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Journey of a DPT Student

First Crying Patient

Published October 24, 2011 3:49 PM by Lauren Rosso

Last week in clinic, I had my first experience with a crying patient. She had been dealing with low-back pain for a few months when she finally decided to see the doctor. Turns out she had an L4-L5 herniated disc. I guess her interaction with the doctor wasn't very helpful, so when she came to PT, it was the first time anyone had actually sat down with her to explain the prognosis.

The patient stocks shelves at a local grocery store, so the physical demands of her job have obviously left her unable to work. My CI explained to her that she probably wouldn't be getting back to work by the end of the month, which I don't think she was expecting. She didn't start crying then, but I could tell that she was really upset.

I took her through her exercise program, and in the middle she completely broke down. I felt helpless. I haven't learned about herniated discs or their recovery time yet, and I felt like I had absolutely nothing to offer her. I honestly didn't feel comfortable telling her anything because I was afraid that I would say something that was completely unrealistic. At the same time, I felt so bad for her. I ended up just letting her talk about it, and chimed in when there was something I could confidently give her input about.

Does this type of situation get any easier? Or even when you do have the knowledge to explain a prognosis, is it still difficult to work with someone who is this upset?

3 comments

Hi Lauren, I am a first year DPT student and I had the same thing happen to me when I was doing my observations to get into PT school! I know exactly how you felt. The pt. was recovering from a right CVA and was frustrated with the inability to be independent.  I had been shadowing the PT with this patient once a week for a few months so I had seen this pt. a lot and one day he just broke down. I really liked the way the therapist handled it.  She let him explain why he was upset and how frustrating the whole process of recovery was for him.  Then, she told him that he was entitled to be frustrated and scared and that these feelings were understandable and then explained how important PT is for him to regain his independence.  Afterwards, she told me that these things happen but it does get easier once the patient starts to see real improvement!

Kristin

Kristin March 13, 2013 11:51 AM

I think this is a very relevant topic in the clinical environment.  In our curriculum, we are learning about different psychosocial aspects of behavior and all the different outside circumstances that can affect the patient in the clinic.  None of the specific verbal instructions can prepare us for one on one situations in the clinic like this though.  I think as we have more and more experiences dealing with patients that have difficult circumstances and emotional experiences, we will become more comfortable and adept at handling them.  I feel that most students going into the PT profession are doing so at least partly because of their care and compassion for other people.  While PT is a direct physical way to help them, the emotional and untangible aspect can not be ignored. Great question to address!

Alison January 12, 2012 12:35 PM

Hi Lauren, I love your perspective- since I recently went through many topics you address (I was a SPTA, though). During one of my last clinicals I worked with a woman who was in a tremendous amount of back pain and suffering through depression. Most visits entailed some tears as the exam room was the one place she felt she could shed her guard and vent. I'm by no means an expert but I have a feeling as therapists we have to embrace that title completely. Generally we are addressing the physical but many times we are addressing mental as well. Working in a SNF, I can spend 75% of my first treatment with a patient just talking about their family and interests so they feel more comfortable with me. Keep in mind we're all people- empathy and listening can be just as effective as SAQs and E-stim. Experience is your best textbook for this situation- because every patient is different and you'll learn what works for you. Good luck- it sounds like you're going to make a great therapist!

Allison October 26, 2011 10:14 AM

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