One week into Neuro placement all of my patients so far have been at least a couple of months post stroke. As a student you have the expectation that if you spend a treatment session with a patient working on a particular activity limitation that the change you make will remain until the next session. This obviously is not always the case. It can be very disheartening to spend an hour on a patients impairments only to see that the change you made has been partially or completely reversed by the next treatment session. Almost like one step forward one step back.
A discussion with my supervisor reminded me that most of the recovery occurs early and then tends to slow so it sometimes takes a little patience. So I have learned so far that even though the change you keep from one session to the next may be small, if you are making a change within your treatment session your treatment is effective. It may be worth considering two shorter sessions per day with these patients. I am told this is what some Neuro PT’s choose to do.
I am learning to recognise that my patients progress may be slow and take this into consideration in my plan for treatment, my discharge planning and my education to the patient.
Is it just me? Please comment
Leslie
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2 comments:
Hi Les,
I hear what you are saying! I had my neuro placment prior to Xmas and although the majority of my patients were admitted with acute stroke - this did not mean that progess was made very quickly. While I realize that a large amount of recovery does occur early on, that patience and perseverance is still required treatment session to session even early on! As for the 2 sessions, I personally think that if possible to do then it can be quite beneficial. Sometimes those longer 1 session treatments seem to really fatigue them for the rest of the day - and maybe this can contribute to it not being a more persistent/permanent change? I guess then the idea it to realize how far you end up pushing them each time too - knowing their limits! Ya, you do have to look for those little changes, but it sure is rewarding when you notice them hey?! Have a good week!
Donelle
Hi Leslie,
i felt exactly the same when i was having my neuro placement. i was in outpatient then and these patients have had stroke for years.. My supervisor was telling me that i may not even see a change after the four weeks and the next batch of students may have to continue to work on that same impairment in order to see a change. It was frustrating and definitely disheartening. However, i did see some improvements in some of my patients. Continue to work hard and i am sure your hard work will pay off.
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