Third Stares

Assessment

Situation
It was an out patients patient coming in to see the Continence Physio. She was a new patient coming in after a feeling of a prolapse when her baby was around 8 months old.

Task
I was to complete her subjective assessment. I was aiming to do her initial assessment to work out what the problem was and then give her some education before she came back for her second appointment the week after.

Action
I did her subjective assessment, on the continence Ax form. I used a ‘cheat’ sheet to cue me what questions to ask and what to note as important. Throughout the assessment I gave her a few education tips and used charts to explain some things.

Result
During the assessment I discovered that the patient was moving back to England in 2 weeks time. We normally would send her home with some education and a bladder chart to do. But since she was moving away she was given more education than we would normally do on an initial Ax. This isn’t ideal since you don’t want the patient overloaded, but due to the circumstances we had to.

Evaluation
After I had done the assessment, I could think of so much more education I could have done while I was going, rather than at the end and my supervisor doing a lot of the education at the end (also because she was leaving so more was done). However, once my supervisor talked to me and I thought about it, I did the subjective fine and managed some education – which is a post grad level. I think that I need to be less hard on myself. With practice I would become more fluent and be able to give education throughout better. I was happy with education that I did put in there and being able to know and understand what her answers meant.

Strategies
In the future I would become better with practice. I would use a cheat sheet again when doing the subjective. It was really good that that patient came in for second appt on my last day so I go to follow her through and do real time US to see what was happening (she wasn’t emptying properly, she had small volumes, residual urine, recurring UTIs and urgency). It was good to see that what I had thought of from her subjective was proven with her bladder chart and RTUS. I think that being able to follow patients through is a good strategy to see how effective your questioning was.