professional behaviour

S: When dealing with people with significant impairments such as stroke, you can be a subject to certain situations that require maturity and professionalism. Instances where pts require help getting dressed or have decreased control of bladder and bowel, are appropriate examples. In many instances the pt is cognitively sound and has just suffered a very rapid and dramatic impairment. Therefore they have often gone from complete independency, to requiring assistance with very personal activities. At this time, the pt is already experiencing extreme hardship and it is important for the physio to show support and professionalism to make it as least emotional as possible for them.

T: To conduct my treatment and session with each pt in a professional manner that, both, aided in their experience with physio and helped build the appropriate rapport.

A: I have been treating a range of patients who are middle aged in an acute stroke rehab setting. Many have become incontinent and or lost a lot of independency. This means that in many cases as a complete stranger I was dealing with dressing these people as well as accompanying them to the toilet and assisting them. From the very beginning I acted as professionally as possible in all situations. Often they became very upset and it was up to me to explain that this was normal and just a complicated stepping stone in their recovery. By acting professionally when dressing pts, this made them feel much more relaxed and reiterated that this was all part of your job. This included steps such as draping appropriately and talking appropriately.

R: As a result I built a strong professional rapport with my pts. They became much more relaxed when having to deal with incontinence issues as well as getting dressed etc. It also made it more comfortable for me as it seemed more natural and part of the job. It became less of an issue and overall I thought it was such a positive step to be able to remove a factor that was making their experience harder on their way to recovery.

E: overall I thought I was very effective in what I set out to achieve. Some areas I thought i did well in included -
• Draping the pt always to ensure you maintained their dignity
• Not laughing or acting inappropriately if pts flatulated or anything of that nature, often they would laugh embarrassingly.
• Always preparing the environment to prepare for any circumstances so that you could resolve it as soon as possible and prevent the pt from having to deal with the experience for too long.

Some areas I thought I could have improved on included –
• Making it easier for other physios working in the gym when I was around, by helping them or maintaining my professionalism.
• Being more mindful of patients using humour or other methods to hide their embarrassment.

S: Some strategies I found useful were –
• Liaising with the nursing staff about any hygiene issues or anything similar that the pt was experiencing.
• Gaining an understanding of each pts personality and any personal trait issues they could be having as a result of the stroke. This was evident in such cases where a pt would act inappropriately and not show remorse, often, instead they would condone it. In such circumstances it was important to show firm instructions that it wasn’t appropriate and wouldn’t be tolerated.