Therapeutic Use of Self

It's amazing seeing someone apply the things you learn in class in real life. S, my supervisor described the first patient (Mr. G.) we were going to see as a "grumpy old man." This was an accurate description of his general temperament. He argued a lot and made several disparaging remarks to S and about the medical staff in general. She was trying to get him to get up out of bed, do some LB dressing and then get his shoes on in preparation for PT to take him for a walk. She told me before hand that she knew he was from up north (she was too) and that she knew if she didn't push Mr. G, he would not do anything for her. I know if I had been the therapist, he would have had me running and I would have just put down "patient refused treatment" in my note. Instead, S kept herself at eye level with him and calmly but firmly corrected his incorrect statements (nursing was responsible for his PICC lines) and clearly stated to him the behaviors he was exhibiting (yelling, blaming her for things she was not responsible for). This did wonders to calm him down and then he was able to verbalize what was bothering him (he was having some gastric distress). Once he was calm, she thanked him for verbalizing his problems and acknowledge his discomfort. This allowed her to talk through and reason with him the necessary steps needed for him to be able to go home and like magic, he was much more cooperative. Lucky for the PTA who came in right after. He was ready and willing to go his walk. This was a great lesson in knowing the patient and how much you can push. Also, it was an invaluable reminder a patient's refusal to do therapy can be changed if the therapist knows how to use herself/himself effectively