I recently treated a patient on a gen med ward whom had been admitted after fainting at home. This particular patient, although still living ‘independently’ at home, was cared for predominantly by their partner. Despite no diagnosed condition this patient’s partner undertook all cleaning, cooking, washing, shopping etc duties, while the patient spent a large percentage of their day watching television. Unfortunately the patient’s partner became unwell, and not long after the patient developed a chest infection eventually causing them to faint at home and be brought to hospital. The first point mentioned in this patients’ notes was that they spoke English as a second language, but that this wasn’t a major problem and had been living in the country for over a decade.
My supervisor asked me and another student to see the patient to assist in clearing their secretions, mobilise them and provide some general education. We found the patient SOOB in their chair staring out the window and introduced ourselves. No comment by the patient. We then simply explained what we were going to do with them that day and again received no acknowledgement that they had heard our comments. While we knew the patient had mild hearing loss and did not speak English as their first language they were clearly ignoring us. We attempted to communicate again and this time the patient just shook their head. Again we explained fairly loudly and extremely simply that we were there to help them, but again all we received was a shake of the head. Frustrated one of us sought out the patients nurse for some assistance, who simply told us that this was just the way he was. Any attempt to assist the patient to STS or take deep breaths was met by the patient blankly looking away or worse going ‘floppy’. This behaviour continued for the next few treatment sessions and each time was documented in the notes. Despite liasing with nursing staff and the patients doctors ( note that the patient had no history of a neurological event and on occasion did speak to the staff) the patient s behaviour remained consistent. Another physio who had managed to mobilise the patient on another day (only because the patient had to have a shower and use the bathroom) said that the patient had replied to them that they didn’t want to comply with physio and walk because at home ‘they wouldn’t have too’ and therefore ‘didn’t want to walk here’.
Both myself and the other student found this patient extremely frustrating. It was clear that they could understand us, therefore must have understood the reasons for treatment and the risk of developing a severe chest infection if they did not comply. It didn’t seem to matter what we did or said the only way to mobilise this patient was to either get them to walk back to bed or to the bathroom, with no treatment specifically aimed at their chest and clearing secretions. Perhaps the patient did not want to return home especially after fainting or maybe was depressed or for some other reason did not want to get better and return home and this was why they acted in such a manner. This doesn’t change the fact that it was and is very difficult when patients ignore all your advice and recommendations when you know the negative implications that this may have on their health. Luckily for this patient they have not got any worse – in saying this they are not any better either. In some cases such as this patient, particularly with their history at home, I think that sometimes all you can do as a physio is provide the patient with the best treatment options and continue to provide them with the opportunities to comply. With this particular patient each day we try to involve them in treatment, with the assistance and support of the nursing staff, but unfortunately they aren’t interested. Thus while language barriers can be a problem usually there is an attempt to communicate via gestures, facial expressions etc. In this case an unresponsive patient (with no pathological basis) who ignores both yourself and refuses to comply with treatment can be extremely difficult to provide a duty of care to. If anyone has had a similar experience or has some suggestions as to how to get this patient to comply with treatment I would be very grateful, as this particular patient is still on the ward!
Monday, October 27, 2008
Public Health
Hey everyone,
Not long to go now! I am on my rural placement, with the majority of my time spent in musculo outpatients. After my first week I am so suprised at the number of patients who do not turn up to appointments. I think part of the problem is that due to the 3 month waiting period to see a physio publicly, patients either see a private physio or their problem naturally resolves in this time. However, I still find it a bit rude that patients don't phone in to say they wont be attending a session.
On Thursday I was supposed to see 6 new patients and only 2 turned up- so the majority of my day was spent sitting around wasting time. Although public health is obviously very important in making sure people from all socioeconomic demographics receive care, I think it may also be beneficial to apply some small, nominal fee so that the service is not taken for granted or at least respected a bit more. Do you think this would be effective or just discriminate against those people who cannot afford the small fee but would really benefit and appreciate health care?
Not long to go now! I am on my rural placement, with the majority of my time spent in musculo outpatients. After my first week I am so suprised at the number of patients who do not turn up to appointments. I think part of the problem is that due to the 3 month waiting period to see a physio publicly, patients either see a private physio or their problem naturally resolves in this time. However, I still find it a bit rude that patients don't phone in to say they wont be attending a session.
