For my ICU placement I spent a week in the high dependancy unit. One pt i was asked to see was a foreign woman day 1 post mastectomy and was in need of a cardio Ax, and likely some deep breathing exercises and potentially a sit out of bed. I approached the pt as per normal, introduced myself, my role and how the Ax was going to take place. The patient looked wide eyed and slightly uncomfortable, but i reassured the pt and began a subjective Ax. I asked the pt a number of questions regarding cardio status both pre op and comparisons to present. The pt also reported feeling quite well.
Following this i began to give instructions on auscultation (open mouth, deep breaths etc) when the pt looked very anxious. It was at this pt that my supervisor stepped in and said would the pt prefer a female physio for Rx. At this pt the pt looked very relieved and nodded her head. She then apologised to me multiple times, thinking that she had offended me. I assured her that she had not, and i apologised for making her feel uncomfortable.
After this encounter i was thinking of ways in which i could have avoided this awkward situation for both the pt and myself. I had obviously missed the cues that my supervisor picked up, that the patient was not comfortable with a male treating her. I think being more aware of cultural and personal issues would have been benefitial in my approach to this lady. This could have even involved me simply asking "Are you ok if I do your Ax". A chest Ax post mastectomy in itself would likely create anxiety.
Prior to this incident i approached pts in a similar manner and the thought had not occured to me that being a male physio student i was not always welcome to treat female pts. From this point I have tried to pick up more on cues that may lead me to question the best approach for Rx and get help if needed. I think a lot of this comes from experience but would love comments on this situation.
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It is really difficult to know each culture and how to treat different people from other cultures. I have never thought that if I am treating a male patient that they may be uncomfortable having a female treating them! Now I will always ask. On my orthopeadic inpatients placement I had a lot of aboriginal patients, some who had come from missions way up north and some who had come from northbridge! My supervisor told me that it is disrespectful to look them straight in the eye. I found it so hard to teach a patient how to use crutched NWB when going up and down the stairs when they didnt speak english and I wsnt allowed to look them in the eye!! I too have alot to learn about cultural differences.
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