Week 4: Weighing up

Week 4: 24-27 March 2015...

After a month of fieldwork, a life-jacket has been thrown to us in the form of a mid-term break. We've been given the chance to halt amidst the bobbing waves of prac and take a look back at how far we've come, and how far we still need to travel.

 

 

 

Over the last four weeks, I've seen my confidence grow as I've become used to the hospital routine and the therapy process. I have a better understanding of what's expected so that it no longer feels like I'm blindly feeling my way around treatment anymore, but am moving according to some sort of logical progression.

 

I've become more adept at building rapport with my clients, and slowly getting used to the knack of extracting maximum information within minimal interview time. I've begun to realise the importance of observation skills, which can confirm or invalidate information from interviews and provide quick, accurate assessment findings.

 

One of the most important principles of ensuring that the session is maximally therapeutic is the structuring of the work environment. Through practice, I find it easier to visualise where the client, myself and the required items should be placed to allow for development of necessary skills or improvement of the required performance components. It has also become easier to adapt as needed, moving things around as the client's position changes or fatigue sets in.

 

 

There are many aspects of treatment that I still need to work hard on before the end of fieldwork. One of my biggest challenges is time management: ensuring that there is enough time allocated to direct treatment, record-keeping and doing the necessary follow-up with other health care professionals.

Often, I find that I spend hours of time with the client only to realise that I have just a few minutes to document my findings in a logical manner within the patient file before having to rush down to catch the bus back to campus.

I still have some way to go, but over the past few weeks, my records have improved from the blue-ink randomly scribbled observations and assessment findings to the black-ink notes in slightly neater handwriting jotted down in an attempted SOAP pattern.

It's important that I spend sufficient time recording my treatment, so that it follows the correct sequence, is legible and gives a concise, comprehensive picture of what I accomplished with the client. Especially within an acute hospital, where patients are discharged or transferred within  a few days or weeks, it's important that whichever therapist takes over treatment from me is able to continue exactly where I left off.   

 

Another factor that I need to work on, and one that will also affect how much time I am required to spend with a particular client, is assertiveness.

It's important that I establish a balance between respecting the client's fatigue or pain, and being firm about what's expected of the client within the session so that no unnecessary time is wasted in trying to coerce the client through therapy. Within the activity session, it's important that I am clear about what constitutes acceptable standards of task completion, so that the client exerts the necessary effort.

 

Another aspect of fieldwork that requires attention is building professional links with other health care professionals working with my client, so that I can get an idea of the sort of therapy they are already receiving, and decide whether any additional referral should be made. I need to structure my schedule so that there is time to find each relevant department and make the necessary enquiries.

 

 

 

From where  I am, I can see the changes in myself from the beginning of fieldwork. As I look forward to the next few weeks of fieldwork, the horizon is bright with opportunities, and I can only hope I am able to make the best of each one.