Monday, 16 July 2007
Acute vs Rehab
HI guys, Im currently on an acute stroke ward and just thought Id raise the question of the different settings we can work in. Im loving the acute ward for the majority of reasons but there is one thing in particular which is getting to me. Its so great to see the progress your patient's make from one day to the next. Its really rewarding and well at least some part of it could be becasue of your treatment. Its amazing but then they get d/c somewhere else to rehab and thats the end of them. You never get to see what thier final outocme is, whether they got to walk again or eat using a regular knife and fork. I find this really hard to move from one patient to the next and just forget about them. As a learning expierence I feel we need to see both ends of the spectrum, i.e. what the presentation of the pt is actuely and various rx techniques but then what the pt can achieve for themselves before being d/c'd home and the rx techinicques you used to get them there. Does anyone else feel the same on their ward? Maybe I just become too attached. Or could someone shed some light on the rehab side of stroke? Thanks Suanne
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2 comments:
Suanne you raise an issue that I've heard many physios talk about over the years. As the acute phase is only one wheel in the cog of recovery post stroke often physios do not get to see the rewards of their efforts. I remember one physio who worked in ICU commenting that this was a particularly difficult aspect of working in that setting as they do not see the outcome of their treatments. As someone who has had the benefit of working a number of years in a rehab setting I know that many of the physios in that setting encourage their patients to go back to the acute ward and ICU once discharged to visit (and thank) the staff that worked with them. Often there is also a fair amount of discussion between the acute and rehab settings about other patients when handovers are occurring between physios. Unfortunately being a student only on a ward for a relatively brief time, it is unlikely that you will get to see any of your patients come back for a visit. However on the positive side, I have lost count of the number of times that I have treated patients who when they find out that I teach at Curtin ask how a student who treated them is going. So you really do have a long term effect on your patients.
Hi Suanne,
I just finished my outpatient neuro prac , dealing mainly with patients who were 6/12 to 2 yrs post stroke. Having missed out on experience in the acute setting, I too find that I'm missing some part of the stroke rehab equation when I treat my patients - wondering what other physio Rx they have had before they arrived at my clinic. By the time my patients reach the outpatient clinic, they have pretty much plateaued and I am also unable to see much progress.
Unfortunately, there is no neuro prac where we can follow through with a patient on his road to recovery, or interact with patients at different stages of their recovery. Maybe you will see some neuro patients on your rural prac who are at a later stage in their recovery. Otherwise, we will just have to wait until we get out into the workforce to see the "other side"...
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