Final Entry

My 5 weeks of clinical placement at Rocky Bay are over and my clinical requirements for the year are now complete. I thoroughly enjoyed my time at Rocky Bay, having learnt many new skills and feel that I finished the year off on a good note. Some of my pre-placement expectations turned out to be spot on the mark, while others weren’t so accurate.

My predictions about the nature of the placement were pretty much correct, in that the focus was very much on detailed assessments and I certainly saw less clients per day than on previous placements. I think being there during school holidays may have made things a little different for me compared to others because so many of the clients are booked in for their annual physiotherapy assessments. As I mentioned in my entries throughout the placement, these assessments are detailed and time consuming, so I was always busy, despite not always seeing many clients per day. Some days I might have only seen 1 person for the day, but the rest of my time was spent writing up the reports of the previous assessments I had conducted. My preparation of specific conditions such as Duchenne Muscular Dystrophy (DMD), Spinal Muscle Atrophy and Friedreich’s Ataxia proved to be very useful as these certainly formed the majority of the conditions that I was exposed to.

The structure of the placement was quite different to those I’d had previously in the year. From the first day there was tasks that I was performing unsupervised, but there were some that I always had supervision for through the entire placement. For example, after I had performed a treatment of passive movements and stretches on a client with DMD, I was then able to perform this treatment independently on all my other DMD clients for the rest of the placement. Compared to the annual physio assessments for which I always had supervision. This was understandable though, as the different physios that I was conducting the assessments with knew more about the particular clients than I could gather from just reading the previous assessments and were able to ask client specific questions for greater accuracy with the history than I could have. Rocky Bay’s perception and expectations of students was very close to my expectations in that I was there to learn and enhance my skills working with a population of clients that I wouldn’t otherwise get very much experience working with. This meant that it was an environment very conducive to learning, which I was very appreciative of and managed to improve my skills remarkably from start to finish. I feel that I was an integrated member of the clinical services team at Rocky Bay by my 3rd week, regularly liaising with the OT’s and social workers and making phone calls to other members of the client’s care team that may not have been on site. I believe I was able to work independently and schedule effectively from an early stage in the placement and just had my supervisors present for the tasks that were required.

My knowledge about the specific conditions, which I was initially concerned about, wasn’t really an issue. On my first day I was shown the information sheets on the computer system about the various conditions and after reading these to consolidate my knowledge I was confident that I was well prepared. When questioned by my supervisors at any stage I was able to respond with the appropriate answers, which was pleasing. Apart from this knowledge base, many of the treatments themselves were very individualised to the specific client. For example, the DMD boys had a very regular and similar set of treatments, mainly consisting of passive movements and stretches to maintain muscle length and joint range of motion when they were lacking the strength to move their limbs independently. Many of the other conditions though, such as Friedreich’s Ataxia had very different presentations and treatment aims depending on the individual, so I had to think quite laterally at times. I had 2 different boys, of similar age, 1 was able to walk independently, while the other was using a wheelchair for mobility because of his balance deficits. It meant that their goals and consequently their treatment programs very different. I had to modify 1 boy’s exercise program and create one for the other and they both turned out to be very different because of the different circumstances and individual abilities.

My other concern was my ability to conduct assessments correctly, which I really need not have worried about. My skills and knowledge were adequate and the assessment templates that Rocky Bay had were very easy to follow. When I started I was definitely a bit slow and my first couple of annual assessments would have taken me between 2 and 2 and half hours to complete. With practise I was able to improve my technique and time efficiency to the point where I was able to complete an assessment in less than 1 and half hours on my final day of placement. It was good to see this personal improvement and I certainly noticed that I learnt the appropriate questions to ask in the subjective assessment and the appropriate instructions to give during the objective examinations. I was pleased with my growth in this particular aspect of the placement.

Finally, I didn’t really find I had any difficulties communicating with the clients. The majority of the DMD clients were about my age, so it was easy strike conversations with them, (especially with the soccer world cup in full swing!). Most of the annual assessments I performed were on younger boys, between the ages of 6 and 12, which I found fun, rather than difficult. I don’t think I had any real difficulties to start off with, but definitely picked up more tricks as time went on. Instead of “bend your elbow” for elbow flexion, the instruction was “hand to your shoulder” or something similar to this. When conducting the respiratory assessment with the vitalograph for VC and FVC everyone found it much easier when I told them it was like blowing the candles out on a birthday cake through a big straw. Just little things like these really helped, especially with the younger clients and helped to further improve my time efficiency. I was certainly able to give instructions to the different clients that would give me the particular movement or action that I was trying to assess.

Overall, I thoroughly enjoyed my 5 weeks at Rocky Bay. I found that I was busy, but not too busy that I couldn’t stop to think in detail about things or have a have a good conversation with the other physios. As I previously mentioned, the environment was very conducive to learning and everyone there was willing to teach and impart their own personal knowledge or experience. The other thing that was really great about clinical services at Rocky Bay was that they were a very close and well organised team. Because of this, they were able to provide excellent care for their clients and in short amounts of time too, which I thought was excellent and really encouraged me to participate as actively as possible in the team environment. I couldn’t speak highly enough of my supervisors and the facility and can only hope that the real world of work will be as enjoyable as this placement.