Recently on muscuko outpatients prac I treated an elderly lady with low back pain which was moderately irritable. This was the first time I had seen this patient as she was a transfer from another physio. She's quite a lovely lady and I don't think she meant anything by what she said, it was just her way of dealing with the situation.
I began my objective assessment as usual; observing gait, AROM, palpation, trigger points, PPIVMS/PAIVMS and checked for pain and/or stiffness as I went through. Initially she was fine but when we got to palpation, PPIVMS and PAIVMs that's when the drama started. At first the swearing was just muttered quietly under her breath but then every time she felt a little bit of pain she'd scream out and then add in a few expletives for good measure. This was particularly the case with trigger point release, as you can imagine. It wasn't necessarily what she said either but it was the fact that it was quite loud. We aren't in treatment rooms either, the cubicles are only separated by curtins so all the other patients and treating physios were subject to her verbal display. It was when she got louder that I began to feel a bit awkward so I asked her if she wanted me to stop because I didn't want to make her pain worse but she told me to keep going and it didn't hurt that much.
I was actually a little confused as to what to do? Do I keep going with Rx and allow her to swear or do I change tact and try something different even after the patient asked me to keep going with my original Rx? I was concernend about what other patients would think after listening to this patient?
I decided to change Rx and go through her HEP which hopefully would be less provocative (thankfully it was!!). Then I went back to mob's and TP's and she had settled down little bit as well.
This experience was quite awkward to deal with and if she had started yelling when I returned to mob's and TP's the second time I would have had to tell her discreetly to keep her voice down. I probably would have said something implying that although I didn't mind we have to consider the fact that other patients may find it offensive.
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1 comment:
Hey Mel great blog! Isnt it amazing the type of people we meet in Physio! I had one lady on my musculo prac who loved to swear too! When she first did it I actually thought I must have miss heard her becuse she was a sweet old lady who had come to physio in her best outfit with a nice purse and heels. But then she started cursing awy as she told me bout her weekly catch up with the girls over a few glasses of whisky! I know it is not professional but I had a good ol' chuckle! I was so shocked and thought it was hilarious!You so can judge a book by its cover hey!
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