Motivation Makes a Difference
So I am officially a rehabilitation aide! After hours of orientation and shadowing, I will pick up my first real shift by myself in a few days! In the one week that I have been at the hospital, I have been able to gain a whole new appreciation for PTs, PTAs, OTs, and OTAs and everything that they all do for patients. Having to deal with patients and their complex diseases and disorders can be stressful as is, but what if patients refuse you? I have already seen patients refuse just being taken to therapy, refuse therapy for the day, and even refuse having a gait belt on. While refusing a therapy session doesn't quite apply to me yet, refusing being taken to therapy sessions and refusing the use of gait belts does. So what do I do?
After contemplating this I came to the realization that every situation will be different. While I can not force a patient to go to their therapy sessions, I can work to do my best to convince the patient that it is in their best interest, highlighting the importance of therapy like helping to increase strength gains, decrease pain, and increase independence and quality of life. In a few days I have come to realize just how important encouragement and motivation are to patient care. Just a few seconds of one's time spent explaining why they need to go to therapy can make a difference. Also, a little encouragement and reassurance can be the difference as to whether a patient will walk 20 feet to the bathroom or around the entire unit.
Another thing that stuck out for me today was one patient's refusal to use a gait belt. One would think that a patient would be more concerned with their safety versus anything else, but I suppose some may consider it embarrassing. Now I know therapists would rather continue their therapy session without the gait belt versus not working with the patient at all, but the thought of me doing that at this stage honestly makes me feel uncomfortable. My greatest concern (like every ones) is the patient's safety followed by standard policies to help cover myself liability wise, so I looked up the policies for my facility concerning the use of gait belts during ambulation and found the following:
13. Gait belts will be used during initial gait training sessions and until the patient has demonstrated independence on appropriate surfaces.
a. Explain to the patient that the purpose of the gait belt is for his or her safety as well as the therapist's.
b. Place the belt comfortably but firmly around the patient's waist prior to having that patient ambulate.
c. During gait training, apply a steady, firm grasp on the back of the belt. However, do not interfere with patient's desired activities.
d. At the completion of the gait training session, remove the gait belt and return it to its proper storage location. Policy #3000_10605 Page 3 of 4 5/2/2008
16. General rules for safe transfer techniques:
a. Explain to the patient clearly what you are going to do and what you want him or her to do.
b. Always use a belt around the patient's waist with transfers or ambulations that require more than standby assistance.
c. Care must be taken to follow appropriate precautions for specific diagnosis.
Since I don't currently feel comfortable enough to transfer a patient without a gait belt, then I will continue to use one, and if the patient refuses then I will ask the treating therapist for their help. I would encourage other students and aides who feel the same way to do the same...it's better to be safe than sorry. Also, I think it's important for everyone to check to see if their facility has specific policies and procedures for refusals just to be safe!