On Thursday I was supposed to see 6 new patients and only 2 turned up- so the majority of my day was spent sitting around wasting time. Although public health is obviously very important in making sure people from all socioeconomic demographics receive care, I think it may also be beneficial to apply some small, nominal fee so that the service is not taken for granted or at least respected a bit more. Do you think this would be effective or just discriminate against those people who cannot afford the small fee but would really benefit and appreciate health care?
Too many supervisors
I am on a community physiotherapy placement at the moment which is going well apart from the fact there are so many different supervisors. I really enjoy community physiotherapy because of the more relaxed set up and the social interaction with the clients. I also enjoy doing the exercises with the clients even though by the end of the last class youre really tired.
The only problem i'm having at the moment is having so many different supervisors. They all seem nice and i get along with them fine but they all have their differences. Im required to take all of the classes in the coming weeks and therefore i will have about 8 different supervisors to impress. Even though it seems good to be able to learn the different ways that different physios do things, its tough as a student because each supervisor will generally want you to do what they do.
We are told that any exercises we do are fine as long as they are safe and we have a correct rationale for doing them. However, i dont think its as black and white as that and i believe that some supervisors may become annoyed if you use certain exercies that they dont like doing even if they are safe and you have a correct rationale for them.
In order to avoid the situation of annoying a supervisor ive decided make sure i go over all the exercises im going to do in the class with the supervisor before i take the class. This way i can omit any exercises that a supervisor doesnt like. However, if i really like the exercise im going to ask the supervisor why they dont like it and then ask if i can use it even though they dont normally use it.
Has anyone had a similar situation? Does anyone have any other ideas of what i could do in this situation?
The only problem i'm having at the moment is having so many different supervisors. They all seem nice and i get along with them fine but they all have their differences. Im required to take all of the classes in the coming weeks and therefore i will have about 8 different supervisors to impress. Even though it seems good to be able to learn the different ways that different physios do things, its tough as a student because each supervisor will generally want you to do what they do.
We are told that any exercises we do are fine as long as they are safe and we have a correct rationale for doing them. However, i dont think its as black and white as that and i believe that some supervisors may become annoyed if you use certain exercies that they dont like doing even if they are safe and you have a correct rationale for them.
In order to avoid the situation of annoying a supervisor ive decided make sure i go over all the exercises im going to do in the class with the supervisor before i take the class. This way i can omit any exercises that a supervisor doesnt like. However, if i really like the exercise im going to ask the supervisor why they dont like it and then ask if i can use it even though they dont normally use it.
Has anyone had a similar situation? Does anyone have any other ideas of what i could do in this situation?
Wasted time
On my recent self directed placement i was required to create 2 educational pamphlets for amputee patients. The pamphlets required me to do a lot of research but i found the topic interesting and i learnt a lot while making the pamphlets.
The problem i encountered was that in the first week of my placement when i was trying to research the topic thoroughly i was told by my supervisor that i was required to attend the facility every day of the first week for at least a few hours.
I thought this seemed ok because i needed to learn about amputee patients and how their treatment works. The only problem was that i needed to spend a lot of time at home researching the topic and i didnt want to be at the facility wasting time.
I was also under the assumption that we werent meant to to be treating patients during our self directed prac (unless it was directly related to our self directed prac). A situation arose on the second day of the prac when after spending some time talking to some patients my supervisor asked me to take another patient for a walk. I agreed but then quickly found out that this patient was irrelevant to the pamphlets i was making. I couldnt leave the patient because they needed someone with them and so i continued assisting the patient while they walked around the building.
The walk took over half an hour and i was quite annoyed with the time i had wasted. I wasnt annoyed at the patient, just at my supervisor for getting me to do things i wasnt there to do. I thought about discussing the issue with my supervisor but decided against it because i thought it would be better to finish my self directed prac without upsetting anyone.
I think as a student i probably made the right move by not discussing it with my supervisor because its never really in your best interest to upset someone when you are a student. Has anyone had a similar situation or does anyone have any thoughts to add?
The problem i encountered was that in the first week of my placement when i was trying to research the topic thoroughly i was told by my supervisor that i was required to attend the facility every day of the first week for at least a few hours.
I thought this seemed ok because i needed to learn about amputee patients and how their treatment works. The only problem was that i needed to spend a lot of time at home researching the topic and i didnt want to be at the facility wasting time.
