wk3: reflection 3

On Friday I was asked to get a patient 4 days post op TKR into the gym and go over the exercises she had been taught and progress the exercises. When I went to get the patient I found she did not her any elbow crutches just a ZF so I knew I would have to measure her up for elbow crutches and teach how to use them. It also became evident by talking with the patient that she had been experiencing a few complications with her surgery as the site of her drain had still been bleeding profusely and that she had not been doing her bed exercises. I realise that my plan of attack had to change into teaching her how to use elbow crutches and the beginning level quads and hamstrings exercises and stretches plus getting an initial ROM for her objective Ax.

I think I did a good job at teaching her how to use the elbow crutches in quite a methodical repetitive order so the patient would be able to remember some of the key points to ensure she was safe in her ambulation and transfers.
I found it a little harder to teach the patient her knee exercises as she seemed to be in a lot of pain and didn’t seen to have much strength in being able to complete the exercises. Due to this I was trying to help facilitate and modify the exercises so she would be able to complete the exercises. I also found it difficult to push the patient to do the exercises as she was clearly distressed form doing the exercises which made me feel like a torturer. My supervisor told me to keep going and that I was doing a good job so I kept persevering! I realised that she was holding her breath as she was doing the exercises and as that causes most of the muscles in the body to tense up making the exercises harder and more painful I got her to count aloud so it would keep her breathing and take her mind off the pain. Throughout the treatment I was very empathetic and encouraging towards the patient which she seemed to appreciate which helped me build a rapport with her.
Overall I think I am getting better at encouraging my ortho patients to push themselves to the end of their ability.
All in all I am really enjoying my placement!