Tuesday, 29 May 2007

Debatable Doctors...

This clinical situation is more related to communication with health professionals than anything strictly patient-related and to be honest is more of a vent, but it impacts on patient treatment and I feel it is a relevant issue which many allied health team members will come across.

During my last prac (RPH oncology) I was seeing a lady who had metastases in her brachial plexus and consequently was losing all voluntary movement in her shoulder, elbow, wrist and fingers. She had been wearing a sling which her husband had purchased from a chemist and which was less than ideal, with a thin neck strap which cut into her shoulder and lack of support at the elbow.
I went exploring to the orthopaedic ward to find her an alternative. I provided her with a wide-based sling with better elbow and wrist support which she was very happy with. I also taught her passive exercises of the shoulder, elbow wrist and hand as she was at risk of contractures due to lack of movement. I also went exploring to the hand clinic and found her some hand 'putty' which she could manipulate in attempt to maintain what little strength/range she had left.
Basically, I went to a lot of trouble in order to make sure this lady had all she needed to maintain optimum function. I recorded the above intervention in appropriate detail in the patient notes.
I returned the next day and opened her file to check up on happening from the previous night. The VERY NEXT entry in her notes, scrawled in almost illegible writing, right below my entry, on the SAME PAGE as my entry, read the following as part of her 'plan':

Physio
Please provide with
- more supportive sling (current chemist purchase inadequate)
- anti-contracture exercises for elbow, wrist, fingers as pt at risk of contracture

Needless to say I was fairly frustrated that I had performed exactly what was asked, without being asked, yet it had been assumed I wasn't capable of doing this and consequently my notes were not even considered worth reading.

My question/gripe is: Do doctors read anything written by anyone other than other doctors? How can relations/communication be improved between medical and other allied health professionals? How can we get doctors to take us seriously?!

No comments: