Today was my last day and i got to finish early! I felt a little sad leaving as i got along with all the staff really well and enjoyed my entire 5 weeks at Osborne park! I felt that i learnt so much and looking back to where i was at the beginning of the prac and seeing where i am at now is an amazing thing!
I felt this prac really confirmed to me that physiotherapy is what i want to do and something i really enjoy. One of my main concerns coming into the prac was whether i would enjoy working with older pts. After 5wks of working with them not having any worries i now know that it isn't a problem and probably wasn't to begin with! It feels good to have gotten that experience under my belt and even though gero isn't my ideal area of work i would work there again.
I feel my knowledge increased greatly over the 5wks and i know feel confident working with the older population. I find hands on learning to be so much more effective for me as i struggle to take in information by just listening to a lecture or reading a book but rather relish the opportunity to be actively learning and employing my knowledge.
So in summary- learnt heaps, had a great time and looking forward to the next one!
Saturday, November 15, 2008
WEEK 5-13/11/08
Today i spent the morning in the day hospital and the afternoon conducting the falls clinic with my supervisor. The falls clinic is an Ax of a pt using a comprehensive subjective and objective that have all been designed for the specific reason of Ax whether or not a pt is a risk of falling.
This isn't the first falls clinic i had participated in and i had become confident with conducting the objective aspects of the Ax. These include an eye sight test, reaction time test, proprioception test, strength test, TUG, 6mwt, Postural sway test, step test and a few more that i cant remember right now!
Today was different though as i took my first subjective with the pt. This was exciting and scary as i had seen it done 5 or so times but i wasn't completely confident with conducting it on my own. I surprised myself and actually found it not to bad and was able to effectively communicate with the pt and his wife. If i had to do it again i would be much more confident with my questions and try and get through it a little quicker. I also missed a few questions but my supervisor said it was important to include these. So in future i would make sure i wouldn't forget! So it was a good experience and i know feel almost confident enough to conduct a falls clinic by myself!
This isn't the first falls clinic i had participated in and i had become confident with conducting the objective aspects of the Ax. These include an eye sight test, reaction time test, proprioception test, strength test, TUG, 6mwt, Postural sway test, step test and a few more that i cant remember right now!
Today was different though as i took my first subjective with the pt. This was exciting and scary as i had seen it done 5 or so times but i wasn't completely confident with conducting it on my own. I surprised myself and actually found it not to bad and was able to effectively communicate with the pt and his wife. If i had to do it again i would be much more confident with my questions and try and get through it a little quicker. I also missed a few questions but my supervisor said it was important to include these. So in future i would make sure i wouldn't forget! So it was a good experience and i know feel almost confident enough to conduct a falls clinic by myself!
WEEK 5-12/11/08
Today i had a pt who presented with a # L NOF which occurred 3/12 ago when she was gardening. She went to bend forward and fell. The pt had been referred to us from SCGH for a LL strengthening X's. Being a new pt we conducted an initial Ax. I conducted MMT of the hip abd and quads. This was a daunting task as i wasn't sure that my interpretation of her strength would be accurate as i hadn't had much experience in this area. I scored her a 2+/5 for her Left hip abd and 3/5 for her left quad strength. My supervisor agreed with my Ax, which was good!!
I then prescribed her an initial HEP which entailed- STS, shallow squats, hip ext and abd in standing(do both legs). This would be her initial programme and my supervisor would add to it the following wk.
I was a little nervous about the MMT but it wasn't a problem in the end. My choice of exercises was good as an initial HEP and i thought my explanation of how to conduct them was good. I cant really think of anything i would have done to improve this. All good!
I then prescribed her an initial HEP which entailed- STS, shallow squats, hip ext and abd in standing(do both legs). This would be her initial programme and my supervisor would add to it the following wk.
I was a little nervous about the MMT but it wasn't a problem in the end. My choice of exercises was good as an initial HEP and i thought my explanation of how to conduct them was good. I cant really think of anything i would have done to improve this. All good!
WEEK 4 - 5/11/08
Today i had a pt present with a previous left side stroke 4/12 ago. He had a extremely good recovery and had recovered almost all mvt except for weakness in his left hand. He had been referred to us for lower limb strengthening and balance exercises. Since of his high level function we used a modified BBS and a dynamic gait index Ax.
I took the pt through the Ax which i was happy to do and also a little apprehensive about as i hadn't conducted these Ax before or even seen them! I felt the Ax went well for a first time run through and the pt understood what to do from our instructions. He 17/20 in the dynamic gait index and and modified BBS.
I think i could have improved the Ax by reading it through thoroughly before hand and even doing a test run if time permitted. I also believe i could have been a little more clear with my instructions, but overall i was happy with the Ax and confident that the results that the pt achieved were reliable.
I felt that it is hard to communicate instructions to a pt that you aren't to sure about your self. I think that next time i perform these Ax i will be much more successful with my communication.
I took the pt through the Ax which i was happy to do and also a little apprehensive about as i hadn't conducted these Ax before or even seen them! I felt the Ax went well for a first time run through and the pt understood what to do from our instructions. He 17/20 in the dynamic gait index and and modified BBS.
