Proper explanation helps with time management!

In the 3rd wk, my supervisor decided to challenge us in terms of time management. Prioritising the order of patients to be seen, the no. of treatment sessions required by patients a day etc.

There’s this pt of mine, 80 y.o. male, post pacemaker implant, with a hx of recurrent pneumonia, requiring physio twice a day. For the first 2 days post op, he was in a rather confused, drowsy state, sounding rather chesty but not expectorating anything although he claims he is not in pain. He was being hoisted to SOOB for the first 2 days as his HR was in AF although with paced rhythm. On the 3rd day, he was more alert & cooperative, and his Obs were stable, so we decided to try to stand him up to do a step transfer to SOOB. His LL strength was not fantastic, he managed a step transfer but ambulation was not an option. By the 4th day, we saw more improvements with him and he was keen to try to have a walk, so we assisted him to stand & walk with a WZF. However the limiting factor was his oxygen sats. He was SpO2 95% on 3L oxygen when he began amb, but desat to 86% within 2mins of walking ~6m. Then I increased it to 4L O2 and his sats was barely 90% after ~2mins. With all the preparation work of getting amb O2, drip stand, WZF and oximeter, he was rather frustrated by the time we got ready to stand him up. He was quite annoyed with the fact that he had to keep the oximeter on, had to stop to let his sats come up and we did not allow him to walk further than 10m due to his very low sats although he claimed nil symptoms. So I had to explain to him the significance of what I was doing; why he had to have his oxygen level monitored, why low sats was not good for him to continue walking. All the preparation, frustration, and explanation took up a lot of time, but it paid off as they all made more sense to him. He acknowledged the fact that I knew what I was doing and the next day when I saw him, he was not frustrated and the treatment was more efficient! And my day was definitely more efficient that day.

One more week to go! Hang in there guys!