already I was confident with my technique and what I needed to do. The physio used quite a different technique as our clinical tutor and suggested I practiced both ways to see which one I preferred. This was a good idea and was fine until the end of the treatment. Usually, if a patient coughs up a lot of secretions into their mouth, we use a different handpiece to clear their mouth. This is what I went do to however the physio told me not to waste my time and just to use the same suction catheter. This is something that both our lecturers and my clinical tutor had told us never to do as it was pretty gross for the patient even though they were sedated. I told the physio we always used the handpiece so that it was more hygienic for the patient and also it was easier to use as the catheter is too floppy to get over their tongue.

Afterwards, the physio was really annoyed and told me that I was not to question what she said again and should do what the physios instruct us to. I found this really annoying as I wasn't questioning her skills or knowledge, I was just doing what I had been taught earlier and what I thought to be better for the patient and easier for me. I didnt argue back as I didnt want to make things more difficult but found it absurd that I would get told off for trying to follow the 'gold standard'. I understand that physios wouldnt want their skills questioned by a student, however I think it was unfair to say that to me when I know that I was not doing anything wrong and did not accuse the physio of anything in the first place. I told my supervisor what had happened and she suggested that if the same thing happened again, to just say that until I am qualified I have to practice the gold standard at all times.

I think as a student it's difficult to know when to stand our ground if we know for sure we are doing the right thing. The physios method was not wrong however neither was mine. I think that if I'm in this situation again I will stand my ground and rationalise the reason for my treatment choice, knowing that as long as my rational is correct and the patient is safe, they are in no position to question my technique just because it is different to theirs.