I have always known from our lectures that you sometimes need to push a patient to do things that they often don't want to for their own benefit, but it is important to not let a paitnet work harder than they are able as this will proabably set them back phsychologically as they will be unable to complete the task! It's one thing to know something and another to experience it.
On my cardio placement I had a patient who had been bed ridden for 5-6days and had become quite deconditioned. She got up on the 7th day and walked on the spot for a couple of mins. The next day she walked 10m. On the following day all I had wanted to accomplish was a walk a bit further than the 10m of the previous day. She had other idea's however and pushed herself to around 40m, the last 3m of this were hard going for her and she became extremely SOB and lost her confidence completely. I then spent the next 10-15mins reassuring the patient that she woudl eventually be able to walk that distance and even further again!
In this specific case there was nothing I could have done to prevent this lady's loss of confidence as I had attempted to get her to turn back and return to her room several times but she was determined to walk the further distance. It just made me think about other exs prescriptions we give patients and how important it is to get the prescription just right!
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I have also come across quite a few stubborn patients on my cardiopulmonary placement that have decided that they want to walk further. But what I've learnt is that you have to have confidence as your role as a physio and put your foot down to your patient over working. Although it’s great to finally have a motivated patient they can really overdo it and where hospitalised patients are concerned you have to realise they're in hospital for a reason. I recon explaining this to the patient however is a handy tool that I hope I will learn one day haha.
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