I was also under the assumption that we werent meant to to be treating patients during our self directed prac (unless it was directly related to our self directed prac). A situation arose on the second day of the prac when after spending some time talking to some patients my supervisor asked me to take another patient for a walk. I agreed but then quickly found out that this patient was irrelevant to the pamphlets i was making. I couldnt leave the patient because they needed someone with them and so i continued assisting the patient while they walked around the building.
The walk took over half an hour and i was quite annoyed with the time i had wasted. I wasnt annoyed at the patient, just at my supervisor for getting me to do things i wasnt there to do. I thought about discussing the issue with my supervisor but decided against it because i thought it would be better to finish my self directed prac without upsetting anyone.
I think as a student i probably made the right move by not discussing it with my supervisor because its never really in your best interest to upset someone when you are a student. Has anyone had a similar situation or does anyone have any thoughts to add?
Wednesday, October 15, 2008
Communication with children
During my last placement paediatrics, most of the clients were children of developmental delay. Most children were not difficult to communicate with, however I found it particular difficult to communicate toddlers who have a mind of their own, only able to follow instructions sometimes and unable to express their ideas and feelings.
One of the regular children I saw on weekly basis. She is a 2.5 years old toddler with global delay. On her medical and psych assessment, her global skills (included motor skills and social skills etc) varied from 10months to 17 months. She has very short attention spam and recognizes very few instructions, for example “more”. During the sessions with her, quite often I have to physically guide her to target. For example walking on balance beam, I have to walk right beside her and often holding her hand so she can’t run off, while her mum waits on the end of the beam encouraging her to go over. This guiding method works very well with her. She does not mind being encouraged repeating the activities and she would otherwise run off. As she gets familarised with the activities, most of the time she requires a lot less assistance and guidance after a few tries.
During one of the weeks of my prac, I had a boy of similar age immediately after her, whom I had not seen before, also with developmental delay, mostly physically and in speech. This boy behaved dramatically different to the girl. I gave him verbal instructions initially for all his activities planned. When he caught attention of other interesting objects in the room and abandons the original exercise, I tried to guide him physically as well. It went alright the first a few instances, however later on he became angry about it. I had to give way and negotiate with him that he could do the activity he wanted to do after he finish the planned ones.
After reflecting both treatments, I realized that I should not starting off treating the little boy the same way as the girl toddler. I was wrong in presuming the little boy wouldn’t mind guiding him in the activities. It is important to give them a sense of choice that they chose what they wanted to do, which will improve their compliance with their activities.
Does anyone have experiences with kids to share? Although I had my paeds prac, I am still not fully confident in treating kids especially toddler aged, would like to hear more strategies =)
One of the regular children I saw on weekly basis. She is a 2.5 years old toddler with global delay. On her medical and psych assessment, her global skills (included motor skills and social skills etc) varied from 10months to 17 months. She has very short attention spam and recognizes very few instructions, for example “more”. During the sessions with her, quite often I have to physically guide her to target. For example walking on balance beam, I have to walk right beside her and often holding her hand so she can’t run off, while her mum waits on the end of the beam encouraging her to go over. This guiding method works very well with her. She does not mind being encouraged repeating the activities and she would otherwise run off. As she gets familarised with the activities, most of the time she requires a lot less assistance and guidance after a few tries.
During one of the weeks of my prac, I had a boy of similar age immediately after her, whom I had not seen before, also with developmental delay, mostly physically and in speech. This boy behaved dramatically different to the girl. I gave him verbal instructions initially for all his activities planned. When he caught attention of other interesting objects in the room and abandons the original exercise, I tried to guide him physically as well. It went alright the first a few instances, however later on he became angry about it. I had to give way and negotiate with him that he could do the activity he wanted to do after he finish the planned ones.
After reflecting both treatments, I realized that I should not starting off treating the little boy the same way as the girl toddler. I was wrong in presuming the little boy wouldn’t mind guiding him in the activities. It is important to give them a sense of choice that they chose what they wanted to do, which will improve their compliance with their activities.
Does anyone have experiences with kids to share? Although I had my paeds prac, I am still not fully confident in treating kids especially toddler aged, would like to hear more strategies =)
Wednesday, October 8, 2008
the good ol recipe
Whilst on my musculoskeletal placement I encountered an interesting phenomena within my own activities. I’m not sure if I’ve been doing it all the way through this year, or if I just started doing it while on my musculo placement.
