I recently completed my rural prac which I rather enjoyed as i had patient caseload with a lot of variety - including musculoskeletal oupatients, paediatrics, woman's health and inpatients.
A 7 wk old baby with a mild plagio was booked to see both my tutor and myself and after reading the operation notes, we realised that this wouldn't be a normal type patient. The mother had recently been off her medications for mental problems, there were family problems in the household and there was a very interesting birth history with the mother ending up in ICU bleeding out and the baby being born 4 weeks premature.
After the inital assessment of the baby, we realised that the child was lacking in certain motor milestones, altered tonal changes and had a hard time concentrating. The problem was that the baby hadn't been diagnosed with anything up until this point in time - ie undiagnosed CP. The mother was seeing a social worker, clinical nurse and GP to sought out all of her problems.
After finishing of the session with HEP of stretches and exercises and simple education about placement of child vs environment, the mother went on her way with her baby.
The tutor explained to me that she didn't want to bring up all of her finidngs to the mother as she has a lot on her mind at the moment. We discussed this further with the mother's clinical nurse who had also noted the baby's changes. The nurse explained that she would explain the potential diagnosis of the baby to the mother on their next visit in 3 days time, as she had just been back on her meds and in a better frame of mind.
This was a very complex situation to be a part of but I think my tutor did the right thing in this situation. If this situation was to come up, especially once reading the complex Hx of both mother and child, I think I would have contacted the other allied health professionals involved with that specific patient and then see what they had observed and noted and what they had planned for them, or perhaps even work out if the baby's diagnosis had been discussed with the parents. I certainly learnt a lot from this experience.
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Hey Hendo great post! I think its fantastic when you get to experience something that you cant learn by reading a text book or prepare for by studying lecture notes. I too think the supervisor did the right thing especially for the childs sake as it sound as if the mother may be slightly unstable and may not cope with the news. Hopefully we will learn these skills quickly when we entre the workforce!
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