Beginning of week 2

Week 2 is so much better than week 1. I find that i feel like i've got my bearings and have gotten used to the hospital system, reading and writing in patient notes, and talking and building rapport with patients just comes that little bit easier, and hopefully will continue to with more practise.

On monday Jesse and I were together with my supervisor, this was good as we both got to see how much we had learnt. Jesse's supervisor had also taught him to do vibes, so today my supervisor taught me how to do them which was really great!

I got to see more patients by myself on monday, which helps build my confidence as my supervisor believes that i can do it. I mainly just ran through the exercises I had previously given patients and ambulated them, which i found i did well. Most of my patients are making good recoveries, with 3 to be discharged over the next couple of days.

On monday I also got to run through a 6mwt with jesse and my supervisor stood by and watched. This was really helpful as it allowed me to practice incase we get this in the gero prac!!

Today I also completed 2 subjective and objective Ax of patients. This was interesting, as both these patients were what i would consider difficult patients.

One of the patients was very confused, and we think it was because of his UTI. He was okay to perform a subjective Ax on him, but he did say things that were a bit weird. So my supervisor asked me to call his next of kin just to get an accurate history. I found this very daunting, but thankfully the next of kin was very helpful and i was able to saught a few things out. Usually i'm really bad on the phone, but thought i stepped up to the ocassion! The pt was okay to perform an objective Ax on, but when Ax his ambulation, he was very confused, thinking his relatives had redone the house and put all these beds in, thinkin the hosiptal was his house. My supervisor just kept agreeing with him rarely stating theres your bed in the hospital with emphasis on hospital, but didn't persist with trying to correct him to where he was, which i found was weird but i discussed it with her after. She said she sometimes just mostly agrees with the patient if she thinks they can become agitated, distressed or very angry if you're disagreeing with what their brain is telling them is right. Interesting, think i will have to get better at ready people to make the right decision in that situation! My supervisor also thought that the confusion was due to the UTI and therefore should pass, another reason why she didn't want to risk him getting upset, and why she didn't think it was necessary to do a MMSE, but will if he continues like this.

I personally think my subjective Ax is getting much better as my questions are more grouped together and not so jumbled with different topics, and they ran well, even though i did them on some difficult patients. In that situation I think I would tried to get him to understand where he was, as he seemed a little distressed in the environment, as he thought his house had been changed.