On my P1 prac this year I was placed at a neurology outpatient department and we had a variety of patients who came in twice a week. One particular patient was a 31 year old female who had suffered a pontine stroke 4 years previously, this left a perfectly normal young woman who was a naturapath with locked in syndrome. This means she had no gross motor funtion other than small, uncontrolled movements of her left hand, nodding/shaking her head, and the only sounds she could make were largely unrecognisable. Therefore her only means of communication were to let us guess what she was trying to say and nod or shake her head, which was slow and depended on how well the therapist knew here. She could also use a lightwriter, a small laptop like device that she could type words into, but this was also very slow. Despite this she had a great sense of humour and for the first couple of weeks she was a really great patient who was alway compliant and tried her best.
During one session around the third week I was trying to facilitate her sitting balance and i was asking her to lean back a little bit. She had very poor abdominal control and so tended to lean forward to get her balance but needed to sit back to get into a better posture. Halfway through this treatment my patient started crying. We were working an open treatment area so we didnt have any privacy and i was sitting behind her supporting her, which was made difficult as she was really upset and shaking. Initially I thought it might have been something to do with the treatment I had done, maybe making her feel unbalanced and not in control and we tried asking her if this was the problem. My supervisor, who knew her much better than me came and started asking what was wrong. It took nearly an hour to find out the problem because we had to guess what the problem was and she could only reply yes or no. Eventually she used her lightwriter to tell us that her ex boyfriend had just got married and this was what was upsetting her. I found this situation very difficult as initially i thought i had done something wrong and also didnt feel that i could say much once the supervisor arrived as i didnt want to upset her more. I also wasnt sure if she would really want me knowing the problem as it was very personal. I also wasnt prepared to face such personal issues from patients as its not often what you expect from physiotherapy. It was also really confronting to think that someone who is just like you and me could have their whole life infront of them and have it taken away in a day. I really had no idea what to say and thankfully my supervisor could say some really things to comfort her. The hard part about this situation is not taking it home but then also not feeling insensitive and as if you dont care. In the next session my patient was alot happier and was very grateful for our help but I still felt that without my supervisor I would have been lost dealing with the situation.
1 comment:
That must have been a pretty heavy situation to deal with. Ive had a similar pt but always had a positive attitude, as hard as it may seem being 'locked in'. I guess though situations like this do come around and lucky your supervisor was there. Having seen it being dealt with, your probably more qualified to deal with it than most of us haha. From your post it seems like you've got a good idea of dealing with personal situations but not bringing it home. I think thats important especially in an area like neuro, where physical deformity might only be a slice of the cake. Thanks for a good blog
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