On my current neurology placement, I have a 17 y.o girl who was diagnosed with multiple sclerosis. Following 3 months deterioration in her functional status, she received a 4-weeks intensive rehabilitation in neurology inpatient ward and she is currently attending neurology outpatient 2x per week. When I was reading her notes, I found a long letter written by her parents concerning her uncontrolled behaviour: drinking and drugs, vulnerability to men, foul language, fear for her to become pregnant & suicidal thoughts and report having no control over her. I managed to build good rapport with her and she reports that she usually spends the weekends at night clubs and getting drunk, and there was one occasion that she ended up in a hotel with 3 male strangers. She is currently on contraceptive pills and is aware that alcohol consumption can make her condition worse. During my last physio session with this patient, she was telling me her relationships with guys again, however this time involves a 36 yo male patient who is also attending neurology outpatient. The stories that she told me were absolutely unusual and very inappropriate such as receiving his naked pictures via mobile phone. Initially, I was not sure if I should be discussing this matter with my supervisor (a male supervisor) as I did not want my patient to lose trust in me. I however approached a female senior physiotherapist for advices regarding this matter and she insisted that I should discuss with my supervisor. My supervisor then told me that it was very important for me to inform him any forms of potential harms that my patient may experience especially due to her vulnerable behaviour as we can help to avoid unpleasant incidents to happen. My supervisor then spoke to her clinical psychologist who then dealt with this problem. My supervisor also told me that if I did not feel comfortable knowing too much about my patient’s personal relationships, I should inform my patient that I cannot guarantee that I will not be telling anyone her stories. It is then up to her if she wants to keep telling me her personal stories. I agreed with my supervisor and said that to my patient which then made me feel much more comfortable when treating her.
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That is a tricky situation. I personally find it difficult to explaining the situation to my supervisor (male or female). The incident that you explained seemed like it was handled really well. If I were in the same situation in future, I would attempt to use the similar tactics as described.
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