TOPIC 3 - PROFESSIONAL BEHAVIOUR

S – I given a patient who had reported to ward following admission for SOB and recurrent falls in the previous 2/52. Her condition had improved but her cognitive state was still impaired significantly. Upon initial assessment she was very drowsy and required a lot of prompting to wake up and become involved in the assessment process. Once I explained to her what I was there for she asked me to “kindly leave the area” (paraphrasing since the language was a little bit more colourful). After some time I had her sitting in her chair at which point she indicated she could hurt me with her elbow and also by kicking me which she did, lightly hitting me in the thigh. No harm done at all but this changed my tactics a lot.

T – I had to determine the best way to get this patient on side and involved in the process without aggravating the situation more and potentially being detrimental to the overall to the patients situation.

A – I made my instructions very basic and explained that this was all for her benefit to get better and return home sooner which is the frame of mind of the majority of the people on this ward. The requests were made step by step instead of explaining the whole process which would only confuse and most likely aggravate the patient.

R – The patient responded positively with some of the more basic commands but when it came to balance assessments and ambulation the patient did not respond well to since she was very tired and just wanted to be left alone by the end of the session. (she once again asked me to “leave the room”)

E – The session should have been broken up into more components over the course of the day instead of trying to get it all done in one go. I should have also notified the nurses about the patient’s potential to become violent, even though when she hit me it was nothing but next time it could have been with more force. I felt that I communicated with the patient as best as I could by not reacting to her comments and highlighting the benefits for her.

S – Next time I would create a priority list for the patient to know the most important items that need to be addressed such as ambulation. If I was to do nothing else for the whole session getting the patient up and moving would be a very important goal to focus on and then assess the remaining aspects in due course. Also limiting the time I spent with the patient because even though she needs more time it should not affect the time I spend with the other patients who need equal attention.