I had a 70 year old lady presented with acute exacerb. of COPD & PMH of Parkinson, AMST score (mental test) 10/10 and with good continence. She transferred to gerontology ward to do some rehab before going back to low-level care hostel. It was in PM when I first saw Mrs P who was still on O2 therapy. Before I could introduce myself, Mrs P asked if I could walk her to the toilet as she had not been taken to the toilet since this AM after breakfast. I checked that her O2 sats was 96% on RA so I took off the O2; however, I still had the O2 bottle with me. As Mrs P needed one assistance with ambulation + wheel walker (from the handover from PT in previous ward), I managed to borrow the only wheel walker in the ward, which however was being used by Mrs P’s neighbour, Mrs C. I also asked a HSA staff for stand-by assistance & to carry the oxygen bottle. When Mrs P stood up, her neighbour, Mrs C asked if she could use the wheel walker as she needed to go to the toilet too. Given that Mrs C was mobile & independent with ambulation + aids, I felt that she could wait longer than Mrs P who had been holding her bladder for the whole day. Before I could tell Mrs C to wait, a registered nurse who was doing regular check up with other patients in the ward interfered & told me to let Mrs C to go to the toilet first & that Mrs P could wait. It was a command rather than a suggestion & being a PT student, I actually gave in. 10 minutes later when Mrs C came back, I stood Mrs P up again, Mrs P could not hold longer & ended up wetting her pants and the floor in front of me, the male HSA staff & other 3 pts who were in the room. She obviously felt humiliated & became really despondent. I reassured her & promised that it will never happen again, and that it was not her fault at all. I felt very sorry & I knew I could have done something. If I was a little bit more decisive & in charge of the situation, I could have prevented it from happening.
On other occasions, I had a blind & deaf 80 year old patient who was literally dragged out from his room by a nurse, not knowing what was happening, he was weeping & cursing when I saw him. I also had a nurse who refused to offer help to stand a patient who needed 2 assistance, saying “I am not going to lift her, I have back pain” in an obviously cold & unfriendly manner in front of the pt. I felt that nursing staff who displayed no empathy to patients greatly affected my treatment as patients were easily discouraged, lost motivation & therefore compliance. I consulted my supervisor & even though I was told to speak to the nursing coordinator regarding nursing staff’s negative behaviours, but I did not do so. Simply being a physio student, I did not want to cause more problems. Although these experiences have greatly reduced my confidence in liaising with nursing staff, I am still working hard to improve my communication skills with them at my current placement. I also learnt that I should be more confident & not let others to affect my treatment decision.
1 comment:
This can be an unpleasant situation in which to find yourself. Two issues with your comments stand out to me. Firstly you have made the statment " I promised that it will never happen again..." Unfortunately this is not something that you have control over and perhaps a promise to the patient that you would talk to the nursing staff about the incident rather than a promise it wouldn't happen again may have been more appropriate. Secondly don't be too hard on yourself (I gave in... I knew I could have done something .... if I was more decisive ...I could have prevented it from happening) In any organisation there is a pecking order and as students we are at the bottom. It is never a good idea to get the nursing staff offside and it is important to develop good judgement in learning which fights to fight and which ones to just walk away from and learn. Embrace each experience, the positive and the negative as a learning opportunity and remember for every nurse out there displaying these negative behaviours there are many many more that will be more than helpful to you if you take the time to build this positive relationship.
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