Week 2: October 20 2008

This afternoon in the physio gym, I was working with an elderly male outpatient with a below knee amputation. I felt we had a very worthwhile session and I know he did too. It was a little different to other patients I’ve had in the past, mainly because there was a lot of ‘friendly disagreement’ going on. By this I mean, I would make a suggestion and the response would be a laughing “no,” followed by a smile, or a cheeky comment such as “why didn’t you tell me that?” when one of the other physios were chatting to him. This was fine and it didn’t upset me, but it was hard to ascertain exactly what was being said to me at times, which was a little off-putting. However, at the end of the session he was very grateful for the effort I had put in with him and the results he achieved, he also apologized for being, what he termed as ‘cheeky’ and said he was looking forward to Wednesday, when he is in next.

There was one particular incident that sticks in my mind though. We were doing a standing balance exercise with his prosthesis on, an exercise we named ‘Hanging out the washing,’ which involved picking up loose theraband from an above head height on a climbing wall and placing it onto a nearby table and then doing the reverse. The purpose of the exercise was to reach outside the bodies base of support and I progressed this by increasing the distance of the table from the patient. I did this while the patient was sitting down to rest and informed him that I want him to stand in the same position, but still place the theraband onto the table, which was now further away. Instead he just moved closer to the table… and I let him keep going. When this happened I thought that, this would be ok for now and I will just change it next time. When I thought about it later I realized that I had not actually progressed the exercise at all and was quite annoyed at myself for not having done so.

I think that I will need to be firmer with policing what I have said in the future to try and achieve the best results for my patients and not let them take the easy/slack option. I feel that my plan for the exercise was adequate and appropriate, I just needed to make sure it was performed in the manor that I intended. If I do this activity again, I will put markings on the floor to provide visual cues for foot placement for the patient. Less specifically, I have learnt that I should stick to my guns while taking a patient through an exercise, with the hope that they will reap the desired rewards from whatever they are doing.