My current placement is my third placement, and it is also the first one that I encountered this issue. My current placement is neurology, most of my patients suffered from stroke.
Most of my patients are very nice and fairly easy to build rapport with. However, it is not uncommon for some of the patients to get frustrated, depressed or even upset during treatment.
One of my patients is in her 50s, she had a dense right MCA about one year ago. She is able to ambulate with standby assistance with a walking stick. She has inattention to her L side. She has minimal if any recovery of her L hand. From the supervisor, notes from previous student, all stated that she didn’t cope with the fact she had a stroke very well and have unrealistic goals etc. So I had the impression that she’s hard to get along with and wouldn’t be very cooperative with treatment.
The first a couple session didn’t go too well as she was worried I won’t be able to catch her if she falls. Therefore she was extremely reluctant to shift weight onto the weak leg. However in the last two weeks she had been fairly pleasant, cooperative and humorous at times and has more confidence in herself and me. She is a heavy smoker as well. Each time she comes for treatment, there’s always a smell of smoke, which I didn’t like but I didn’t say anything. At the last treatment, while I was taking her down to the gym, she complained that she hadn’t had a cigarette for a few hours and she wasn’t in a good mood. So I tried to comfort her a little bit. During the treatment, she was still cooperative. However, with my repeated instructions, she became a bit agitated that she wasn’t able to do perfectly as asked, and I tried to encouraging her, saying to her her walking has improved from the first time I seen her. Soon after she started to use more aggresive words in her sentences like bloody. She wasn’t using it against anyone, just letting her frustration out about her slow recovery. She said it in a pretty loud voice. All outpatients receive treatment in the gym with no curtain or anything to separate; I’m not sure how many other patients heard that if there’s any (as everyone’s chatting around). As I have never in this situation, I wasn’t sure what to do yet. Then she said the f-word and before I could react to it, my supervisor came around and lightly asked her if she’s in a bad mood. She replied that she wasn’t feeling well because of lack of smoke. However she apologized, and stopped using those words. So in hindsight, when she started to be verbally aggressive, I should have calmed her down a little bit, or even reminder her that there are other patients in the gym receiving treatment. If my supervisor didn’t come out and I didn’t do anything, the verbal aggression may be offending other people in the gym. I guess the mortal of the story is to be more aware of patient’s mood and psychological condition and take appropriate action as early as possible.
Anyone else had similar experiences? And any other suggestions if patients start to be verbally aggressive?
Subscribe to:
Post Comments (Atom)
1 comment:
yeah i've definitely had that experience, a couple of times. i've had patients deliberately say really offensive stuff toward me, and yell at me. i guess the important thing is to try and stay in control of the situation, and to be calm and logical in your answers. being calm and not responding emotively helps to calm the person down, usually. it can be hard to tho, sometimes, as you really have to suspend your ego and detach yourself emotionally so you can remain calm, and be able to reason.
easier said than done, hope that helps
Post a Comment