Sometimes we are get familiar with certain things that we do that we become complacent. Anybody feel the same way too?
One morning, I had a day 1 post radical prostatectomy patient to see. I have seen a couple of those pts, so I had the mindset of the same routine things that I usually do. So as usual, I did the relevant subjective & objective Ax, then went on to treatment. I educated him on importance of early mobilization, upright positioning, DB ex’s & supported cough. The pt was well enough to get out of bed, and ambulated a short distance. Thereafter, I got him to SOOB for a while. He then started to feel cold & clammy, and got a bit sick. Then after a min or so, he said he was better & he could manage SOOB. So, I thought..good, he is feeling a bit better & he says he wants to try SOOB..and I decided to let him stay in the chair. As I was walking out of the room, I felt uneasy about the while thing, decided to take his BP to see for sure if I had made the right decision. Gosh, his BP was 80/55, far from his usual of 110/60. Back to bed it was for him and I also explained the reason to him. Though SOOB was important for him, compromising with his low BP was not exactly what I wanted. I am so glad I took his BP to justify my decision and not have it based only on the pt subjectively, especially on the last week of placement.
Congrats everyone for completing this placement! Good luck for the coming PCR!
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Hi Beryl,
well, i think i have the same problem too. For me, was on the musculosketelal aspect. i had seen a couple of rotator cuff repair patients and they all follow a certain protcol of pendulum exs,active assisted, passive exs. i went in thinking will be easy and treatment can be done really fast. However, this particular patient of mine was told by the doctors not to remove the sling and not to lie supine. i was shocked and did not know what treatment to do!!! i think i need to get out of the recipe type of treatment and always remember that all patients are different. Thanks for the blog, i will keep in mind what u had written when i see my Cardio patients.
Thanks guys. A good reminder that not all patients are the same. It's easy to get complacement and expect you can go in and treat a patient without thinking about it. Maybe in a couple of years that will be the case but for now I am resolved to the fact that I have to keep my finger on the pulse with every new and ongoing patient. You never know what surprises your going to get. I had a patient who was in for an exac of COPD and all his S and O indicated he would be fine to amb a short distance on O2. In 4 steps he desat to 75. Needless to say I got him to sit down and he was ok but you can never be to careful, especially when we are all so new at this. thanks guys. good luck for PCR
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