Yesterday I had some work experience in the physiotherapy department of Darent Valley Hospital in which I shadowed some physiotherapists and observed what they were doing. I really enjoyed this experience and I learned a lot from it. I went to a number of different departments and gained a better understanding of the role of doctors as well as physiotherapists in these departments.
Firstly, a senior physiotherapist explained to me and 2 other work experience students the main roles of physiotherapists and of what was going to happen throughout the day. He also showed us some x-rays of some surgery patients before and after surgery and then told us about the ways damaged/fractured bones can be repaired and about different joint replacements (e.g. hip replacement). I then went to the orthopaedics department, where I saw the physiotherapists talking to patients who have had knee/hip/other joint replacements in the last few days and helping these patients recover after their surgery. The physiotherapists did this by first checking if the patient does not have any other problems (e.g. low/high blood pressure) since the surgery and then telling them to do some exercises daily/regularly as part of the patient’s rehabilitation programme to strengthen their muscles and reduce any pain/swelling. As well as this, the patients were also told why it was important to do the exercises and what was going to happen next, which is important as the patients need to be aware of their health problems. Also, by doing this the patients would be more likely to do the exercises and cooperate with the physiotherapists as they would understand the point of doing their exercises and of following the physiotherapists’ instructions. Prior to this, the patient’s doctor(s) would have done some tests and talked to the patient to check if the patient has any other conditions that the physiotherapists should be aware of.
Next, I went around the A&E department and had a look at the different areas in A&E (Resus/ resuscitation area, minor and major injuries units, etc.). As I had expected, this department was very busy and I was told that it is sometimes hard to see 95% of all A&E patients within 4 hours as there are a large number of patients coming into A&E at once and as 4 hours is a short amount of time to see all of these patients. Afterwards, I went into the short stay unit, where patients with minor injuries were being looked after until they were well enough to go home. The physiotherapist then did an assessment on a patient to see if they can walk and do basic tasks such as getting on a bed and going up and down stairs without any problems. This was done to see if the patient is able to do everything independently and to prevent further problems when they are sent home. If a patient has had problems when cooking in the past that are putting them at risk, a kitchen assessment is also done to make sure that they can cook and use kitchen equipment (e.g. kettles) without putting themselves and others in danger. Social services referrals and referrals for problems such as falling are also sent when necessary to prevent further problems and so that the patient can get more help and support.
After going around A&E, I went to the physiotherapy outpatients department, where patients who needed treatment but did not have to stay overnight were being treated. The problems the patients had here were similar to the problems the patients in the orthopaedics department had. When the physiotherapist was with the first patient, he first discussed the patient’s problems and what happened during the previous appointment. He then assessed the mobility of the patient by telling him to do some exercises to see what had improved and the areas where the patient was still having pain in. When it came to the second patient, he also discussed the problem she had and what had happened during the previous appointment but he also knew that what he did for her would not make a difference in her health. This was because the cause of her leg pain makes it very hard to stop the pain, which shows that physiotherapists and even doctors are not always able to do something to treat a condition due to a lack of knowledge about it and that as a doctor I would have to work within my limits.
Lastly, I saw a CT scan of a patient’s brain before going to see him in the stroke ward. I noticed that when the physiotherapist was interacting with this patient she was patient and maintained a soft tone when talking to him despite the fact that he could not respond properly at times and that there was not much improvement in the movement of certain areas. The patient could say yes and no and was also able to respond using gestures and movements but he was unable to say anything when he wanted to speak. This can make it harder for other healthcare staff (e.g. nurses and doctors) as well as physiotherapists when interacting with patients but in these situations it is important to remain calm and not rush the patient/force them to do certain things.
Throughout the day, I came across a range of patients from patients with a knee replacement to patients with strokes that affected their mobility on one side of their bodies and with previous infections. Every patient was unique and their situations were all different from one another. By seeing the physiotherapists and other medical staff interacting with the patients I realised that it is important that the staff always spoke with the patients in a gentle manner and that they explained what was going on in terms of the patients’ care/treatment to the patients so that the staff are trusted and so that the relationship between the staff and patients is always good. This is also important for doctors as a doctor-patient relationship cannot exist if the patient does not trust the doctor and doesn’t believe that the doctor can treat their condition or at least make a significant improvement in their health.
Overall, I thoroughly enjoyed this work experience and I now have a better understanding of how different departments of the hospital were run as well as a better understanding of the contribution of physiotherapists in the multidisciplinary team of a hospital.