Patient who does not like physios

On my last day at rural prac, I was given an interesting patient to work with. She is a patient who just got transferred from hospital in the city. She required basic physiotherapy services like a mobility assessment and ambulation. She has been in hospital for 6 months now and the nurses have told us that she is sick of physiotherapy, sick of physiotherapist shouting at her demanding her to do stuff.

I approached the patient who had just finished with the nurse and was lying in bed. I started off with introducing myself and giving her an overview of what we would be doing. She consented to the session and I thought to myself that she is not as scary as the nurse made her out to be. I started asking her some questions being very careful not to repeat any questions that she has been asked before by other staff but half way into it the patient stoped short in her replies and stated that she has already answered these questions to someone else who came in before me. I apologised and acknowledged that she is probably tired of repeating the same stuff but because the information has not been put in the notes I would need the information to plan my treatment with her. The patient was very understanding and we continued with the subjective assessment. Later I managed to proceed through my objective assessment without much hiccups except that the patient was not willing to stay standing for longer than 1 min or ambulate. I did however managed to get her doing many incidental sit to stands and completed my objective assessment. However, the patient dictated the end of the session by going straight back to bed when she decided that she’s had enough. I spoke to the nurse regarding what I managed with the patient and suggested that the nurse encourage the patient to ambulate simply because the patient might be more receptive to other health professionals.

I came out of the session wondering why she was portrayed as such an intimidating character for physios. Personally, she felt like a patient who is just not very complaint. However, with patience and true empathy, the patient was quite co operative. I suppose if future similar situations arise I will not go into the session with preconceived idea as it will make me nervous and cloud my judgement about the patient. It is also a good opportunity to practice multidisciplinary team effort by communicating with the other health professionals to incorporate some of our treatment goals into their session. This would be especially helpful for patients who do not work well with certain health professionals and thus time spent with the patient can be more efficiently used by concentrating on the goals that can only be achieved by physio intervention.