Communication

 

 Communication

 S

This situation is that of a 62 yr old female who recently discharged from the hospital as an inpatient and is now frequenting the spinal unit as an outpatient. The pt suffered injuries during a water sports accident and has had significant difficulties adjusting to her reduced physical capacity. She previously had an active lifestyle, and has made great gains in function, yet is consistently pessimistic and negative about her gains (in comparison to her pre-injury status). It has been noted that the pt may have a trying social situation at home, which appears to contribute to her demeanour and mindset. I had not yet worked with this pt but was informed of her tendency to bog down in depressive thoughts and comments.

T

Physical intervention of stretching, upper limb mobilisations, weight bearing via the tilt table, sit to stand practice and gait training was to be administered. Because the pt is now an outpatient, there is some focus on the pt taking more independence in her program i.e. starting on own stretches.

A

After the pt was brought in, I was introduced to her and given some instructions on what would be done during the session together. The pt seemed cordial enough but soon displayed the behaviours of that mentioned above. I acknowledged her concerns but moved the conversation back to the task at hand. I did not focus greatly on the repetitive points she made regarding her inabilities, but kept the treatment directed towards her goals.

R

The session was completed as expected and having worked with this pt for the first time, believe it was a successful treatment.

E

While this pt does (naturally) has some emotional concerns, I tried to keep the conversation light in nature (whilst not disregarding her issues altogether).  Building a rapport with her and gaining a mutual respect and understanding of how we work together was important for me to implement. I acknowledged her concerns (i.e. today was volunteer transport issues and its possible restriction, along with others), and aimed to provide a simplified and timely solution to it.

S

It’s apparent with a pt like this, that if the negativity and self-pity is allowed to be drawn into the session, the progress and the success of her rehab may be restrained. The stages of grief may also play a part in her situation and should be kept in mind. I guess the balance here is limiting the negativity but also being careful not to disregard the patient and her concerns altogether. Some empathy should be shown to the patient but in an appropriate manner and proportion. I believe I managed this with this patient but it’s certainly difficult to balance. More experience will further that skill.