Whilst on my rural practical in a small town I learnt how you must be a flexible health professional and be willing to step outside your discipline to provide optimal patient care. The town I went to had visiting occupational therapy, speech pathology and podiatry approximately once every 2 months. Therefore as the part time physiotherapist you can be expected to work as an occupational therapist and a speech pathologist too. There is a part time therapy assistant employed two days a week however these staff members must see the occupational therapist and speech pathologist when they are in town and learn what to do with patients and develop programs for them. The therapy assistants are therefore very challenged as they are learning many new assessment and treatment techniques for each patient.
During my time at the health service I saw a patient who had a skin flap on the side of her face which had caused damage to her facial nerve and consequently the patient was having difficulty speaking. As there was no speech therapist within the area I was seeing her and giving her exercises to improve her speech. The physiotherapist had a video conference with the speech pathologist in a larger town to develop assessment and treatment for this patient. I continued to assess this patient’s degree of jaw opening and perform vowel exercises with her to reduce her palsy.
In addition the physiotherapist ordered equipment for outpatients and the residential patients to improve their independence and fitted them appropriately. She also did home visits to see what equipment was needed for patients. This may be seen as an occupational therapy job however the patient may not be able to wait two months.
I really enjoyed my rural placement. I saw a large variety of patients and I saw how important it was to be an interdisciplinary team member and a flexible health professional.
Subscribe to:
Post Comments (Atom)
4 comments:
That's brilliant that you got to see something pretty out of the ordinary and be a part of the rehab for that patient! I am also finding a similar thing on my rural prac, however it sounds like I am in a much bigger town than you! (there are quite a few physio's and OT's and the hospital I am at). It seems that being in a smaller town/hospital there is alot more interaction with other health professionals, and more of a team environment than i have found at the bigger hospitals in perth. We frequently chat to the OT's and speechie's before a pt is DC. Today the speech therapist came and gave all the OT's and PT's a talk on her role, how she Ax's, and our role in knowing when to refer pt's. This was really really helpful as I initially thought it was just stroke pt's who required a swallowing Ax, i learnt so much! like you, i am thoroughly enjoying my rural placement!
oh and i forgot to add in... the other pt's the speechie see's quite frequently are pt's who are short of breath eg COPD, CAL (chronic airway limitation), pt's not wanting to eat for some reason (eg potential oesophageal problems), Dementia pt's, and she also said she gets alot of referral to see elderly pt's who have had a fall and NOF #. Explanation for that was that these pt's are generally very frail and this incident tips them over the edge and they begin to have many other difficulties.
there is also a chart of the progression of liquids to solids that people must go through to determine their swallowing status. they used to be listed as 3, 2, 1, and now they have numbers of 900, 400 and 150 which refers to how dense the liquid is (900 the thickest)... just something interesting that if you see in the notes is good to understand!
This is so true, especially in the rural enviro where other health 'specialists' aren't always on hand.
Another observation I've made of allied health teams in rural areas is how many sessions meet the goal of a number of disciplines - this is especially true in treating children ie instead of a PT and OT and speech session there is a single sesson which easily encompasses all goals, but does not require the presence of all three therapists. This saves the time of the patient and therapists!The treatments generally complement each other, so having other allied health input can really enhance your session, actually making it a lot easier for you to run. It's really made me remember we are part of the allied health TEAM, not just individual therapists.
this is a very good opportunity for us physios to learn more about the other health disciplines. It's good that you took advantage of that opportunity. I was talking to my current supervisor about the interdisciplinary approach just recently. She used to work in Broome and up there, oftentimes you only get to see patients once every couple of months so it's important to provide them with a very holistic treatment program and more often than not, she had to incorporate speech pathologists' and OTs' treatment into her sessions.
Post a Comment