I think i could have improved the Ax by reading it through thoroughly before hand and even doing a test run if time permitted. I also believe i could have been a little more clear with my instructions, but overall i was happy with the Ax and confident that the results that the pt achieved were reliable.
I felt that it is hard to communicate instructions to a pt that you aren't to sure about your self. I think that next time i perform these Ax i will be much more successful with my communication.
Thursday, November 13, 2008
WEEK 4 - 4/11/08
1. This particular pt i had seen a couple of times previously and i felt confident taking him through the session without any help from my supervisor. For Rx i conducted a TUG with the pt which went smoothly and then i r/v his HEP and added a couple of new x's. I observed that the pt was really struggling with one on the balance x's- tandem stance- so much so that he couldn't even get his balance with out holding on. I instructed him to move more into a step stance which still challenged his balance as he was visibly working hard to hold his balance.
2. I believe that i have developed a good raport with this pt through previous visits and this has made my session with him easier. I examined how well he was completing his HEP and he was going quiet well and through seeing this i have forward planned to Ax the BBS with him in the next session to see if there was an improvement for when it was originally Ax on his first session.
3.I thought for the next Rx i would try and spend more time with a subjective type questioning as i just jumped straight into this Rx without really asking him how he was going.
4. My overall thoughts of the Rx were positive as i was able to take the pt with minimal Ax from my supervisor and i felt confident throughout and had no trouble communicating with the pt.
5. To improve i just need to keep practicing my communication skills and take in any tips form my supervisor and employ them.
6. N/A
2. I believe that i have developed a good raport with this pt through previous visits and this has made my session with him easier. I examined how well he was completing his HEP and he was going quiet well and through seeing this i have forward planned to Ax the BBS with him in the next session to see if there was an improvement for when it was originally Ax on his first session.
3.I thought for the next Rx i would try and spend more time with a subjective type questioning as i just jumped straight into this Rx without really asking him how he was going.
4. My overall thoughts of the Rx were positive as i was able to take the pt with minimal Ax from my supervisor and i felt confident throughout and had no trouble communicating with the pt.
5. To improve i just need to keep practicing my communication skills and take in any tips form my supervisor and employ them.
6. N/A
WEEK 4 - 3/11/08
Today i took all my pt myself as my supervisor was sick. If i had any problems i could ask the other physios in the DH.
1. I was a bit nervous for the first pt of the day as i hadn't been on my own yet. I first reassessed her TUG, which i was confident doing as i have completed numerous TUG's before. I also completed a step test which i was also very confident doing. I then ran through an obstacle course with the pt which was aimed as a high level balance and mobility exercise. I explained each task before we started and used language which was relevent and easy to understand for the pt.
2. I thought i conducted the TUG and step test well, as i was confident with the procedure. I also believe the obstacle course went well but i wasn't as confident with this as it wasn't something i had done before.
3. If i had to change anything the Rx, i would have tried to alter the obstacle a bit more as the pt had also done it the wk before.
4. I believe my communication was really good with this pt and that i had started to develop a raport that would help my Rx to be as effective as possible
5. I think if i was to ask the pt wat they thought of my Rx i wld receive feedback that would be invaluable to my development.
6. I believe that this pt would be ready for D/C and this is what i would discuss with my supervisor the next day when she was back at work,
1. I was a bit nervous for the first pt of the day as i hadn't been on my own yet. I first reassessed her TUG, which i was confident doing as i have completed numerous TUG's before. I also completed a step test which i was also very confident doing. I then ran through an obstacle course with the pt which was aimed as a high level balance and mobility exercise. I explained each task before we started and used language which was relevent and easy to understand for the pt.
2. I thought i conducted the TUG and step test well, as i was confident with the procedure. I also believe the obstacle course went well but i wasn't as confident with this as it wasn't something i had done before.
3. If i had to change anything the Rx, i would have tried to alter the obstacle a bit more as the pt had also done it the wk before.
4. I believe my communication was really good with this pt and that i had started to develop a raport that would help my Rx to be as effective as possible
5. I think if i was to ask the pt wat they thought of my Rx i wld receive feedback that would be invaluable to my development.
6. I believe that this pt would be ready for D/C and this is what i would discuss with my supervisor the next day when she was back at work,
Thursday, November 6, 2008
15/10
1. On Tuesday i was still observing and on of the pts i saw presented with a #NOF(R). We conducted a Berg balance Ax and the pt scored 38/56 which indicated her as a falls risk. Also conducted a 10mwt- 31steps in 48secs- which is very poor. pt amb with a wzf.
2. I just observed the BBS and 10mwt and took in how i was expected to perform the outcome measures in the day hospital.
3. i was comfortable and was interested in the Ax and Rx on the pt.
4+5- N/A
6. I feel as though i learnt a lot today, but i am still a bit apprehensive working with older people.
2. I just observed the BBS and 10mwt and took in how i was expected to perform the outcome measures in the day hospital.
3. i was comfortable and was interested in the Ax and Rx on the pt.
4+5- N/A
6. I feel as though i learnt a lot today, but i am still a bit apprehensive working with older people.
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