WEEK 5

S: 75 year old male presented to hospital with severe ongoing chest pain. The patient has a past medical history of chronic obstructive pulmonary disease, angina, triple vessel disease, and hypotension. He lives in a caravan park with his wife, who is 91 years old and resistant to services or assistance. He was previously walking ~10 metres within the home with a walking stick.

T: To perform a full subjective history and appropriate treatment for the patient.

A: I asked the patient numerous relevant subjective questions regarding the patient's home living situation, smoking history, cough and sputum production, and previous level of mobility. I took the patient's relevant objective measures such as auscultation, oxygen saturation levels, blood pressure and heart rate. I then asked the patient to sit over the edge of the bed, which the patient refused. I then comprimised with the patient and positined him into high sitting, and gave the patient deep breathing exercises to perform throughout the day independently.

R: I was able to obtain a thorough subjective history from the patient, which the patient was willing to answer. However, the patient refused to sit out of bed despite me emphasising the importance. I was able to achieve an effective treatment session, however it was not optimal as the patient was refusing to participate.

E: I think overall, although the session was not the best treatment I could have done, I think I was able to at least achieve an effective treatment. The patient was refusing to participate in any physical treatment which made the session difficult, however I think I handled the situation well providing an alternative which enabled me to achieve something out of the session.

S: I consulted with my supervisor, who agreed to take a similar approach as I did in dealing with a patient that was refusing to participate in physio.