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Clinical Integration Discussion

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Padlet #1 Pain Medication and Drugs used by Patients - 

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Padlet #1 Pain Medication and Drugs used by Patients - 

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I had an experience where I was speaking with a clinic tutor regarding a patient that had come in smelling of cannabis. The questions had to be asked of how long prior to arriving did they inhale this drug and if they were smoking  or taking any other drugs as well. The patient responded that he was doing cannabis for recreational use and he had smoke it not long ago, then the student practioner asked the patient to leave for reschedule for today as this was a contraindication to treatment (C1 - 1.7)The tutor explained that when some patients ingest drugs may affect their decision making process therefore they are not safe to treat.    I understood that depending on alcohol, smoking or drugs such as weed, canabis etc., affects the quality of our treatment and the patient is putting themselves in danger if they don't tell what exactly they are taking. I thought about morphine patches and how they give pain relief, but my question was when we apply a mobilisation technique how do I know if I am applying too much pressure, as the patient's pain threshold is not accurate therefore theoretically I could be actually harming the patient (C4). I analysed the fact that patients on long term pain relievers or have chronic pain should have an accurate sense or perception of their pain threshold. I came to realise in the future when taking a patients case history I should ask them what pain medication they are taking in order to treat them properly and accurately however this is also on the basis that the patient has enough trust in me to report such a thing. To act upon this I should make a list common pain relieving medication and their uses (C2).

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Padlet #2 Case-History Taking and Language Barriers

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Padlet #2 Case-History Taking and Language Barriers

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At clinic I witnessed a conversation between a tutor and a student osteopath, they were speaking about how the student had taken the case history. He hadn't been able to write an accurate report due to a lack of information and this is because of the language barrier. The patient spoke very little English making it difficult to record this cause the student to take longer than usual in the initial consultation (C2) . In the follow up sessions it was noticed that due to the lack communication the student was finding it difficult to accurately treat due to difference of language. The tutor advised that despite said language barriers, we as osteopaths should try our best to still get our questions answered because it is important to understand the whole picture . It is natural at every session to follow up or you might end up missing important bits of information. I can empathise with the difficulty the student faced however I think you should still push the patients to clarify the truth as this affects the quality of performance that you can provide. Some ways to solve this is to ask the patient to bring someone else with them to translate therefore gapping the language barrier. However I realised that there can be multiple problems with doing so as the translator may not always accurately represent what the patient is trying to convey and if the patient might also omit information due to uncomfortability if some sensitive subjects are mentioned. I have heard in GP practices or hospitals use translators over the phone so perhaps this can be implemented if needed. (A2).

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Padlet #3  The Mind Affects the Body and Vice Versa

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Padlet #3  The Mind Affects the Body and Vice Versa

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At clinic today I observed a middle aged woman who had patellar femoral syndrome and she found it difficult to kneel, lunge and take the stairs. This affected her hobby of lawn bowling and I found that she was especially afraid of the stairs. The student practitioner had already helped her to the best of his ability and decided to deal with her trauma in a different way(B4). Through encouragement and prove to herself that she could go down the stairs (A5, A3). her pain perception had a lot to do with her emotional trauma and as she was conversing she started to cry. After this session she regained her confidence to go down the stairs and realised that in fact it was herself and her mind that was causing the pain in her knee. Encourage the patient nourishing their mental health is also an important aspect when treating a patient with wholistic approach. The emotional and physical aspects of the body have an interrelationship and I think this will always be true as many conditions manifest as physical problems on the body for example insomnia, depression, anorexia and anxiety. To take this into consideration in the future, when working on the patient take time if they are willing to talk about themselves and their concerns.

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Time passes quickly therefore get a watch

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Time passes quickly therefore get a watch

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A student practitioner was mentioning how to manage time when working on a patient as often you can lose track of it when you are too focused. She recommended keeping a watch instead of a phone at hand as it would be insensitive and unprofessional to bring a phone in unless you are using it to explain using a picture or diagram. Therefore I must get a watch in the future to keep everything in order. Often I feel that 40 minutes is not enough time to treat a patient.

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Padlet #4 How to Prioritise Patient Treatment

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Padlet #4 How to Prioritise Patient Treatment

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At clinic today, a patient came in with a new presenting complaint. Previously the patient had a shoulder and a hip long-term hip problem. They came in with a knee problem and for me a dilemmic problem occurred.. What problem would I treat and in what order? Should I treat the recent problem if it is too painful to give the patient short term relieving pain or should I work on the long term chronic problem. When treating a patient I comprehend the significance in taking into my professional opinion, the body's opinion of what it needs and what the patient thinks they need. I believe in a wholistic approach, so no one's opinion can be prevalent and I perceive that a mixed approach is a good way. To make a plan that targets what the body needs and what the patient's wishes so that they will have an easier daily life. Therefore you can solve this problem, through spending some time on the current injury and then focus most of the time on the other problems. This plan may not work for someone else, therefore a tailored individual treatment plan is a good idea when approaching any patient.