Hey guys,
Currently I am completing my cardiopulmonary placement with the majority of my time being spent on the medical ward. That was up until last Wednesday when there was an outbreak of the norovirus. This resulted in the ward being closed; staff who work on this ward are not allowed to any other areas of the hospital. Unfortunately for me the policy of the hospital is that students are not allowed into wards that have been closed due to norovirus outbreak.
Therefore I was very limited to the number of patients I could treat. The surgical ward has very few patients and the majority of the surgery is lower abdominal, it is very rare that any patients here have a PPC. With my supervisor struggling to find patients for me to see cardio wise, I was able to attend emergency with him in relation to a patient who presented with severe acute LBP.
“Steve”, 46 y.o. male presented with severe pain, and unable to stand or walk; previously he was independent with everything. He was t/f to hospital via ambulance. Steve has had 3 previous episodes of acute LBP that resolved spontaneously within 3-5 days in the past. On this occasion Steve hurt his back at work two days earlier shovelling gravel. He went home immediately and had been mainly resting in bed and doing some light walking around the house. The back was improving over the next day and a half until he started to get the severe pain again and was unable to move.
Due to the irritability Ax was limited to Steve moving from supine to SOEB. With attempting to stand he slumped back down to the bed. Steve displayed a large list towards his painful side and unable to sit vertical due to the pain. His greatest relieving position was right side lying.
Our intervention was to apply a heat pack for 20min in right side lie. This had a good effect and relieved the pain so my supervisor told me. Unluckily for me I was unable to follow up with Steve. But I was told that in conjunction with some very strong pain med’s Steve was able to walk out of the emergency department after a couple of hours.
Even though I was unable to access my cardio patients I was still able to learn something in another area. Having to think on my feet in a completely different area to the placement I am completing was a great challenge and gave me good variety.
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3 comments:
Mike, hope the noro clears up on your ward but your experience brings up an important point. I’ve definitely noticed that even though we’re placed in one particular stream of specialisation (i.e. neuro or cardio), its important not to rule out all our skills as physiotherapists. The first responsibility on my current neurology placement is to ensure that a patient’s chest is clear. If not, then the management options we learnt on cardio come into play. Additionally, one of my patients had a swollen ankle which was actually the major factor restricting his mobility, not due to any motor deficits. So the use of musculoskeletal skills were then required. So Mike your blog makes a great point reinforcing the fact that we must now think of ourselves as holistic physiotherapists and not to think in boxes when managing patients.
Gareth
Bad luck... I hope you don't catch anything!
Your attitude is good, it wasnice to be able to help a different pt and learn something in the process.
My Cardio placement involved working with an amp. so I had some of the same crossover... enjoy it, I say!
hey there
I know where you are coming from swanny. My cardio placement has consisted of me seeing rouhgly 4 cardio platients my entire placement! This didnt really leave me in a good position for my final assessment yesterday, but I got through it. But as Gareth said, that is the reality of working on a ward, especially a medical ward, and it is a very good opportunity to put into practise stuff we have learnt through our other placements, and general stuff like time managament, discharge planning and becoming comfortable with liasing with other staff. However, we could be doing all of this PLUS getting some cardio experience. I do feel a little annoyed, as I'm sure you do, that my only cardio placement was predominantly taken up with doing UL and LL bed exercises in ppl with infectious diseases or gastro problems. Oh well, were made it :)
Bini
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