My previous placement was at a women’s health facility. Patients who were referred by the nurses or who needed to be reviewed from the previous day were the highest priority patients. Once these patients had been seen the remaining patients had to be given post natal education.
Women who have had uncomplicated vaginal births are only in hospital for 2-3 days and those with caesarean sections 3-5 days, therefore there is a large turnover on the wards. There isn’t time to give everyone a 30 minute education session, so those patients who cannot be seen are given information booklets and are told to contact physiotherapy if they want to.
I decided to give a 16 year old girl post natal education because I believed she would really benefit from pelvic floor exercises and back care. I began by teaching her pelvic floor muscle exercises and good bowel and bladder habits. During the explanation she would not maintain eye contact and looked very disinterested. In addition she refused to practice pelvic floor muscle exercises and transverse abdominus exercises as she was in too much pain. I decided to stop the education session and didn’t continue with back education. I gave her the information and told her to contact the physiotherapy department with any problems.
I was quite frustrated following this education session because the information I was providing was extremely important for this young girl. I took her response quite personally and I felt that the treatment had been ineffective and a waste of time. I’m unsure why she wasn’t responsive. It may have been her pain levels, information overload or I may have caught her at a bad time. Seeing as though I am only 21 years of age she may have been more responsive to an older physiotherapist. After leaving the room my supervisor acknowledged that I had recognised and identified non verbal cues from the patient and had responded in an appropriate manner.
This treatment was a learning experience. I realised that many factors may have contributed to her being disinterested in the information that I was providing and I shouldn’t take her response personally. For this young lady the birth was probably very overwhelming. Although this patient would benefit hugely from this information I understood that if she wasn’t responsive I should provide education to more receptive patients on the ward who would appreciate the information.
During future education sessions I was quicker at responding to non verbal cues. If uninterested, I gave a more brief explanation and gave them the booklets to have a read. I expanded on education sessions when the patient was receptive and interested. I didn’t take their response personally and understood that the new mothers were overloaded with information and were experiencing a very new and challenging time of their life.
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I definitely think you did the right thing, prioritising 'treatments' which are most effective ie giving education to receptive patients. I experienced similar situations on a womens health prac and was hesitant to condense the sessions at first, as many of those who appeared disinterested were perhaps the ones who needed the education the most - they were perhaps less likely to seek help. By highlighting S+S of 'problems' and giving them an appropriate avenue to seek help, we are no longer focused on prevention but at least they have the information should they require it. I also found it really helpful when my supervisor reminded me that we all learn differently and that some patients may gain more info from reading, rather than interacting with the educator.
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