During my paediatric placement I felt right at home due to my ability to pretty much let go and be a kid with the patient and make everything a game where they don’t realise they're getting treated. This is great for compliance but I soon found out you had to be careful how 'young' you become and how you treat the kids due to their condition/past.
One of the kids had a very nasty past history so not only was I playing the friendly everything’s a game physio but I was treating her differently, more gently without even realising it. She therefore was getting a little bit carried away and suddenly I had lost control of what she did. She would just laugh and think it was a game when I tried to get her to do anything a certain way as she just didn’t take me seriously. When I tried to use the stern lowered tone that works a treat on most kids she got upset, as suddenly it wasn’t all a game. This meant the compliance level dropped and I got a kid doing the arms crossed hmph that I'm sure anyone with younger siblings or nieces or nephews have seen.
I carried on the session with the other child that was there and decided to talk to the principal of the special Ed department who happened to be one of the foster carers for this child. Straight away she was giving me tips on being firm from the start and not letting her past get in the way. I had to look at her as a child from the start and not let her push the boundaries even if I did feel extremely sorry for her. Whilst I could make things into a game for compliance, rules had to be set from the start. ‘You can do this or this’ (make them believe they have the choice) or set out a layout of the treatment at the start with them and stick to it. I was also told to maybe keep the sessions shorter as the child’s attention span was not good and was another thing that was being worked on in her behaviour modification classes.
The next week when I came back I laid down the rules from the start when she was all happy to see me. I let her chose from two games at each station (balance, strength, core posture) ‘as long as she listened to me as to when each finished and the order’ and that was enough to keep her happy. I still joined in and kept most of the exercises as games (as when you have an excitable kid you have to keep them occupied and keeps the session flowing). But I changed my approach to the treatment and child and therefore got the compliance and she stopped pushing the boundaries. I may not still be on placement but I do swim teaching and still use this way of dealing with any new kid. Be the nice physio but don’t let them push your boundaries, even one inch.
Subscribe to:
Post Comments (Atom)
1 comment:
I came across the same problem whilst on my paeds prac. i was just not firm enough with the children and they walked all over me at first. My supervisor gave me a few tips and once I achieved the balance between work and play things got easier. Another good trick is to use th fun stuff as rewards :) even tho they might not know that they are working at the same time!!
Post a Comment