Time for Discharge
I'm starting to realize that laying the groundwork for discharge could be one of the most important pieces of communication that a PT (student or clinician) tackles with her patients. Though I haven't run into it yet, I can foresee some tricky discharges in the future with patients and their families who would prefer to continue with therapy indefinitely.
This is a topic that my clinical instructor and I have recently visited. She gave me some very valuable advice that has to do with "planning ahead" to ensure that both patients and their families understand when discharge will take place. She said that from the beginning, it can be helpful to emphasize that we need to see objective progress in order to justify the continuation of therapy.
Part of the conversation has to do with explaining outcome measures, their meaning, and their application to a patient's recovery. The other essential piece of communication has to do with measuring those outcomes frequently and providing continual input to the patients and their families regarding progress or, in some cases, plateau.
Unfortunately, I currently have two patients with whom I haven't applied this advice and I anticipate some difficult conversations in the future. That being said, I've tried my best to start incorporating these principles into our sessions (ever so elegantly). It's a great lesson to learn as a student, and very valuable piece of advice to take forward in my career.