Daily Dairy - Week 2

Week 2 (19 - 23 April 2010)

Day 1

7:30 - 10:00

I assessed and treated two outpatients. I'm still struggling with the language barrier and base my assessments on my findings of the physical examination and palpation. The physiotherapists and physiotherapy assistants are not always available to assist as a translator.

We (Rosy, Jocomie and I) made arrangements with the chief physiotherapist at Elim and the transport department to accompany others during the community outreach program tommorrow. There may not be space in the car for all three of us to go which is unfortunate as I feel we will benefit greatly from this experience

10:00 - 10:30

Breakfast

10:30 - 13:00

I assessed and treated more outpatients.

13:00 - 14:00

Lunch

14:00 - 16:30

I went to see my ward patients (new surgical ward) and made sure they were compliant to there exercise program (previously given). My one patient has a large leg length discrepancy due to poor management (skin traction) of a midshaft femur fracture. He is currently awaiting surgery at Polokwane.

I was fortunate enough to observe and assist foot strapping of a 3 day old baby who I beleive has signs of hypermobility syndrome. The Occupational therapists (OT)could apparently do nothing to assist. I am glad that early intervention is taking place but I feel that strapping the child once a week is ineffective and I still hope that the OT's may help and supply the baby with a more permanent splint.

I further spent my day assessing and treating outpatient's.

Day 2

7:30 - 13:00

I waited for the dietician to call us so that we could leave together to do community outreach. We (Rosy, Jacomie and I) went to three clinics, namely; Vleifontein, Nthabalala and Manyima accompanying a dietician, speech therapist, occupatienal therapist, optomotrist and one of the physiotherapy assistants.
All three of us treated each patient together as there was insufficient space to allow us to do individual treatments. I thought that the treatments were not as effective as they could be due a shortage of resources. We had a total of ten patients to see, of which eight had OA and two had CVA. I can now see why the previous Medunsa students felt the need to give health talks and exercise programs for OA. I feel that we need to continue their efforts as it can greatly benefit the community.

13:00 - 14:00

Lunch

14:00 - 16:30

I went to see my two ward patients in the new surgical ward. We had received another patient referral. I approached the patient to begin my assessment of her and she refused my help and was rather rude. I was not sure as to why she did not want to get physiotherapy as I could not understand a word that she was saying. I later found out that she was a traditional healer. So I proceeded to write in her file that she was unco-operative and refused treatment, when she became upset and tried to take the file away. It was a funny situation. (see spar notes still to be blogged). Jacomie is currently treating the patient.

When we got back to the department we arranged to speak to Mrs Louw (chief physiotherapist) concerning the history of the hospital as we thought it would be interesting to have background knowledge of the hospital. She tried to answer some of our questions and referred us to relevant people who could be more helpful in answering some of our questions. I will add this to my blog as soon as I have completed the task.

Day 3

7:30 - 10:00

I spent the day treating outpatients at the physiotherapy department.
I saw a few CP children as there was a cp clinic today. I've realised that I lack experience when treating CP children. Fortunately Mrs Louw was willing to help me with any problems that I encountered. I assisted her with the CP patients that came for the CP clinic today. This was rather benificial and I learnt a lot in the process. I learnt that there is a problem with the way the interdisciplinary team operates. Each patient has to go to each of the relevant departments and information is not shared appropiately.

10:00 - 10:30

Breakfast

10:30 - 13:00

I saw more OPD patients.

13:00 - 16:30

I went to see our my ward patients again and encounted a problem with one of my patients. He was suppose to go to Polokwane and did not go apparently due to transport problems. He was very dicouraged and asked me to find out if it would be possible to tranfer him to another hospital as he felt that it would take long to get another chance to get proper treatment. I told him I'd get back to him and speak to the relevant persons to try and help his situation. It is his right to have access to another hospital and I feel that he will have a permanant deformity if he is not operated on soon.

Day 4

7:30 - 10:00

Rosy, Jacomie and I worked on our health talk. We managed to plan the health talk and began developing a questionnaire for our screening.

10:30 - 10:30

Breakfast

10:30 - 13:00

We then, using our own transport, went to visit our home patients (Watervaal community). My patient (Used in the case report) had another CVA two hours prior to my arrival. Please see Spar notes for further details (22/04/2010).

13:00 - 14:00

Lunch

14:00 - 16:30

I saw my ward patients again who seem to be compliant with their exercise program.

After seeing my ward patients I went to see my home visit patient who was admitted to the Gynaecology ward (shortage of beds).She was sedated and did not recognise me. I will see her tommorrow to see how she is doing.

Day 5

7:30 - 10:00

I spent the morning working on our health talk

10:00 - 10:30

Breakfast

10:30 - 13:00

I visited my ward patients and assisted Jacomie with an elderly patient that she was seen who had an above knee amputation (AKA).
He has pressure sores on his left buttock and had general body weakness which I beleive has developed as a complication of long bed rest due to delayed surgical intervention. This is unfortunetly the situation at Elim hospital.