Dumb student and impatient supervisor

Hi All,

I am experiencing some difficulties in my placement and I am really frustrated at the moment:

My Curtin Supervisor came for mid-placement yesterday and it was the worst two hours I have so far. My supervisor has high expectation on student, for example: She expects student to know the effect and mechanism of every single drug on patient’s medicine chart.

I could only answer some of her questions and she was very impatient after a while. I was threatened and not motivated after the first hour. I confess my knowledge in neurology is limited but I do look up things which I don’t know. I tried hard to revise my neuro every night after clinic, but some skills (e.g. Observation) really come with experience.

I am planning to get some extra supervision next week and do you guys have some strategies to deal with this? I would love to hear your advice,thanks!

Stroke rehab path

I have just started my neuro placement, which is in a rehab setting, and thought I would share an issue that I have been introduced to. The focus at my facility is on a Bobath approach to treatment which is about encouraging normal movement as much as possible.
However, before patients are admitted they are treated in a more acute area, who often take a different approach. In these settings patients may be allowed to use whatever pattern or muscles possible to achieve a task e.g. rolling. This can hamper the rehabilitation process, as the brain relearns the wrong movement patterns, and can also result in increased overactivity in the "unaffected" side.
I believe it would be in the patients best interests to communicate between facilities in order to acheive the optimum outcome, although I'm sure I am not aware of all the issues involved, or the evidence behind it (but I'll save that for another post). Anyone?

rural prac...

Hi everyone, i just wanted to say a little bit about our rural placement...
i am on mine at the moment and really enjoying it. I am finding that the patient load is a mixture, and even though its not a specialist area i am enjoying practicing a range of treatments - from womens health to cardio, neuro and musculo. i think that working in the country as a physio would be very rewarding, and as long as you have a good support network with other physios, your skills in all areas are maintained.
Occasionally it would be quite challenging as you have nobody to gain a second opinion from, but it would definately make you attend as many continuing ed sessions as possible and keep up to date with the latest treatments available.
i hope everyone else has enjoyed their country placements also, and has found the mixture of patients great practice also!

FINISHING!

I just wanted to talk about how much I am looking forward to finishing prac this year and starting work next year. I have enjoyed prac so much this year and it feels like I have learnt more in this year then the three years we spent learning at uni! But I must say I am looking forward to not being asked questions every two seconds and just concentrating on my treatment sessions. I know that learning never stops and that you can never know enough but it will be good to be a bit more independent next year. It will also be good to finally earn some money- I’m sure that everyone feels that way after being poor for 4 years. Even though initially he pay isn’t that brilliant- but I suppose as long as you enjoy your job then the money doesn’t matter so much. I just wanted to say that I think that the physiotherapy course has been really great and will set us up for a solid career with exciting prospects!

Purchasing a gopher?

I sometimes have been told that patients will teach you more valuable things than what you would have learnt from the books.

Part of my prac consists of pulmonary rehab program. It's not the exercise part that is interesting. It's the 'health topics open discussion' which I find rather valuable not only for the patients, but also for me. During this session, the patients can either ask the physio about issues of their concerns or share their own experience.

One of the topics which came up from last week's session was the motorised gopher. One of those topics which you didn't expect to know or matters. And I thought I would share some of the things I learnt.

Here are some practical gopher-related facts:
1. max speed of a gopher is 40km/hr.
2. battery power duration depends on how often you go up a slope and the steepness of a slope.
3. patient gets only 1/2 price rebate (can't remember which type of rebate) if they are taking normal taxi, whereas they only need to pay 1/4 of the cost to call a maxi taxi so that they can bring along their gopher.
4. sunroof for a gopher costs extra.
5. sheep skin cover makes the seat more comfortable.
6. patient can also fit customised foam cushion on the seat via an OT if the seat is not suitable.

I hope that at some point these facts will assist you when your future patients do ask you about a gopher.

Head Injury Patient

Hi All,

At the moment, I am on a neurosurgical ward in RPH. I have come across a few difficult situations and would like to share some of my experience with all of you.

On the first day, my facility supervisor had clearly stated she was a big fan of Bobath technique and she wanted me to treat patients with this technique. As a student, this was a really good learning opportunity and I was more than happy to learn this new technique from my supervisor. I had used the Bobath technique to treat my patient and things went pretty well until I met my Curtin tutor.

When I first met my Curtin tutor, she asked me what I had done for the last few days. I gave her a quick handover on patient’s condition and reported what sort of treatment I had given to my patient. She was not really impressed on my choice my technique and she gave me a big lecture on Bobath technique and said this technique was not appropriate for most patients (Head Injury) on this ward.

During the three hours with my Curtin tutor, I had treated all my patients with ‘Carr and Shepherd’ approach and when she was not there, I had to use the Bobath technique to treat my patients.

I understand every clinician will have his/her own way to treat a patient but I just wonder will this inconsistency of treatment affect patient’s recovery. Is it better to stick to one approach than using different techniques on head injury patient?

Private Practice

Working in a private practice is at times very challenging. It is a constant balance between physiotherapy and business. What makes effective physio does not make effective business. For ethical reasons effective physio always comes first, but to be successful business has to come a close second. Ways to make good business include having a variety of equipment such as fit balls and orthotics to sell. Investing in good gym equipment, this is handy for treatment and during after hours you can run a public gym. Good, effective physio treatment will always bring the clients back. However, if you offer not only symptom relief physio but exercise prescription/training and add pilates in to the mix you can establish a large clientele which will continue to return over long periods of time. Private practice is a challenging place to work but I find it very rewarding. If anyone else has any other ideas of how to balance physio and business please share.
Dickie