On my cardiopulmonary placement I was presented with an extremely difficult patient as my final assessment patient. Although I had prior warning of this patient's past difficult behaviour I felt confident in my ability to find an approach that would work with him in order for us to achieve what I wanted in the session. As soon as our session began, however, I realised that this was going to be a lot more difficult than I had anticipated. The patient was moody, difficult, inappropriate and verging on aggressive. As it was an assessment situation I felt like his behaviour was causing me to feel even more flustered than I would usually have felt, which compounded the situation.
I tried to use a number of different approaches with the patient. It felt like every approach I tried was inneffective, and often led to the patient being even more stubborn and irritated. Despite this, my supervisor and I managed to get the patient to do ALMOST everything we wanted him to in the session. It took a lot longer than it should have and I left the session feeling like I had not done a good job with him and that I had not achieved what I had set out to do, which was get the pt up and walk as he was day 1 post-op.
On reflection, however, I realised that with some patients there you will just never achieve EXACTLY what you want to achieve. There are occasions when, despite your best efforts, your patients need to make the choice to help themselves and let you help them. Once you have exhausted all avenues of trying to convince a patient to do what you would like there comes a point when you need them to realise that you are only there to help them and they need to make the choice to accept that help.
At first I felt that this was a defeatist attitude, but now I realise that all we can do as physiotherapists is offer our services and our expertise. Not all patients will be perfect and we can never know fully why a patient is difficult or angry. I feel like this was an important lesson to learn as i am sure I will encounter many more difficult patients throughout my career and I will be better equiped to deal with them.
Hi! I agree with you, angry or moody patients are very frustrating as a physiotherapist and I think the best way to deal with it is to just keep positive and hope they will see that physiotherapy is helping them in their progress and even if there is some work to be done in the short term, that in the future it will benefit them!!! Hope your placement is going well. :):)
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