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Toni Talks about PT Today

Patience

Published September 7, 2010 8:40 AM by Toni Patt

I don't think I'm very patient. Often I'll be working with a patient and be biting my tongue or forcing myself to sit still. The funny thing is I'm frequently complimented on how patient I am with my patients. Obviously it's a good thing no one can see what's going on in my head. What is patience anyway?

To be patient is having the ability to take the time to do something correctly. To let situations play out around me without letting myself be affected and still accomplishing my goal. Some people define patience as the ability to sit quietly while a patient focuses on everything but therapy. I'm not sure that is patience so much as calm under fire. Patience is the ability to explain the same thing over and over again without getting frustrated. It is the ability to keep trying to explain something until you hit on the right words.

By those definitions I would be considered patient. I've learned how to do all those things. Patience isn't a given. It is learned. The first lesson is that things never go quickly in therapy. The second is you will be repeating yourself over and over again. I've worked with people who have learned to do those things but would never be called patient. They've learned the actions but not the demeanor.

Patience is not the ability to sit quietly when a patient interrupts therapy for a phone call. It's one thing to be waiting for a specific call. It's another to stop and chat therapy time away. Cell phones now come with caller ID. It's no longer necessary to answer to see who is calling. Patience is not waiting while a patient visits with grandchildren. I had one woman who refused therapy whenever one of her grandchildren wanted to sit in her lap. My popularity took a dive when I banished the children from the room during therapy.

Patience does not go well with manipulation. Manipulative patients take patience as a signal to keep it up. That behavior must be stopped immediately. Those people have been doing it for years. Reasoning with them won't work. The same is true of bad behavior. Unless you're dealing with a TBI or someone severely demented or confused there is no excuse for bad behavior. I am not a maid or servant. Being ordered around is not part of my job description.

Maybe I'm more patient than I think. I don't put up with those examples of lack of patience. But I can sit with aphasic patients for 10 minutes trying to figure what they want to say. I have spent 30 minutes working on standing with someone who just isn't getting it, only to come back the next day and try it again. Sometimes improvement is measured in inches, not feet. It can take a long time to get those inches.

Impatience may really be pressure to meet productivity standards. Patience takes time. Meeting productivity standards can put time at a premium. Spending more time with one patient means eventually another patient will have less time. It's much harder to be patient when you're overloaded with patients and do paperwork at lunch. I wonder what would happen if less emphasis was put on productivity and more on quality. That's going to be a problem when reimbursement takes patient satisfaction into account.

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