Week 5 3

Today we went on a bus outing to the Dolphin Discovery centre.
We had had afternoon tea and were getting up to go for a walk when a lady spilt her drink on her. We were cleaning her up and I was talking to her when she began to not make sense then go quiet and appear blank like she was off in a different world. I asked her if she was ok and I didnt get a response and she wasnt her normal self. She was sitting on a chair with no arms and so I held onto her so she wasnt going to fall off the chair and signalled for the PTA to come over. When the PTA came over she instructed me to go get the other PTA.
I went outside and got the PTA and I stayed outside with the other residents, since there were dementia patients which couldnt be left alone.
I stayed outside and made sure I kept an eye on where everyone was and was going and encouraged the residents to stay outside, since they were unaware of what was happening inside.
After the patient who had the TIA had come to we had to load everyone onto the bus and go back to the nursing home.
NOt that I would wish it to happen to anyone but it was a good experience to have and have to deal with. I was happy with the way I responded, since there is nothing we could have done except make sure she didnt choke on her tongue or teeth and make sure she didnt fall off the chair.

Week 5 2

We had a patient who we visited to rub flexol into his knees in the morning. He lived in a room with his wife. HIs wife can be very moody and she had previously accussed one of the PTAs of having an affair with her husband, so we were warned that she may be dispondent or rude to us when we went in there.
We decided so that she didnt think that we were just there for her husband we would take her exercises to do every day. We took a variety of balls and hand and foot massagers everyday and she seemed to respond well to us. It also allowed her to get her hands moving a little bit.

Before being told this situation I never even thought about things like this occuring. This allowed me to become aware of how you deal with patients and if they share a room with others or have a partner.

IT also taught me to give appropriate equipment to particular patients, as this lady had limited strength and could only squeeze the softer balls rather than the harder ones.

Week 5 1

Three times a week we do exercises with a patient who has parkinsons disease. This patient does his conditioning exercises everyday on his own and when we see him he does these exercises with weights or theraband. We also do sit to stand practice with this patient, along with marching on the spot, as this patient's goal is to get walking in the parallel bars.

This patient is very compliant with exercises and motivated to do them because he wants to walk in the parallel bars again. Although he does everything he is told and wants to do it, when he marches on the spot he doesnt weight shift well enough to have a go on the parallel bars yet. This is hard because he is so egar to try them and keeps asking if he can have a go on them. That is a hard thing to tell a patient everyday when they really want to do something they physically are unable to do yet.
This patient has parkinsons disease and speaks with a very quiet voice and is hard to hear sometimes. To ensure you hear what he says you need to make sure you are close and are fully focussed on him.
THis patient doesnt have a mental deficit and so he gets down on himself when his body doesnt do what it used to do.

With this patient you have to be careful he doesnt do too much exercise and tire himself out, because he wont tell you he is tired and sometimes he does too much in a day if he goes to group exercise classes and then does individual sessions with us.

Week 4 3

The physio department got a wax bath this week. The PT used it for the first time yesterday on a patient with arthritis who has been complaining of pain in the previous days due to her arthritis.
When this patient put her hand in the wax bath she complained that it was too hot. SHe displayed a very overt reaction in response to the temperature. The patient tolerated only 4 layers of wax before the PT wrapped it up and allowed it to cool. The patient displayed animated reaction to pain in her hands, which appeared to disappear as soon as she was distracted by drinking her cup of tea or in conversation. Her pain reaction only appeared when she was asked how her hand felt or if she was left doing nothing. After the wax was removed she complained loudly that her hand was hurting and was holding it in a protected position. Her hand didnt have any abnormal redness.
She told the PTA that she thought that the wax bath helped her hand and that it wasnt that hot and she would like to try it again.
Today I took the patient for the wax bath, I was feeling a bit unsure because the PT doesnt work today, only the PTAs and I was feeling unconfortable on whether to stop if she complained of teh pain she had yesterday, even though the PT let her do a few more dips yesterday after complaining of the pain. I set up the wax bath, washed her hand and rubed lanolin into them. I then explained again what to do and she did it. Today she didnt complain of pain like yesterday, which may have been because there was a room full of people. She only complained of heat on initial contact but insisted she was ok to keep going. This may have been because today she had got the hang of just dipping her hand n the wax, rather than leaving it in there.
After removing teh wax I made sure that her hand was ok and that she had movement. I told her to continue with the exercises that I had prescribed her the day before.
i was happy with the way today went, I got to use the wax bath twice with patients who are both finding it beneficial.

week 4 2

Today we gave a patients peddles for the first time in a long time. We have previously just been doing upper limb strengthening and conditioning exercises with her.
I felt a bit unsure about how the peddles would go since this patient had ceased the use of them previously because her foot was slipping out of them. We took her down to the physio room, so that she could use the 'wobbler' machine after she had finished peddling.
We got her feet into the peddles and she began peddling however she cant peddle the full way around, so she just peddles half round then back.
She seemed to be able to peddle for a while before her foot began to slip out. When it was about to slip we just stopped her and put her foot back in. I was expecting her to have more of a problem than she did in keeping her feet in the peddles. It wasnt hard for us to readjust her foot when she was about to slip, so I cant see why she is unable to continue peddles treatment.
We then put her legs on the 'wobbler' machine and took her back to her room
I was confortable with this patient because she wants to do things and will do anything to help you out.
I was happy iwth the way today went except that there are auditors in at the moment and they sometimes have the patients files when we wanted them.

week 4 1

We have been doing stretching exercises with a right sided stroke (left sided hemi). This patient tends to neglect her left side, she wont talk to anyon who is on her left side. When we first saw her, I thought that she didnt like me and only would respond to Jenna. After the second visit and continuing ed from out supervisor, we realised what it was.
This patient is bed bound and we are to stretch her affected arm. At the first visit we realised that the patient said her arm was too sore so that she could get out of stretching. We never pushed the patient past where she said there was pain but the next time we saw that patient we gave her a massage first and she didnt complain of pain at all and we were able to give a better stretch to her.
Another idea we had was to work her good arm, using a ball to squeeze to maintain her grip strength. When we do this she also allows us to stretch her arm better and tells us that its is "good".
In the days that wehave been seeing her we have felt that her contracture is improving slightly.
We have noticed that she doesnt wear a splint and that we beleive she would benefit from using one. We talked to our PT about it and as far as she was concerned she had had one, so she is currently following up about the splint.
It feels good when the patient now responds to us because she now remembers who we are.
I was happy with the way in which we worked out what worked with this patient for her to be compliant with Physio treatment.