We work with patients in emotionally unstable, sometimes very painful and distressing situations that they are learning to deal with. In my orthopaedic placement, I'm seeing patients walking the day of some huge surgeries. I'm constantly amazed at how quickly patients return to independent function after such big operations. Mostly I'm treating hips and knees, which the surgeons seem to have down to a fine and fast art. But sometimes, you remember the massive trauma they have gone through, and how it affects so much of their body.
One particular lady had some abdominal surgery and was having pain laterally from the incision site, which was crippling her ability to get out of bed. The incision itself was not painful. The surgery can end up bruising the internal organs significantly and this was what was causing her pain. To determine how we could help, we tried different patterns of movement in and out of the bed. This required her to push through her pain several times as we tried different things. By the third attempt, she suddenly turned her face from me and paused. Then she slumped face down on the bed and began quietly crying. It seemed to be a mixture of pain, frustration and helplessness. There is that awkward moment, when you decide whether to gently push on with trying to help the patient with further physiotherapy, or give her time to cry it out and move on later. I wasn't sure which to do, so I decided to leave her for a moment to get her some tubigrip for support of her abdomen. She finished crying and seemed ok afterwards, still in pain and not her usually cheerful self.
Having seen so many patients recover so dramatically well, I was refreshed by this reminder that the surgery can have effects on a patient's body other than where the incision lies, and it is a truly traumatic process that we help them recover from. Having a little sensitivity and patience with their complaints and concerns is needed to best help them recover. I had not had a patient cry during my treatment before, so it was a reminder of how difficult the whole process of recovery can be for a patient. And how important our sensitivity as therapists is!
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2 comments:
I agree it's definately a challenge to know when to have a break or to continue. It's especially hard as a physiotherapy student as it is unlikely that we have undergone something similar to them so we cannot really relate to the pain they are going through. I think in this situation giving the patient a break and returning later was a good idea.
I actually had the same experience (will be posting a blog on that). It is so crucial for us to be really sensitive with the patients because more often that not we work with them on a regular basis. We need to be able to determine if the treatment is working and modify as appropriate. You did a good job at recognising that the patient was in pain and deciding to give the patient a break.
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