Rural

On my current placement (rural) I am working with a lot of patients who live in remote communities, or in home situations that are not the same as what we'd experience in Perth. For me, the hardest thing about this is knowing when to change my plans or treatment sessions and goals to suit the patient and hospital better. For example, last week I saw a lady who was admitted with hip pain and was unable to walk, post MVA. She lived quite a way out of town, and appeared to live quite roughly. After assessing her strength and range, and determining that she did not require the oxygen therapy she was receiving at the time we got her out of bed and went for a walk. I would ideally have sent her home with a frame to assist her ambulation and decrease her pain, but after talking to my supervisor, this would likely not have been appopriate. A falls prevention group, regular checkups and provision of an aid would have been by discharge plan, but in this case was not appropriate.

Many walking aids are given to patients from outlying communities, and few are ever returned. Some are returned, but are often burnt or destroyed in some other fashion. My supervisor told me that many patients will use the frame for a day or two, but then discard it due to social situations, uneven or unnegotiable terrain or other factors. THe outlying communities are visited, but it is often hard to track down patients or see everyone on the limited visits.

It is therefore important that we as physios in this situation ensure that the patient recieves optimum care whilst accessible in hospital, and that they are ready to go before they go home, no just becuase the bed is needed. Plans need to be constantly updated and modified as required, and not two patients are ever the same!!!