Monday, December 8, 2008

Final thoughts

this placement has done me the world of good. i wanted to use this experience to re-iterate my decision to study to become a physiotherapist. it did just that, im really happy with the hospital i worked at and i enjoyed the hospital sector, working with all the allied health professionals. orthopaedics was a perfect way to begin. it was a routine physio treatment that gave me the confidence in my treatment and i now know im capable of being and good physio. i loved working with people and real Pts, i was constantly broadening my comfort zone by meeting different people and enjoying a whole range of different characters. i like to think of myself as a friendly outgoing person and i was delighted when that was the feedback i got.
what i learned:
i learned pretty much everything about ortho, what treatments to prescribe for what surgeries. manual handling put in practice. a lot about surgery and anaesthetic because anaesthetic plays a big part in our post-op treatment. i learnt the hierarchy of the hospital system and how to communicate and work with other health professionals. in conclusion this experience has been amazing and its fueled my desire to work towards becoming a well rounded physio.

Tuesday, November 11, 2008

treatment

today i was treating a patient trying to get him 70 degrees active knee flexion. lying supine on a plinth the patient started actively flexing, but only reaching 50 degrees. i then got him to practice passive flexion by putting a sheet around his foot so that he could pull with each hand and achieve knee flexion. this is a standard technique that is often used. however he was still not quite getting to where i wanted. so i tied a pulley to the cage over the top of the bed and put a sling under his knee. he would then pull on the handle and the pulley would cause the sling to pull up under his knee. this took the knee into full flexion and he actually achieved 80 degrees. i found it really effective and i think the pt was really happy aswell. i have also discovered some effective techniques to improve quads lag also. moving the knee cap on the good leg and telling the pt to stop you moving it causes them to go into quads firing. get them to incorporate this into the operated leg at the same time so they can get a feel for the co-ordination. once they wake up quads then chuck the quads wedge under the knee and off you go. i found this really effective. also try beginning quads treatment with some eccentric lowering. it strengthens the muscle to allow it to get higher ranges.

Monday, November 10, 2008

running the ward

well this week i will be running the ward at kaleeya which will be challenging and exciting. this will involve me discharging patients, filling out all the paper work, handing over to doctors and nurses and basically taking control of all the physio roles on the ward. this gives me the initiative to prioritise which patients to see so that i can discharge them. this gives me a great sense of responsibility and i feel like i am ready to take on this challenge. im really happy with where im at with placement atm however id be lying if i said im not looking forward to friday when i can actually work and earn some coin. over the last few weeks i have been taking on more and more responsibility so hopefully i can put it all into practice this week....

Tuesday, November 4, 2008

Aborigine-me

i had some experience dealing with Aboriginal pts the other day. An aboriginal lady from fitzroy crossing in whoop whoop presented with a broken ankle. im comfortable with the routine treatment for post surgery ankle ORIF, so it was just the pt that i needed to become familiar with. she seemed pretty traditional so i took on board what i have learnt.... things such as little eye contact and speaking in a dialect they are familiar with. i must admit i do find it challenging not to shy away from judging a pt such as this, not because of race but other things such as they havent discovered the wonderful essence of rexona, or their bed habbits arent particularly pleasant. but i think to my credit i handled myself very well and did what i needed to do. you get your pts that are easy because they are clean, have a good attitude and comply really well with treatment, however its not always roses and happy days and in saying that im glad i got the chance to test my character with a more difficult pt. i think you just had do what u have come to do, dont get off topic and be happy that our sense of smell can accommodate to even the more potent smells in a matter of minutes. happy days

Thursday, October 30, 2008

TKR

well well, the old Total knee replacement hay? it seems it is the nemesis of the kind image that is the "physio" ive had TKR's coming out my ears, nose and... well you get the drift. the look on the face of a pt when the PT walks into the room. a reaction along the lines of "NO, NOT TODAY! IVE HAD ENOUGH... GET OUT". Oh but u cant rid of me that easy... no no its down to the gym to do your X's and get ur ranges!!! seriously tho.. being able to relate to a pt and empathise with them is very important, otherwise they wont comply. ive had happy pts - which are great, i can joke around be a bit cheeky and they seem to thrive on it and it keeps me going as well. pts with depression, chronic pain, social issues and more which means u have to adjust and come in from an angle where u can get them to comply with ur Rx. the public system means u have to free up beds asap which means d/c pts quickly which means mobilising day 1 and reaching ranges and crutches use and inner range quads and outta here by D4. absolutely love it tho it challenges me and im learning so much. my supervisor is a gun,, he is so smart so i just constantly ask qns... everything is being put into context.... COPD and how it affects spO2 and how u should work ur Rx around it... and so much more.... booked into see surgery all day next friday, yep hips and knees.. ill let ya no..

Monday, October 20, 2008

week 2

well its monday and the start of my second week. last week was characterized by copious amounts of vomit, lots of pain and lots of walking up and down stairs. ive got the use of crutches down-pat, i know to consult the nurses because they are vocal pt records and can tell you things you often wont find in the notes. ive been seeing lots of hips and knees and believe i will be seeing a few shoulders this week. orthopaedics is good and im really enjoying myself. i feel like im making a difference which is really rewarding even if at the time really painful for my pt. i look forward to another 40+ hour week which dont get me wrong has me in a good routine. hope all is well.

Wednesday, October 15, 2008

placement

well i didnt make an initial post which i appologise for as im still trying to get the hang of this... im in day 3 of placement now and im thoroughly enjoying it.. orthopaedics at kaleeya with brad and kiri who are doing gero. ive learned the total knee replacement patients arent particularly fond of physios due to the pain we make them go through... my supervisor is young but very talented and im enjoying soaking up his knowledge. i learnt about cushions disease today which is a tumour on the pituitary gland, my clinical supervisor has asked that i follow up research on it.. hope everones placement is good.