Once I read my assigned case, I knew I was in for a challenge. My patient had a TBI d / t MVA, he also has expressive and cognition problems. I've had several experiences in handling kids with disabilities. However, I was wary of handling the geriatric population. I was scared from the start. Scared but determined.
My patient, BG, had a TBI d / t MVA, he also has expressive and cognition problems. I was disheartened at first glance. However, I was able to psych myself up. I perceived this as a challenge and this newly found motivation gave birth to several of my strong points. Two days to the night before my treatment, I've prepared powerpoint presentations loaded with relevant images for both cognitive and psychomotor my objectives. I've strategised for the best possible way to teach, including the provision of cues, rest schedules and other techniques. But of course, nobody can ever be prepared for the real thing.
ver and established rapport. I found out that she will be leaving BG's family this upcoming Holy Week so I asked her to take notes of my lectures and self stretching exercises; I asked her to convey the information to BG's wife. The caregiver complied well. During the session, I was also able to establish rapport with the patient. Both BG and his caregiver apt paid attention to the lecture. The caregiver also took down notes as instructed. Also, when asked if he understood the topic, BG nodded his head. The lecture was concise, straight to the point and loaded with visual cues as appropriate to BG's condition. I've also had a steady tone of voice and smooth cadence in speaking, these also facilitated the smooth learning experience.
My weak points lie in the teaching of self stretching exercises itself. Initially, I was not able to gauge the level of cues needed to be given to BG. Since he has comprehension problems, he also was not able to follow immediately and must be taught patiently. Also, I've learned that one must not be a perfectionist in the field. The patient had 80% of the forms correctly, however, I wanted 100%. When I gave him feedback, he became discouraged. So I opted to sacrifice the 20%. Better than 80% of the patients not perform the self stretching techniques at all. I had the most difficulty in getting the patient's reaction. At the start of the activity, I established that once he feels a stretching sensation, he should raise his right hand. This did not follow through in the actual performance of the techniques. I also consistently asked if he feels okay, and he nodded. I found out after a round of exercises that these nods were not reliable. There were times that he was in mild pain, it was apparent after each technique. At the end, I decided not to push through with the last self stretching techniques since it was too difficult for him. The conclusion of the activity was also a bit sloppy because there was a bit of a hurry for me to finish. There were some good points here as well, I've lowered the intensity of the activity if the patient was not able to perform well. I've also terminated the activity if needed. Professionalism was also maintained during the activity. I've seen the patient frustrated easily, it would not do well if we were both frustrated so I kept my calm during teaching. I've also provided tactile cues as necessary and also encouragement in order for the patient to do a return demonstration on his own.
After the session, I had a debriefing in the CS room. Unknowingly, I've been frustrated during the activity but it was pent up. I did not have untoward feelings to the patient or the caregiver, in fact, I felt that I just gave an 'okay' performance. I was frustrated because I did not gave them the best. Fortunately, my proctor highlighted some of my good points so that uplifted my spirits a little. I could have demonstrated first while the patient was seated. I could have provided cues systematically. I could have gauged the patient's reactions better by tactile cues. I could have provided two exercises instead of three. I could have prepared for evaluation of adverse reactions, in this case, the visual analog pain scale or the Wong Baker's pain scale. I could have provided ample rest periods. I could have been better.
And I promise to be better. I was disheartened but I will not give up. I will treat this as a learning experience, never to repeat the same mistakes and bank on my strong points. I believe I am not ready to be a teacher. But who is ever ready? I will become ready once I'm in the field. And when I meet BG again, I swear I'll make him smile at me.