Reflection Essential Chiropractic: 4/11/2020

Reflection: 4/11/2020                                           Hours: 7

 What happened:

 Today I saw four patients in clinic, one for neck and shoulder pain, one with a suspected hamstring strain, and two for soft tissue massage.

One case which was particularly interesting was a lady who previously came in to see another therapist but due to a lack of communication between the therapist and patient, they were left feeling unhappy and that their aims were not met. Consequently, the patient was booked in with me to address her concerns; this made me really aware of the importance of communication and asking the patient what their goals for treatment are and discussing how this will be met.

A big proportion of this appointment was taken up with the assessment, the subjective assessment took a long time, to ensure myself and the patient were clear on how treatment would progress in the future. We discussed her short term aims which were to be pain free in her shoulder, to achieve full range of motion in her shoulder as soon as possible and in turn to improve her quality of sleep. We discussed these aims and how they would be achieved such as working towards reducing pain in the first week and introducing range of motion exercises immediately and then progressing to work on reaching end range and beginning to normalise strength.

The whole appointment I made sure I kept checking with the patient that she was happy with what we had decided and made sure I answered any questions.

What I was thinking and feeling and what was good or bad:

I was feeling nervous to begin with as I felt a lot of pressure after her not being happy with a previous therapist. However, once I addressed what the issue was and spoke about her concerns, I felt much more confident and relaxed about how I would address this case.

It made me realise that it is important to speak to patients about what didn’t work with their previous appointments or therapists to make sure the same mistakes aren’t made, as one treatment plan doesn’t work for all patients and it is important to work with the patient to improve their adherence (Brewer et al., 2000; Scherzer et al., 2001).

What else I could have done/areas for improvement:

Be careful when patients are complaining about other clinicians that they don’t try and ask my opinion and that I remain neutral the entire time.

 Action plan:

  • Continue working on assessments (subjective and objective assessments).
  • Improve my confidence by pushing myself out of my comfort zone and trying new techniques and not being afraid of awkward conversations with patients.

References:

 Brewer, B., Van Raalte, J., Cornelius, A., Petitpas, A., Sklar, J., Pohlman, M., Krushell, R., & Ditmar, T. (2000). psychological factors, rehabilitation adherence and rehabilitation outcomes after anterior cruciate ligament reconstruction. Rehabiliation Psychology, 45(1), 20–37.

Scherzer, C. ., Brewer, B. ., Cornelius, A. ., Van Raalte, J. ., Petitpas, A. ., Sklar, J. ., & Ditmar, T. . (2001). Psychological skills and adherence to rehabilitation after reconstruction of the anterior cruciate ligament. Journal of Sport Rehabilitation, 10(3), 165–172.

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