I am so glad I got to go to Collie. I can’t express enough just how much fun I had. I could have never imagined myself working in the country, but now it definitely seems like a fantastic option. I think the reason that I loved it so much was because of the people, everyone at the hospital made me feel so welcome and part of their team, I couldn't have asked for more!
ISSUE ONE: I think I am mainly nervous about being away for so long and feeling like there will be less people to ask for help. I am also worried about our accommodation. Jess and I might be a bit lonely if we’re the only people there.
Not at all an issue! There were more people to ask and everyone was willing to stop and give you a hand! Also, the accommodation was great. There were quite a few other students there and I made a really great friend with an OT student from curtin. We might go back for a Collie road trip together!
ISSUE TWO: Diversity, small country town hospital and a small allied health team?
I did see a much more diverse range of things! I had cardio, peads, neuro, WH, ortho and MSK patients….a bit of everything! It made a FANTASTIC earning experience, I feel like I have seen so much. I also got to look after he ward and see people in an acute setting which was great! The hospital was a lot quieter though than my previous, but it meant you could put more time into patient preparation and care, so it wasn’t the downfall I expected!
The allied health team was huge, and very inclusive. You could ask anyone for help and there were constant inter-departmental referrals.
All in all, best prac ever!
Friday, August 28, 2009
week 5 STARES
COMMUNICATION
S- My patient, A young girl who had previously fractured her ankle and then suffered from RSD, came in to see me with recurrent ankle pain. She came in with her mother and they had SUCH a bizarre relationship. The mum answered every question for her daughter and kept cutting in. For example, when I asked her the intensity of the pain the girl answered only a 3, but then her mother cut in and said its definitely more like a 9. Then mother then continued to rattle off every disease under the sun that her daughter had, including rheumatoid arthritis which was causing the ankle pain.
T- My task was to assess the girls ankle and provide treatment as required. However, all of the mum's information was making me think that she just wanted a sick child for attention and I felt it was a bit of a red flag for Münchhausen's. We sent the girl home with a program and booked her in for 3 days later. My supervisor then rang the specialist at PMH and sure enough the mother has been flagged for potential Münchhausen's (but non harmful) and her dependency on PMH was noted. Our task then became to really utilise our communication skills to try and explain this to the family.
A- I asked my supervisor to come in with me as I didn't want to say the wrong thing and make it worse for the child. We then chose to speak only to the daughter so that the mum could not butt in as much. We explained that she did not have a disease process in her ankles, but that she has some hypermobilty, which is completely normal. We emphasized that she should not be having days off school and that she can play sport (originally her mum was even letting her walk far) We talked about her ankles for about half an hour, and hopefully it helped to drive home to her that there was nothing wrong!
R- I think that my education and communication skills were to the point as the daughter was responding to questions on her own rather than looking to her mum. She was glad to hear that she was normal! I showed her my knees just to prove that having some hypermobiity doesn't make you abnormal!
E- I was really glad that I asked my supervisor to come in with me. I think I did a good job but sometimes I'm not quite strong enough in my convictions and I think the mother could have bullied me into changing what I said. My supervisor is reviewing her once a week to ensure she is doing everything that a normal 13 year old should be doing!
S- The main strategies I used were communication and education, which is definitely what the family needs the most. Also, her dad (a totally normal guy) will bring her n next time under the guise of also having to review his knee...getting her away from her mum will also be the key!
S- My patient, A young girl who had previously fractured her ankle and then suffered from RSD, came in to see me with recurrent ankle pain. She came in with her mother and they had SUCH a bizarre relationship. The mum answered every question for her daughter and kept cutting in. For example, when I asked her the intensity of the pain the girl answered only a 3, but then her mother cut in and said its definitely more like a 9. Then mother then continued to rattle off every disease under the sun that her daughter had, including rheumatoid arthritis which was causing the ankle pain.
T- My task was to assess the girls ankle and provide treatment as required. However, all of the mum's information was making me think that she just wanted a sick child for attention and I felt it was a bit of a red flag for Münchhausen's. We sent the girl home with a program and booked her in for 3 days later. My supervisor then rang the specialist at PMH and sure enough the mother has been flagged for potential Münchhausen's (but non harmful) and her dependency on PMH was noted. Our task then became to really utilise our communication skills to try and explain this to the family.
A- I asked my supervisor to come in with me as I didn't want to say the wrong thing and make it worse for the child. We then chose to speak only to the daughter so that the mum could not butt in as much. We explained that she did not have a disease process in her ankles, but that she has some hypermobilty, which is completely normal. We emphasized that she should not be having days off school and that she can play sport (originally her mum was even letting her walk far) We talked about her ankles for about half an hour, and hopefully it helped to drive home to her that there was nothing wrong!
R- I think that my education and communication skills were to the point as the daughter was responding to questions on her own rather than looking to her mum. She was glad to hear that she was normal! I showed her my knees just to prove that having some hypermobiity doesn't make you abnormal!
E- I was really glad that I asked my supervisor to come in with me. I think I did a good job but sometimes I'm not quite strong enough in my convictions and I think the mother could have bullied me into changing what I said. My supervisor is reviewing her once a week to ensure she is doing everything that a normal 13 year old should be doing!
S- The main strategies I used were communication and education, which is definitely what the family needs the most. Also, her dad (a totally normal guy) will bring her n next time under the guise of also having to review his knee...getting her away from her mum will also be the key!
week 3 STARES
week 3 STARES
S- In week 2 I saw my first patient by myself. The patient had been diagnosed with a shoulder impingement and biceps tendinitis. She has also been to the physio here for a number of other problems however and has numerous pain issues. She attends a class run by the physio department during which she sits out most of the exercises due to pain. She came to our appointment wearing a sling and was displaying her illness very obviously.
T- I had to perform an assessment and treatment to best help this patient, keeping in mind her pain issues and trying not to feed into them any further.
A- I performed a thorough assessment. A few things that I noted were that her active shoulder range on assessment was no further than 120º yet she could take off her jumper using full shoulder ROM. She also had very poor posture and didn’t understand her diagnosis or what it meant in terms of her pain. As such, I really focussed on education. I made sure she understood the mechanism of her pain and how poor posture affects her shoulder and really is the solution to her pain. I also discouraged her wearing of the sling but suggested she ice her shoulder to help with inflammation. I then gave her an exercise program focussing on improving her posture and strengthening her rotator cuff.
R- The patient was really happy with the explanation of her pain and felt that knowing the problem gave her more control of the issues. She performed the exercises well and was happy to continue them at home. I also saw her at the exercise class a week later and she said her pain had reduced and that she was constantly correcting her posture.
E- I was happy with how our session went. I was especially happy with my explanation as I feel that her interpretation and lack of understanding was having the most impact on her pain and her ADL’s. (As wearing the sling meant she couldn’t do too much). I think though that I need to get into a much better routine during the assessment, as I had my patient moving from sitting, to supine to prone…etc and it was a bit all over the place. She also had some trouble moving on and off the plinth so it really didn’t help! Next time I see her (or any other patient) I am going to organise my tests into those categories before I start so I am more confident and prepared.
S- The strategies I used were education and postural re-education. I was happy with how I used these and my confidence in the education process.
S- In week 2 I saw my first patient by myself. The patient had been diagnosed with a shoulder impingement and biceps tendinitis. She has also been to the physio here for a number of other problems however and has numerous pain issues. She attends a class run by the physio department during which she sits out most of the exercises due to pain. She came to our appointment wearing a sling and was displaying her illness very obviously.
T- I had to perform an assessment and treatment to best help this patient, keeping in mind her pain issues and trying not to feed into them any further.
A- I performed a thorough assessment. A few things that I noted were that her active shoulder range on assessment was no further than 120º yet she could take off her jumper using full shoulder ROM. She also had very poor posture and didn’t understand her diagnosis or what it meant in terms of her pain. As such, I really focussed on education. I made sure she understood the mechanism of her pain and how poor posture affects her shoulder and really is the solution to her pain. I also discouraged her wearing of the sling but suggested she ice her shoulder to help with inflammation. I then gave her an exercise program focussing on improving her posture and strengthening her rotator cuff.
R- The patient was really happy with the explanation of her pain and felt that knowing the problem gave her more control of the issues. She performed the exercises well and was happy to continue them at home. I also saw her at the exercise class a week later and she said her pain had reduced and that she was constantly correcting her posture.
E- I was happy with how our session went. I was especially happy with my explanation as I feel that her interpretation and lack of understanding was having the most impact on her pain and her ADL’s. (As wearing the sling meant she couldn’t do too much). I think though that I need to get into a much better routine during the assessment, as I had my patient moving from sitting, to supine to prone…etc and it was a bit all over the place. She also had some trouble moving on and off the plinth so it really didn’t help! Next time I see her (or any other patient) I am going to organise my tests into those categories before I start so I am more confident and prepared.
S- The strategies I used were education and postural re-education. I was happy with how I used these and my confidence in the education process.
