I have just finished my forth week in a peadiatric placement and I have never made so many people cry, by people I mean children. I really have a lot of respect for those physios who work with children as is is an extremely difficult job!
Last week I was given a referral from a paediatrician that said "child not rolling by 7 months (just starting to) now at 10.5 moths not WBing. Sitting, reaching, casting OK.". This was all the information I was given prior to the session. I prepared and thought through what i was going to assess and had some idea what interventions I could do if i found certain impairments. When the child arrived with his mother he walked into the room! At that point all my preparation and planning went out the window. I got through the subjective assessment ok with the mother and found out her main concern was that her points at objects with his middle finger and uses that finger to grasp objects. She also stated that the child is terrified of strangers and will scream and cry with any one except her and her husband. I decided to perform the objective assessment by telling the mother what to do and observing. As I had not prepared for him to be walking I was relly stuck on what to test! The child became more aggitated and I became more stressed and my clinical supervisor kept telling my to keep the session going and the child began to scream and cry and I kid you not the child screamed and cried for half an hour. The clinical supervisor took over and tested ROM and mm tone etc with this child who was hysterical. I hve never felt so terrible in all my prac career. At tht point in time I thought if this is what physio is all about then I am not fit for the job. The clinical supervisor came to the conclusion that the child may have sensory defensivness and he used his middle finger as this is less sensative to the index finger.
I was really stirred up about the whole experience, it was awful. Next time I will be more prepared to face any situation...I guess it will take time and experience. Peadiatrics is very hard as you cannot explain to young children why we have to do what we have to do. I have come to realise that with children it is very hard to prepare for a session as it could go anywhere.
Subscribe to:
Post Comments (Atom)
2 comments:
Sounds like a hard session to run yourself! I had a paeds placement earlier this year and it seemed to always work okay if i got the mother to try and participate with the kid if they were a bit upset/stressed. I know where you're coming from when you got a shock cos this child was walking cos kids can develop at pretty fast rates sometimes. I used the motor development assessment scale a lot which really helped me. It meant that if the child was at a level you weren't expecting it didn't matter that much cos you could just prgress to assessing a different level. i.e. if they're walking do climbing over A frame, walking along a low beam, jumping, kicking etc. It's such a handy tool to have. Sounds like the little guy you assessed had a few other issues as well tho. It's so hard to prepare in paeds tho especially if you had never seen the child before so i wouldn't be too worried.
I did not have a paeds placement but recently observed a paeds physio working with a young boy and even she struggled to ax and treat the boy. as you cant explain what and why you're doing it, its almost impossible to get the child to cooperate. i think your idea of getting the mother to try and work with the child was a great idea! at our stage its hard enough sometimes working out whats wrong with an adult and they can explain their problems in detail! i hope your supervisor went over what happened with you and gave you some techniques on how to adapt your sessions to different children.
Post a Comment