Patience with Patients

My first prac this semester was in Neurosurgery. I had a really lovely patient who had been in a motor cycle accident and had severe dyspraxia and dysphasia. He had voluntary control of his upper and lower limbs, head and trunk spontaneously but not on command and was very irratic with movement when given instructions (eg rolling over, would roll away from you right to the edge of the bed). The first time I saw this patient I became really inpatient because he wasn't following what I wanted him to do and wouldn't stay in positions that I new he was capable of. I had a chat to my supervisor about my patient and that I wasn't getting alot done in the session because of his dysphasia and dyspraxia. She gave me a few hints about what to do, but generally made me go away and think about it and change the structure of my treatment sessions for this patient.
The second time I saw him was for my final placement assessment. I decided that the session would rely on what the patient was willing to do, so I went into the treatment with an open mind of what to do. I didn't plan my session rather had ideas of what I could do during the treatment (position patient in upright position to work on his core stability, strengthening work of his glutes and quads, bed mobility and posture).
Firstly I started in supine and facilitated his lower limbs so that he was in a bridging position. He didn't last to long in this position and returned to supine. I then facilitated him into sidelying which he was capable of but again got tired of it and moved himself into prone. I thought this would be a good position to work on his posture and give his back extensor a stretch. He sustained this position well. From here I facilitated him into 4 pt by getting him on his elbows and tucking is leg underneath him, which I was very suprised of doing! I treated him in this position, but really wanted to get him up into 2 pt to stretch his hip extensors and calves as well as strengthening his quads. I got him into 2 pt from 4pt by crawling his hands up the vertical cage at the top of the bed (he also got down in this way also). In 2 pt I facilitated the pt to do some squats by using simple words and physical prompts.

In the end the treatment went really well purely because I did not have any expectations of how the treatment would pan out. I treated the patient in positions that he wanted to go in, so the session was more interesting for him. I also adjusted my handling and improvised how to get the patient into positions rather than using the usual steps (eg to get into 4pt, 2pt etc)

I always thought I had a lot of patience with most things, but this patient made me realise how important patience is when dealing with people and sometimes you need more with certain patients. It also made me realise how much improvisation you need when dealing with different patients. This was such a good experience and really challenged my handling and communication skills.