Final Entry

And so another placement comes to a close. Such a cliché, but the pracs to date have sped by at a rapid pace.

 

While one of my initial expectations was that the placement would be very hands on, it’s actually moreso than I expected. As it’s a neuro placement, the rehab work is quite physical and demanding at times. This just reinforces how hard it actually is for the patient, and perhaps how valuable our input probably is for patients that have suffered a stroke for example. The majority of the patients are elderly, but helping someone to walk again for the first time can be hard work. Some of the occasions where this has happened, I’ve naively thought beforehand, surely there’s no chance of the patient “walking” again. But to my surprise on more than one occasion, we’ve helped facilitate patients stand and “walk”, which obviously greatly affects their quality of life through ADL’s, and their own confidence. My limited clinical experience has certainly learnt that if you don’t at least try these things in the patients rehab, then they just wont happen. That’s why they’ve come to the facility!

 

I had wanted to see the full course of a patients recovery whilst on the placement. I was fortunate to see this happen, as one of the patients I’d referred to the clinic from my first placement, was discharged back home to live. This was great to see, and the huge difference in the patients mobility and strength from the time I first saw her, to the time she left was certainly significant. I’ve noticed that a patient can really differ in their appeared rehab prognosis and how they settle into a non-hospital environment. For example, for a 90 yr old lady, she really was so different in that hospital environment, compared with the transitional care (more routine) environment. With medical stability, own clothes!, more specialised rehab, and routine faces and activities, this particular lady seemed like a different person. This lady was expected to move on to low level care, but indeed she made it back home and living independently – which is great! This is something to keep in mind if and when I work in a hospital and consider a pts suitability for referral to such a place.

 

Being the only student on this placement was to my own benefit I believe. I was the only focus for mentoring for the physio staff there, and I was able to learn from each of those staff, because the workload was shared among the three of us, not a second student as well. I’d have no hesitations going on placement again on my own as a student.

 

Going to a smaller facility, I got plenty of mentoring as I’d hoped. I had my own caseload from the start of the placement, which increased as the weeks went on, and I had the near-by supervision and feedback whenever I needed it. I felt well supported and mentored over the course of the placement.

 

Once thing I’ hoped for was a variety of presentations. While this didn’t necessarily occur, I still found the experiences consolidated my knowledge over the placement, and also the biopsychosocial importance in each of those cases.

 

Certainly I’m appreciating the biopsychosocial aspect of each patient and their situation. Presentations ranged from the injury itself, the mental health of the patient prior to the incident, and aspects like family support. I’ve seen how each of these factors can influence the outcome or progress of a patients rehab. Ive seen a highly motivated and active patient prior to a stroke become introverted and non-committed in their rehab (understandable of course). I’ve seen the effects of alcohol abuse over a lifetime affect the patient in their rehab potential, patients without any family whatsoever. There are a range of factors that all need to be taken into account. These are things that books and resources at uni cant really convey sufficiently, as they are so individual,  but clinical practical experience and how to handle each of these is attained as experience grows. I’m appreciating this more over each placement.