English as a Second Language

Whilst on prac, it was requested I see a young boy who recently had arrived in Australia and spoke very minimal English. He was admitted to the hospital post a tib/fib fracture and had been fitted with external fixation. As he was still in the acute stages, physio intervention primarily consisted of active-assisted movements of the ankle, hip and knee, as well as static and inner range quad exercises.

As my supervisor was watching, I was quite conscious of the way I approached this patient. As I know I can have the tendency to over-explain a situation, I thought I would simplify and keep my explanations to a minimum with this boy, as I did not want to overwhelm the young child. After I introduced myself to the patient and explained that we needed to do exercises, I basically got straight into the treatment. To demonstrate how to do the exercises, I would show him on his unaffected leg and then progress to his affected side, yet did not offer an explanation as to why he needed to do it. I did try to make small talk during the session, but found him to be quite unresponsive, and would initially complain of pain as I tried to move his leg. Despite this, I managed to perform what I had planned for the treatment session.

Upon leaving the room, my supervisor commented on how I did not outline and explain the treatment situation normally as I would for any other patient. I explained my reasoning, which she understood, but still said it is always best to explain the need for the exercises, in simple terms, as even the non-verbal signals I would portray during my explanations would help to put the patient at ease and receive a better response during the exercises. Another point which my supervisor mentioned was that even though the child may not fully understand English, it is quite common for a child to play on this, and use it as a mechanism to get out of exercises. Also, in future, it may have been of benefit to time physio intervention whilst having a parent in the room to act as an interpreter (if possible).

Through this situation, it has shown me that even though a patient may have limiting factors such as English being a second language, it is still important to offer the person the same opportunities to understand the reasoning and importance of the exercises. Not only will this increase compliance, but also help to develop better rapport. I will be mindful of this in the future.