During this cardio placement I had to treat a Croatian woman with acute renal failure who required chest care for a very moist chest. This lady had very limited English. Having introduced myself and briefly explained why I was there and that I wanted her our of bed she immediately attempted to get up. However her nasogastric bag was pinned to the sheets and as she rolled to her side the nasogastric tube detached from the bag and sprayed bile across the sheets and the patient (missed me!!). Thankfully it separated at a safety release point rather than her nose!!
I reassured her that everything was OK and her lovely nurse assisted in cleaning her up and changed the sheets.
I quickly realised during the remainder of the session that she was impulsive in her movements and I had to ensure that everything was in place and that I was ready before I attempted to explain what I wanted her to do because as soon as she thought she understood what I wanted she would move.
What did I learn from this incident
1) it is better to pin bags to the patient's gown rather than the sheets so that it goes with them when they move! and
2) the necessity of very clear specific short instructions particularly with patients for whom English is not their preferred language.
Subscribe to:
Post Comments (Atom)
3 comments:
It would also be helpful if her nurse had informed you about her impulsive movement before you saw the patient for the first time, so you could be more prepared on how to communicate better with the patient. And what my current supervisor's favourite quote is "always predict the unpredictability of your patient". Well done anyway.
That must be a difficult situation, with the patient being eager to move when your not ready. I have had a couple of patients whom I had difficulty communication with, due to language barriers. In those situations, (like you suggested), short and specific commands worked. I would also do some hand gestures to indicate what I meant, while using short/specific commands.
this is a difficult situation, because you are seeing a patient for the first time with limited english. I believe it takes a few physio sessions to get to know an effective communication style with this type of patient and for the patient to understand what a physio wants and what we dont want. unfortunate about the bile!
Post a Comment