Non compliant patient

One aspect of prac that I have found very difficult to align with theory is the concept of patient consent. Throughout our early years this is one of the most important things we learn to first explain everything to the patient and then gain consent. The physical experience of this when on an acute ward where you are seeing patients 1-2 days post abdominal or orthopedic surgery is that they really dont want to move at all. Although most patients are recieving pain relief everyone responds differently and have different pain threshold levels. Although some patients are quite compliant when you come to walk them, some patients outright refuse. When you first encounter these patients your first reaction is to say 'ok, I guess I can't force them' however your supervisors seem to have a totally different idea and its 'get these patients up at all costs'. Alot of the time it hardly feels like you have patient consent and have used every trick in the book to get them up. After spending more time on prac I have been able to take a more logical approach to motivating these patients within a reasonable time frame... i.e if they dont want to get up because of pain ensure they have enough pain releif, if they are nauseas discuss with medical staff to see if they are able to receive anti-emetics, if they are dizzy check bp etc.

One patient on a surgical ward was 1/52 post abdominal surgery and had been documented as being ++ non compliant with other staff. When I went to see her for the first time I spent 15 minutes trying to convince her to walk and when I finally did she only walked half the distance she had the day before with my supervisor. When I reported back to my supervisor, she thought this was totally unacceptable as her notes had read that the patient must mobilise. My explanation was that this was my first encounter with the patient and didn't know what to expect. My supervisor said that if this patient had a different physio everyday and they took at least one session to know how to deal with her then she wouldnt move at all, which was fair enough. My next session with the patient was a double treatment with the ward OT, as expected the patient declined treatment, the problem was that I was trying to convince her to walk, because my supervisor expected no less, and the OT was looking at me saying " well its really her decision, we can't force her", in the end we managed to make her walk the same distance as the day before. I wonder if anyone else has dealt with an experience like this and what they have found helps in motivating patients?