Saturday, August 1, 2009
week 1
One week down of my placement! It’s been going really well, but I don’t feel as though I have much to report on as I have only been observing the 4th year student and my supervisor rather than getting my own hands on opportunities, that’s not to say I haven’t learnt anything though, or had fun. Also, I'm finding it's A LOT quieter in the country as opposed to perth!!! Next week I have been able to book in patients so that will be more challenging. I have 3 post natal referrals which I’m especially looking forward to as we haven’t had that much practical exposure yet, I don’t know if I should be nervous or excited!
S- A ‘no falls’ class for clients referred with balance issues. The class focuses on stretching, strengthening, lots of balance work, mobility and multitasking.
T- Take the class (which I had never seen only once before) while my supervisor worked one on one with an elderly gentleman who needed quite a lot of extra help.
A- I took the class and we ran through some gentle arm weights, leg strengthening and balance work. We also did some walking while bouncing the ball to encourage multi-tasking.
R-The class worked well and enjoyed the exercises I gave them.
E-I think that I did a good job in that I was confident and enthusiastic, but next time I think I could definitely branch out a bit more. I stayed on the same track that my supervisor follows but I think I could spice up the program with some of my own ideas.
S- I’m going to go and have a look through some of our past notes/lectures and find some new and exciting exercises that the class can do. Especially some new balance work.
S- A ‘no falls’ class for clients referred with balance issues. The class focuses on stretching, strengthening, lots of balance work, mobility and multitasking.
T- Take the class (which I had never seen only once before) while my supervisor worked one on one with an elderly gentleman who needed quite a lot of extra help.
A- I took the class and we ran through some gentle arm weights, leg strengthening and balance work. We also did some walking while bouncing the ball to encourage multi-tasking.
R-The class worked well and enjoyed the exercises I gave them.
E-I think that I did a good job in that I was confident and enthusiastic, but next time I think I could definitely branch out a bit more. I stayed on the same track that my supervisor follows but I think I could spice up the program with some of my own ideas.
S- I’m going to go and have a look through some of our past notes/lectures and find some new and exciting exercises that the class can do. Especially some new balance work.
pre placement post
COLLIE!
I am feeling very nervous, and excited, about heading to Collie tomorrow. I just arrived home from Melbourne and am now packing a truck load of things to take down for 5 weeks; I didn’t leave myself much organising time! I am bound to forget something!
I think I am mainly nervous about being away for so long and feeling like there will be less people to ask for help. I am also worried about our accommodation. Jess and I might be a bit lonely if we’re the only people there.
Heading down to Collie I am expecting to see a much more diverse range of things than I did at Bentley. My supervisor deals with everything, from paeds, WH, musculo and lymphodaema, so I need to be much more prepared and ready for anything. I am also expecting the hospital to be much quieter than my previous placement. I think the structure will be much the same, with the physio's seeing out patient referrals, but I also know that the physio takes care of patients on the ward as well. I think my role as a student may expand. There's only one physio working in the hospital so her role and jobs may include things not necessarily under the umbrella of physio. I'm not too sure if there is a large allied health team, I'll guess I'll just have to wait and see.
Mostly though, I can’t wait! I am so excited to see a bit more of the South West and be challenged with things that I might not get to deal with in Perth.
(Note: I did leave something in Perth, probably the most important thing, my wallet!!)
I am feeling very nervous, and excited, about heading to Collie tomorrow. I just arrived home from Melbourne and am now packing a truck load of things to take down for 5 weeks; I didn’t leave myself much organising time! I am bound to forget something!
I think I am mainly nervous about being away for so long and feeling like there will be less people to ask for help. I am also worried about our accommodation. Jess and I might be a bit lonely if we’re the only people there.
Heading down to Collie I am expecting to see a much more diverse range of things than I did at Bentley. My supervisor deals with everything, from paeds, WH, musculo and lymphodaema, so I need to be much more prepared and ready for anything. I am also expecting the hospital to be much quieter than my previous placement. I think the structure will be much the same, with the physio's seeing out patient referrals, but I also know that the physio takes care of patients on the ward as well. I think my role as a student may expand. There's only one physio working in the hospital so her role and jobs may include things not necessarily under the umbrella of physio. I'm not too sure if there is a large allied health team, I'll guess I'll just have to wait and see.
Mostly though, I can’t wait! I am so excited to see a bit more of the South West and be challenged with things that I might not get to deal with in Perth.
(Note: I did leave something in Perth, probably the most important thing, my wallet!!)
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