Well last blog i spoke about trying to break the habit of a subjective recipe, this week my supervisor really challenged me to ask myself what do I really need to know objectively and why. I'm on my last week of cardio. Often the patients we get are COPD plus other co-mordities. These patients often come in with SOB etc. It's easy just to think straight away "this pt has exacerbation of COPD with either viral or bacterial chest infection". This is because most of them are. Mostly but not always the case. My supervisor challenged me to always exclude all of the other possibilities that may cause SOB. These include PTx, PE and LVF/CCF. Its easy just to assume exac of COPD. So I previously assumed, "well the doctor's should know that" I'll just bang on their chest and get them walking. The reality is it sometimes takes the team a little while to figure it out. A number of times pt's come in and they start treatment for infective exac and realise its CCF. The point my supervisor was making is that you can play a bigger role than you think in the Dx of a pt and ensure they are receiving appropriate treatment. Use all of the Obj Ax you have, particularly observation for example changes in ankle swelling or how sweaty and clammy a pt is, not just the standard recipe objective Ax.
I think this idea is relevant for all areas, don't make assumptions was my lesson. Use the vast knowledge that you have.
Hope this helps you improve in your chosen area, whatever it may be.
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Great post Les,
I also have completed my cardiopulmonary prac on your ward and learnt alot regarding a patients presentation. One thing I learnt was that we all often approach a pt for the subjective and objective that we learn at Uni, however, sometimes a little common sense can give us alot of information. What i mean by this is this; as students we all get caught up in "have i asked that?, have i done this?" when something {as you have stated), as a 'thorough' observation can give vital clues to a pts function. Us as physios play a VITAL role in the role of rehabilitation, in all fields
Not long now!
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