Pain then, pain now

Wow, what a contrast some (limited) experience makes. We saw a patient today who presents very similar to our very first patient we saw on the ward. The patient has a fractured NOF, just as our first patient. The contrast is understanding the process of healing in a clinical setting (on an individual basis) and just how much pain might be expected and for how long. Treating our first patient with the fractured NOF (who had severe dementia) was initially a little bewildering. Our lady was a tiny little thing, in a beautiful dress and so pleasantly spoken. When we began our therapy, we literally put her through substantial pain, it was in fact worrying and a little daunting, pressing her to do her exercises and continue. A discussion was had with our supervisor regarding our concerns as to how much pain is appropriate, and are we in fact "damaging" her. Today was a different story. We were able to gauge expected pain levels given the time post fracture, educate the patient about appropriate loading and the importance of mobilising appropriately. We can now do this with more confidence and progress our patient as required. We will still monitor her pain and watch for possible increased requirements of pain relief, but it will be done so with a little more experience and direction.