Have you Ever Harmed a Patient?
I read a post today that astounded me. As the father of a child who was born with an orthopedic issue -- developmental dysplasia of the hips, or DDH -- I still monitor a popular list serve devoted to the condition. Although DDH is usually correctible and my daughter is now fine, I like to keep up with the subject, listen to what other parents are dealing with, and offer advice and resources when I can.
(For those interested, I charted our family's journey in a 2005 cover story here.)
This post came across the list serve a few days ago:
Ashlyn broke her femur today at physical therapy. Ashlyn was trying to get away, the physical therapist yanked her back as Ashlyn twisted. Then Ashlyn started screaming like never before. We took her to the ER where they took X-rays and diagnosed her with a broken left femur. Her left leg is her leg that was operated on in February.
Luckily, the break is minor (well as minor as a femur break can be) so she doesn't need surgery or a spica. Although it is a possibility if it doesn't heal properly. She has a cast from the top of her left thigh down to her toes. It will remain on for 4 to 6 weeks. I have to call her ortho in the morning to make an appointment to follow up with him.
I'm beside myself and need help with ideas for what to dress her in. Do you think baggy pants will work? The cast is just on one leg.
Also I'm concerned about all the X-rays. She's already had a lot and tonight they took 9. They wanted to check her entire leg in various positions to be on the safe side. I know the X-rays are needed, but its worrying me.
So many questions came to my mind after reading this. Obviously it's an exceptionally rare occurrence. I've been covering the PT and rehab fields for over 10 years and have never heard of an instance even close to this.
But it raised the question in my mind -- Have you (or a colleague) ever caused serious harm to a client? Have you heard second-hand of any similar stories? What was the result?
What's the best way to proceed if something like this happens in a session? Is it taught in PT school what steps to follow if you're involved in a situation like this?
It also brings up a point about patient communication. Does it ever pose a risk if a patient can't verbalize whether something is hurting them, or if they're being pushed too far? Does this complicate the treatment of older patients, very young children, those with cognitive difficulty, people with sensory problems who might act aggressively or impulsively, clients who don't speak English, or patients with developmental disabilities that hamper their ability to communicate? How do you compensate?
And finally, for the PTs out there who also happen to be parents, what would you have done if this happened to your child? I'm looking forward to your thoughts.