I noticed that, towards the end of the placement, some of my treatments were starting to become very rote-learned. That is to say, that a patient would come in with a condition, and I would already have the treatment plan I intended to do set in my head, before I’d even really assessed them. Ya know, it’d be like “plantar fascitis- ok, treatment is ultra sound to plantar fascia, and soft tissue release to gastroc-soleus”.
I guess I began thinking like this because I’d already seen patients with the condition and I’d kind of established that “this is what I do for this condition” in my head. Initially, when I saw a condition for the first time, I would consider (or try and consider) all possible factors, all possible treatments, and use the ones best for that patient at that time. After seeing a couple of patients with the same condition though, it becomes easy to simply apply the same treatment from the last patient to the current patient. This means you don’t have to think as much, you become faster and more efficient. However, it is a little boring, just using the same old recipe for each condition. More than that though, I realized that it’s not best practice.
I realized that because I already had an idea of the way the treatment would go, I wouldn’t really be paying too much attention to the assessment- I’d really only notice the things that were consistent with my previous patients, thus on a subconscious level justifying my intended treatment plan to myself, I guess. And in so doing, I was failing to notice the intricate little differences (both in the subjective and objective) that are so important to noting the difference between patients, and determining the best treatment.
Anyway, after a while I became conscious of what I was doing- that I was basically reducing each condition into a nice convenient little treatment recipe, and following that without thinking too hard about the assessment findings or considering alternate treatments. I realised that even though some of my patients did have the same condition, that did not necessarily mean that the cause of their condition was the same, and since we want to not only treat the symptoms but also address the cause, treatments between patients should therefore differ. For example, one of my patients’ plantar fascitis was caused by an antalgic gait from a previous Achilles tendinopathy. Another of my patients’ plantar fascitis was caused by recurrent strains from playing soccer. The treatment for the symptoms was similar, however the treatments for the cause was completely different. That is what I was beginning to miss.
Now that I’m aware of my tendencies to reduce treatment for conditions into simple recipes, I can make more of an effort to really analyse each set of assessments, even if I’ve seen a very similar presentation before, and consider all treatment options, thus ensuring best practice. Has anyone experienced this with themselves?
I noticed that, towards the end of the placement, some of my treatments were starting to become very rote-learned. That is to say, that a patient would come in with a condition, and I would already have the treatment plan I intended to do set in my head, before I’d even really assessed them. Ya know, it’d be like “plantar fascitis- ok, treatment is ultra sound to plantar fascia, and soft tissue release to gastroc-soleus”.
I guess I began thinking like this because I’d already seen patients with the condition and I’d kind of established that “this is what I do for this condition” in my head. Initially, when I saw a condition for the first time, I would consider (or try and consider) all possible factors, all possible treatments, and use the ones best for that patient at that time. After seeing a couple of patients with the same condition though, it becomes easy to simply apply the same treatment from the last patient to the current patient. This means you don’t have to think as much, you become faster and more efficient. However, it is a little boring, just using the same old recipe for each condition. More than that though, I realized that it’s not best practice.
I realized that because I already had an idea of the way the treatment would go, I wouldn’t really be paying too much attention to the assessment- I’d really only notice the things that were consistent with my previous patients, thus on a subconscious level justifying my intended treatment plan to myself, I guess. And in so doing, I was failing to notice the intricate little differences (both in the subjective and objective) that are so important to noting the difference between patients, and determining the best treatment.
Anyway, after a while I became conscious of what I was doing- that I was basically reducing each condition into a nice convenient little treatment recipe, and following that without thinking too hard about the assessment findings or considering alternate treatments. I realised that even though some of my patients did have the same condition, that did not necessarily mean that the cause of their condition was the same, and since we want to not only treat the symptoms but also address the cause, treatments between patients should therefore differ. For example, one of my patients’ plantar fascitis was caused by an antalgic gait from a previous Achilles tendinopathy. Another of my patients’ plantar fascitis was caused by recurrent strains from playing soccer. The treatment for the symptoms was similar, however the treatments for the cause was completely different. That is what I was beginning to miss.
Now that I’m aware of my tendencies to reduce treatment for conditions into simple recipes, I can make more of an effort to really analyse each set of assessments, even if I’ve seen a very similar presentation before, and consider all treatment options, thus ensuring best practice. Has anyone experienced this with themselves?
the good ol recipe
Whilst on my musculoskeletal placement I encountered an interesting phenomena within my own activities. I’m not sure if I’ve been doing it all the way through this year, or if I just started doing it while on my musculo placement.
