Hey guys
If there is one take home message I have learnt from my neuro placement is that with our assessment and treatment of neurologically impaired patients, we are alwyas looking for movement, which will ensure that they are given the best opportunity for recovery. What this means is that we have to give our patients the opportunity and the time to show us what they can do, not just assume what they cant.
For example, one of my patients (mentioned in my first blog) who suffered a TACS affecting almost her whole left hemisphere, was left with global aphasis, right hemiparesis and, initially, very little movement on her left side as well. Given the nature of the stroke and the areas it affected, I had a picture in my mind (as we should) of her impairments. And after examination, these impairments were found to be present. Initially this patient was treated by loking after her chest, passive movements and positioning. This went on for a few treatment sessions and it wasnt until my supervisor came and sat in on a session that I realised how much more we could be doing. For some reason I had this block in my mind, in that I was performing passive movements and stretches on this patients, not even attempting to see if she was capable of anything more. My supervisor then took her through some movements, with heaps of encouraging feedback and found that she was activating some of these muscles, on her hemi side! I would have totally missed this progress if not for her.
A couple of weeks after this as I saw this patiens with my Curtin tutor, who was very suprised that we had not stood this patient yet and wanted to know why. Again, I had not given my patient every opportunity to show us exactly what she could do, instead just assuming that I knew what she couldnt. And she stood and is improving. While she may not walk in any functional way, we have all learnt the importance of being upright and weight-bearing, and standing a patient after a neurological insult is something that needs to be achieved as soon as the patients is able.
So it is crucial that we do not hold pre-conceptions about what patients can do and will achieve, but give them every chance to suceed.
Cheers guys, and enjoy!
Bini
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1 comment:
Great point Bini,
I like you have sometimes fallen into the trap of seeing what patients can’t do, instead of looking & Ax at what patients can do. It is really important to continually Ax and see what the patient can do as in the initial stage they probably don’t have much but as recovery occurs you wont know unless you Ax. That’s really great you were able to stand the patient up and you made progressions in your treatment after you assessed. I have learnt many lessons on reflection from treatment sessions about what I could have done better to get more out of the patient. I think continued Ax and progressing Rx with challenging exercises is the key to maximising recovery for our patients. Great post, it reminded me of things I have done to.
Catch you later
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