Apologies for not posting a blog earlier, my semester has been a little different from other students in regards to prac so I hope you are all well.
Whilst on my rural prac in Northam I had the opportunity to sit in on an initial geriatric assessment with a geriatrician that had travelled from Perth to assess some patients in particular. The patient had come to the consult with her son and the thought prior to the Ax was that Parkinson's Disease may be present. Fortunately, I have had experience in a particular Parkinson's Clinic and was able to understand thoroughly and contribute to the discussions taking place.
Watching the Ax take place without the geriatrician making any deductions until the end of the consult gave me the opportunity to make my own conclusions regarding the patient's health. The doctor really made me feel like part of the health team and constantly asked me to take over manual handling and asked me to clarify for the patient the physiotherapy input in the management of living with Parkinson's and occasionally even asked for my advice. I also had the opportunity to perform manual transfers, an area the doctor admitted that medical professionals needed more training in. This made me realise how important it is for our own safety and for that of the patient, to perform correct transfers particularly when their motor control is already compromised. The doctor did not explain things to me as she went along her Ax, rather she made comments to me regarding what she had found in her assessments making me feel like less of a student and more of a colleague which was really encouraging.
I have seen the signs of PD in the past many times before although in past circumstances a Dx had already been made. In this situation, because the patient did not have a Dx it was necessary to apply my clinical reasoning to the observations made and formulate a Dx by exclusion and rule out any other cause for the signs and symtoms. However, when the symptoms of akinesia, bradykinesia, rigidity, festinating gait, mask like appearance, micrographia and low BP are present, the Dx was obvious. Learning the theory behind the disease is one thing but actually obsevring the symptoms clinically is something else completely. Being told what to look for doesn't compare to seeing it first hand.
All in all, its nice to be noticed for our input as PT's and valued for our advice.
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2 comments:
I have found on all of my pracs that no matter how prepared you are in terms of theory and background knowledge, actually seeing patients with certain pathologies ties everything in and seems to make what we learn at uni so much clearer. It is great when we are able to feel like health professionals on prac rather than students - it makes such a difference if you feel welcome and needed as opposed to in the way.
I've had a similar experience when a patient I treated for pneumonia told the doctor that she found physio very helpful and was visibly better. This patient came in with pneumonia and was very breathless. She responded very well to education about managing breathlessness and we practiced the strategies together too. The doctor documented the patient's comments in his notes and it did really feel great that another health professional acknowledges your work.
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