I noticed that, towards the end of the placement, some of my treatments were starting to become very rote-learned. That is to say, that a patient would come in with a condition, and I would already have the treatment plan I intended to do set in my head, before I’d even really assessed them. Ya know, it’d be like “plantar fascitis- ok, treatment is ultra sound to plantar fascia, and soft tissue release to gastroc-soleus”.
I guess I began thinking like this because I’d already seen patients with the condition and I’d kind of established that “this is what I do for this condition” in my head. Initially, when I saw a condition for the first time, I would consider (or try and consider) all possible factors, all possible treatments, and use the ones best for that patient at that time. After seeing a couple of patients with the same condition though, it becomes easy to simply apply the same treatment from the last patient to the current patient. This means you don’t have to think as much, you become faster and more efficient. However, it is a little boring, just using the same old recipe for each condition. More than that though, I realized that it’s not best practice.
I realized that because I already had an idea of the way the treatment would go, I wouldn’t really be paying too much attention to the assessment- I’d really only notice the things that were consistent with my previous patients, thus on a subconscious level justifying my intended treatment plan to myself, I guess. And in so doing, I was failing to notice the intricate little differences (both in the subjective and objective) that are so important to noting the difference between patients, and determining the best treatment.
Anyway, after a while I became conscious of what I was doing- that I was basically reducing each condition into a nice convenient little treatment recipe, and following that without thinking too hard about the assessment findings or considering alternate treatments. I realised that even though some of my patients did have the same condition, that did not necessarily mean that the cause of their condition was the same, and since we want to not only treat the symptoms but also address the cause, treatments between patients should therefore differ. For example, one of my patients’ plantar fascitis was caused by an antalgic gait from a previous Achilles tendinopathy. Another of my patients’ plantar fascitis was caused by recurrent strains from playing soccer. The treatment for the symptoms was similar, however the treatments for the cause was completely different. That is what I was beginning to miss.
Now that I’m aware of my tendencies to reduce treatment for conditions into simple recipes, I can make more of an effort to really analyse each set of assessments, even if I’ve seen a very similar presentation before, and consider all treatment options, thus ensuring best practice. Has anyone experienced this with themselves?
I noticed that, towards the end of the placement, some of my treatments were starting to become very rote-learned. That is to say, that a patient would come in with a condition, and I would already have the treatment plan I intended to do set in my head, before I’d even really assessed them. Ya know, it’d be like “plantar fascitis- ok, treatment is ultra sound to plantar fascia, and soft tissue release to gastroc-soleus”.
I guess I began thinking like this because I’d already seen patients with the condition and I’d kind of established that “this is what I do for this condition” in my head. Initially, when I saw a condition for the first time, I would consider (or try and consider) all possible factors, all possible treatments, and use the ones best for that patient at that time. After seeing a couple of patients with the same condition though, it becomes easy to simply apply the same treatment from the last patient to the current patient. This means you don’t have to think as much, you become faster and more efficient. However, it is a little boring, just using the same old recipe for each condition. More than that though, I realized that it’s not best practice.
I realized that because I already had an idea of the way the treatment would go, I wouldn’t really be paying too much attention to the assessment- I’d really only notice the things that were consistent with my previous patients, thus on a subconscious level justifying my intended treatment plan to myself, I guess. And in so doing, I was failing to notice the intricate little differences (both in the subjective and objective) that are so important to noting the difference between patients, and determining the best treatment.
Anyway, after a while I became conscious of what I was doing- that I was basically reducing each condition into a nice convenient little treatment recipe, and following that without thinking too hard about the assessment findings or considering alternate treatments. I realised that even though some of my patients did have the same condition, that did not necessarily mean that the cause of their condition was the same, and since we want to not only treat the symptoms but also address the cause, treatments between patients should therefore differ. For example, one of my patients’ plantar fascitis was caused by an antalgic gait from a previous Achilles tendinopathy. Another of my patients’ plantar fascitis was caused by recurrent strains from playing soccer. The treatment for the symptoms was similar, however the treatments for the cause was completely different. That is what I was beginning to miss.
