I'm currently on my Ortho Inpatients prac, mainly TKR and THR. I work mainly in the therapy area and haven't really been on the ward much. So the patients get wheeled down to the therapy area and we go through a standard set of exercises for the hips and the knees.
I had one lady who had a (R) THR and she was excessively anxious ++++ all the time. She was quite emotional on more than one occasion and needed constant reassurance and encouragement. I thought it was simply due to her personality and didn't pay too much attention when she was stressing. I tried to be sympathetic and show her that she really was making progress but none of it seemed to do any good. This went on for a few days until something caught my eye when I was writing in the integrated notes....she had cancer which had metastasised . Her worry and anxiety suddenly made sense. Needless to say, I now try and read all my patients notes.
I felt horrible after finding that bit of information out. This patient had been struggling to come to terms with that diagnosis and if I had been aware I wouldn't have been so quick to judge. Luckily, in this case it didn't have an impact on the Rx i was providing.
From this experience I have learnt the importance of knowing a full history of the patient and have seen first hand how information can change your interaction with the patient and has the potential to alter your Rx of the patient.
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The one thing that really shocks me when on the wards is seeing these patients that have such intense PMHx you have to wonder how some people can have so much wrong with them, its really unlucky. When you come accross these patients sometimes you dont know where to start and you can understand how they can almost want to just give up. I had a patient in an out patient clinic who had akylsosing spondylitis, fibromyalgia severe asthma which had lead to # vertebrae in a coughing fit and she had unrelated sever Cx pain- she was only 33. What I found really inspiriational about this patient was how self motivated and lacking in self pity she was. I think its sometimes impossible to put ourselves in our patients shoes and everytime we treat someone, they do have this whole history which although sometimes seems irrelevant can have a massive effect on how they view both you as their therapist and what is happening to them
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