Neuro 1 The education monkey is off my back!

Earlier in the year, one of the constant difficulties I experienced relayed to my explaining and educating a patient. By and large, I was concentrating so hard to learn Ax and Rx skills that I wasn’t developing my Education and Advice skills as I should have. I dutifully worked time out to include 5 minutes at the end, explaining, educating, prescribing exercises. Problem with that was that I was always rushed for time and I wouldn’t call the best quality 5 mins ever spent. Needless to say, compliance was an issue. It frustrated me that we didn’t reap the results I wanted. It was easy to see that my approach wasn’t working.

My musculo curtin supervisor highlighted some areas for improvement: she underlined the importance of spreading the education throughout the session to reinforce it, and being creative with different tools to help you out. For one particular patient, I thought back about how I could have done a better job of educating him. I came up with the idea of drawing a diagram of a shoulder joint from a superior view, pointing out how short mms vs long weak mms affect where the HoH sits on the glenoid and how that can cause irritation and pain in the anterior structures. I’d go on to explain that we need to work on strengthening one side of the joint, and releasing the other side with stretches etc. to maintain correct centering the HoH. Maybe this will then reinforce for him the importance of his exercises. I’m excited to try this next time when I see a similar patient.

Taking this reflection on board, I went onto my neuro placement ready to impart with the pearls of wisdom. Unfortunately, I again got caught up with learning for myself. The supervisor here emphasized the importance of always leaving ONE msg/task to take away from today’s session. I think of one patient with loss of sensation and fine proprioception of the (R) forearm and hand, and neglect of that hand… I really could have done a better job of explaining the pathology to him and the importance of using his (R) hand during ADLs. I got it towards the end though! I treated a man with moderate (L) sided neglect, (L) trunk and limb weakness. My “msg” for him was along the lines of: “Your brain is playing tricks on you and isn’t allowing you to pay much attention to things that are happening on your left. You need to take it upon yourself to take your attention to the left as much as possible...”

When I reflected over this, I thought how fruitful a little insight into the pathology can be for the pt. I have observed the improvements in rapport, patient satisfaction, patient’s confidence in myself as I worked to improve this aspect of my treatment. I feel that we weren’t given enough emphasis on this at uni. OSPEs for example, didn’t include a component about giving education to the patient. But on pracs this year, it was strongly emphasized… I feel it’s an important aspect of this profession to take on.