Now that I’m aware of my tendencies to reduce treatment for conditions into simple recipes, I can make more of an effort to really analyse each set of assessments, even if I’ve seen a very similar presentation before, and consider all treatment options, thus ensuring best practice. Has anyone experienced this with themselves?
Embarrassment
On my cardio placement, as I have previously mentioned I was on a cardiothoracic ward. However, as there are limited numbers of heart surgery patients, some of my patients are general medical, ortho and gero patients.
This particular elderly patient had been a inpatient to have a pacing wire corrected or inserted. It is a fast procedure usually normally discharged within one to two days. As this patient has been deteriorated over the past a few days. I had been asked to treat him. His treatment involved ambulation with WZF, UL and LL strengthening exercises and as well as balance exercises.
On the first day of seeing this patient, he was sitting in the chair. However as I approached him I noticed that his pants was quite wet. I did not notice any continence issue in the medical notes. As I stood him up, it became obvious that his pad were quite saturated. I informed the nurse who happened to be in the room at that time. So she changed the pad as I stood him up again.
On a later day, I went to see him as usual in the morning. He was still lying on bed waiting for a shower. So I asked him to do some exercises in standing while waiting for nurse to prepare for his shower and would later walk to the shower. He agreed pretty pleasantly. So he got out of bed with some assistance. As soon as he was in standing, he said he needed to go toilet. So I asked him if he can make it to the toilet which he replied that he needed to go at once. I didn’t worry too much as he had a pad on at that time. His nurse was in the same room helping another patient, she replied she’ll help as soon as she finishes. My patient was still standing holding onto frames, then his pants and pads fell off completely as the pads fully saturated. Luckily I had curtain drawn around when I went to see him. As I was about to pull his pads and pants back up, he started peeing on the floor. I totally blanked out, it was first time something like this happened to me. I didn’t not what I should do, if I should sit the patient back on the bed or not. His nurse quickly rushed in and put him on a shower chair and quickly wiped the floor.
Later on discharge his continence had appeared to be an important factor on returning home with his wife.
I felt very embarrassed at this, and must have embarrassed my patient too at the same time. My supervisor was in the same room treating another patient at the same time. Later she comforted me saying it happens frequently in gero.
For patients with possibly severe incontinence, I should have checked if there’s a need to go toilet as a priority and prepare for accidents like above situation, for example have a spare pad nearby.
Has anyone had similar experiences and any suggestions on preventing accidents like this?
This particular elderly patient had been a inpatient to have a pacing wire corrected or inserted. It is a fast procedure usually normally discharged within one to two days. As this patient has been deteriorated over the past a few days. I had been asked to treat him. His treatment involved ambulation with WZF, UL and LL strengthening exercises and as well as balance exercises.
On the first day of seeing this patient, he was sitting in the chair. However as I approached him I noticed that his pants was quite wet. I did not notice any continence issue in the medical notes. As I stood him up, it became obvious that his pad were quite saturated. I informed the nurse who happened to be in the room at that time. So she changed the pad as I stood him up again.
On a later day, I went to see him as usual in the morning. He was still lying on bed waiting for a shower. So I asked him to do some exercises in standing while waiting for nurse to prepare for his shower and would later walk to the shower. He agreed pretty pleasantly. So he got out of bed with some assistance. As soon as he was in standing, he said he needed to go toilet. So I asked him if he can make it to the toilet which he replied that he needed to go at once. I didn’t worry too much as he had a pad on at that time. His nurse was in the same room helping another patient, she replied she’ll help as soon as she finishes. My patient was still standing holding onto frames, then his pants and pads fell off completely as the pads fully saturated. Luckily I had curtain drawn around when I went to see him. As I was about to pull his pads and pants back up, he started peeing on the floor. I totally blanked out, it was first time something like this happened to me. I didn’t not what I should do, if I should sit the patient back on the bed or not. His nurse quickly rushed in and put him on a shower chair and quickly wiped the floor.
Later on discharge his continence had appeared to be an important factor on returning home with his wife.
I felt very embarrassed at this, and must have embarrassed my patient too at the same time. My supervisor was in the same room treating another patient at the same time. Later she comforted me saying it happens frequently in gero.
For patients with possibly severe incontinence, I should have checked if there’s a need to go toilet as a priority and prepare for accidents like above situation, for example have a spare pad nearby.
Has anyone had similar experiences and any suggestions on preventing accidents like this?
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