Communication/Interpretation (Daria's Post)

Hi All,
During my neuro placement I have learnt how important is communication both verbal as well as written. There are many reasons for this such as benefit of patient, from the legal point of view, better team work and relations with other health professionals.

One of my patients is after PCI with severely impaired posterior circulation presents with very ataxic gait. This patient balance varies sigificantly from day to day or even during the same day, for example one day patient can maintain his static standing balance with eyes open then closed for 60 seconds, another day can not perform these tasks at all. I have noticed that patient's balance and functional level were generally worse after weekend as patient hasn't have chance to "experiance"/practice his balance and walking. Other factors that influence on patient's balance are mediacations, especially sedative ones that patient receives if he is restless and "significantly impaired memory"(assessment performed by OT).

The patient that I mentioned above is at a hospital ward therefore nursing staff rely on information regarding functional level of each patient provided by physio. Functional level assessment is assessed/reviewed on daily basis and has to be documented in the notes and on functional chart in a patient's room. Then any changes have to be handovered to nurse who looks after patient as well as to co-ordinator nurse. When I have assessed my ataxic patient functional level and I found his balance deteriorated a lot that I wasn't able to walk him on my own (for mine and my patient safety) I asked another physio student to give me hand. After session I have reported my concern about patient's balance to medical staff.I documented in notes my assessment, findings and changes in functional level then I changed information on functional chart in patient's room ( ambulation: 2 A max). I was very suprised when I showed/informed coordinator nurse and I found that her interpretation was different to what I meant. When I have written "ambulation: 2 A max" (this is commonly used abbrivation used on this ward) I meant that patient can ambulate with maximun assistance from two staff members. The nurse understood that patient needs assistance maximum two staff members ( can be less than two but not more than two). It was good lesson!

Daria