Patients Refusing Treatment

During my placement in orthopaedic inpatients I experienced two patents who refused physio treatment. The first patient was an ex member of the bikie gang the coffin cheaters, who was admitted after an osteomyelitis infection and mal-union (which he blamed physio for). My supervisor and I tried to persuade this patient to do some form of exercise, but he was reluctant and told us that physio would only make things worse. We tried to explain to him that the doctors had told us to give him some exercises and that the aim of physio was to prevent further complications as well as enable him to return to function as quickly as possible. The patient still refused, commenting that he would perform his own exercises.


The second patient was an elderly Italian man who did not speak much English. He had been admitted after a fall which resulted in a hip fracture requiring a dynamic hip screw. My supervisor and I tried to persuade him to ambulate and perform some exercises. The patient refused, commenting that he would not get out of bed for 10 days. We then had a translator and the medical team come in to try and persuade him to ambulate with us, but he still refused and only agreed to perform some ankle pumps and deep breathing exercises while lying in bed.

Upon reflecting on these two incidents I was a little angry that both of these patients seemed to hold physio in such low regard, but further education on the benefits of physio with both of these patients proved unbeneficial. On further reflection I realised that we can only educate a patient to the best of our ability regarding the benefits of physio and mobilization but in the end it is up to the individual whether they decide to take the information on board. These situations have made me realise that we cannot change a patients mind but can only aim to guide them to the best treatment available and in the end the decision is theirs.