Whilst on my neuro placement, I found that I became somewhat lazy when planning a particular patients treatment sessions. This patient sustained a head injury from a car accident and as a result had severe short term memory loss. His treatment included gym based excercises and also hydrotherapy, however his memory loss was so pronounced that he could not ever remember having been in the pool, even though he had been going twice weekly for several weeks.
His memory loss also meant that he could not remember what exercises he had done with me between sessions and also within the same session. His physical impairments were quite limited and we were mainly focusing on core stability, very high level balance work and gait retraining. Initially I tried new and different things with him but soon ran out of new ideas. This is where I felt i became lazy, as instead of seeking out new ideas or techniques as I would have with any other patient, I was able to keep doing the same things as he could not remember what we had done. Whilst they were still effective exercises for him, I just feel as if i was somewhat taking advantage of his memory loss and not trying out different things as much as I probably should have done. Obviously I didnt need to change his treatment to motivate him or keep him interested however other things could have worked better for him, however I never knew because I didnt try them.
This has made me realise that I shouldnt take advantage of any patients situation just to make the work easier for me. There may not have been anything hugely different I could have tried, however I now realise that I should have looked for these harder and not just taken the easy way out.
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2 comments:
that was a very honest reflection. I believe we are guilty of that sometimes, can't speak for everyone but at least I myself am. I find that it happens when I've got a heavy caseload and I tend to be a little slack in giving my patient the best treatment. However, there were times during my musculo prac that my superviosr commented that I did not have to change my interventions for the sake of changing them. Ie: should the patient be improving, conitnue with what you are doing. At the end of the day, its the heart that counts, wanting the best for our patients.
I agree with mel. Whilst variety is important for motivation and keeping your patient interested, the main thing is that your interventions are providing thhe best outcomes you believe you can deliver. For this particular patient, variety was not important for motivation or interest so much.
In my opinion, provided you thought repeating the same exercises were providing the best outcome for the patient this is not a problem. Changing exercises for the sake of changing them is not so important, though I have been told by supervisors that where possible it is good to vary your interventions, especially as students and new grads until you decide what you are best at and which patients respond best to different interventions.
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