So during my placement I’m getting lots of chance to go out and work with other teams and healthcare professionals. Today I got to send a morning with the physiotherapy team at my local community hospital, shadowing and helping them out with the patients they were seeing that morning.
What have I learnt?
The physiotherapy team, just like all the other allied health professionals, all have a vital role within the hospital. With the way the NHS is working at the moment, the nursing team have so little time for rehab that having a physio team working alongside means that patients can actually get that extra help they need to get mobile again. However, I also learnt that the role is incredibly stretched, with just a few physios (and their assistants) seeing many patients over a very short period of time. They explained that this means they must try and prioritise which patients they’re going to see, particularly those who are likely to be going home sooner, and therefore some patients can miss out. They also explained that effective rehab and physiotherapy works much better over a longer period and that a lot of the programmes are designed to take 9-12 months, not the couple of weeks they have available. An example of this is the Otago programme, which is specifically designed to help prevent falls, a key issue in the aging population of Cornwall. In some cases, the physio team can go and see the patient at home to continue their therapy.
So we all know that nurses have busy days, and because of this they will often take shortcuts to speed up processes. One example was with a patient who required an enormous amount of encouragement to stand and use a specific walking frame; previously this patient had been using a sara steady, a piece of equipment that the patient can pull themselves up into a stand with. During busy periods or when the patient was tired, the nursing team had fallen back to using the sara steady as it was easier and quicker to use, something that isn’t bad practice, but also didn’t allow the patient to develop her strength and confidence in standing using the new equipment.
While during our nursing careers we won’t always be able to spend the amount of time physio’s have working on those rehab skills, but it’s always best practice to try and incorporate as many of them in our patient’s day to day lives as possible. Trying to use the appropriate equipment and not just using whatever is easier and trying to set aside extra time for more difficult transfers when doable. This way we ensure that the patient is given the best possible chance to recovery quickly, improving their quality of life. Simple things like getting the patient to take part in their wash or getting them out of their bed or chair and walking a short way, just to get the muscles moving. The physio also stressed the importance of working with the patient and not trying to help them too much and using your own strength to push or pull them. Not only does this not help the patient improve their strength or skills, but also could lead to an injury for them or you.
Improving a patient’s mobility has many positive outcomes, not only in improving the patient’s mental health, but also their physical. Being able to increase their mobility also gives them a goal to work towards, even if its only a small one and can improve their quality of life when leaving hospital. Even a few days of bed rest can lead to a rapid decline in strength and aerobic function, so getting your patient’s up and about is in everyone’s best interest. Obviously, there will always be patient’s where this is not appropriate, and the physiotherapy team will treat them accordingly. It’s doing what’s best for your patient and working with them to get the most out of their stay with you.