I am grateful for many of the undergraduate experiences I have had thus far. Most of them have been challenging and thought-provoking. Many of them have also made me wonder how I could have handled the situation better.
Most recently I found myself in a scenario where a patient I was treating expressed to me many of his personal problems, in addition to his existing physiological problems which affected all aspects of his life. His problems were extensive and I was stunned at how, despite it all, he managed to remain positive and did his utmost to provide the best he could for his children. Despite the empathy I felt towards the patient as he spoke, and the little bit of encouragement I could give him, I wondered what I could do to help him. Were my words of encouragement enough; was there anything else I could do; should I refer him to social work or psychology – will any of that even change his situation? I had lots of questions and feelings of helplessness as I felt like I could do nothing to change his circumstances.
Physiotherapists have a lot of personal contact time with patients. According to McDermott, Ryan, Holton, Swartz & Mundh (2018) this is why we may discover non-physical problems patients may be facing. Problems which the patients, themselves, may not have disclosed to anyone else. I feel we cannot simply ignore the problems or concerns that patients mention or vent to us about. An article by Alexanders & Douglas, 2016 states that it is essential to consider the psychological well-being of patients. This has become increasingly recognised as an integral part of physiotherapy and is highlighted by the World Health Organisation (WHO) as well. We know individuals are multi-faceted and very complexed. As aspiring physiotherapists we must be aware of the influence of psychological issues which may not only impact the physical rehabilitation, but affect the patient’s quality of life and all-round well-being. Therefore it makes sense that we should focus on the holistic management and treatment of patients and refer patients to relevant members of the interdisciplinary team when necessary.
This makes me think back to a module done in the first few years of the physiotherapy programme – where we learned about the biopsychosocial model of health. In understanding how the biological, psychological and social factors within an individual affect their health and quality of life, we can more effectively manage patients and their needs. Understanding that the recovery process is influenced by not only how severe the condition is but also by how an individual reacts to their condition, how well they cope with their condition, and whether there is any family support. In the situation with the above-mentioned patient, along with the information obtained through researching this topic, it is evident how the efficacy of treatment as well as his progress can be affected/influenced by his personal barriers.
As physiotherapists we are first line practitioners. We have the ability to refer individuals to social workers, psychologists etc. We should then work in association with these practitioners to achieve the best outcomes for our patients. We cannot solve problems of the patients (although we can offer encouragement) so the next best thing to do is to recommend that they be open to speaking to someone who is qualified and experienced at helping people with finding solutions to personal problems.
McDermott et al., 2018 states that it can be considerably overwhelming for student physiotherapists as they must deal with such a broad range of conditions as well as differences in patient personalities, beliefs and motivation and personal problems. Despite this and the lack of experience, we should do our best to make decisions which are in the best interest of the patient. Ones which will best influence their well-being and quality of life.
References:
Alexanders, J., & Douglas, C. (2016). The role of psychological skills within physiotherapy: a narrative review of the profession and training. Physical Therapy Reviews, 21(3-6), 222-227. doi: 10.1080/10833196.2016.1274352
McDermott, E., Ryan, F., Holton, R., Swartz, S., & Mundh, Z. (2018). Effective communication techniques. Retrieved from https://www.physio-pedia.com/Effective_communication_techniques
2 thoughts on “Empathy: what more can I do to help my patients?”
Hi Kristen
Interesting read. I too have been in situations where my patients have expressed really deep, traumatic incidences to me such as rape or abuse, and have confided in me things that are very personal. In the moment I felt quite incompetent in my ability to give sound advise, as I could not empathise with my patient as I have never been in such a predicament. I found that just listening to the patient, letting them talk uninterrupted was extremely therapeutic for the patient. Letting this person know that you understand them and support them is a huge comfort.
It is true what you say about it being difficult for us as students to not only be able to manage and treat such a wide range of conditions but also to treat the person behind the condition too. Every patient has their own experience of their pain and suffering, and many of the patients we are faced with come from backgrounds of extreme social problems and psychological issues.
What advise did you end up giving this patient? And was this patient eventually referred to social work/psychology?
I found the first paragraph slightly vague, as it did not give the reader much insight into this patient and the problems the patient faced. In some cases, a patient venting to their physiotherapist about issues at home and getting it off their chest can be very helpful to the patient. However, there are other cases where this may not be enough and the patient needs to be referred to a social worker or psychologist, especially if the patient is unable to afford their basic needs, are homeless or are being abused.
I’m glad you mentioned the biopsychosocial model in your piece. We sometimes get so busy and so “turned off” from our patients that we do not always realize that failing to address a patient’s psychological well-being is failing to treat the patient holistically. We went to get stuck in the thinking that the absence of pain, illness or symptoms is a cured patient, but this is not always the case.
Hi Kristen
I enjoyed your piece because you selected a topic that is crucial to the functionality of the health sector in general and makes it difficulty for us to solve problems in the compartmentalized fashion that humans love to.
It was very important to me that you added a degree of objectivity to create the premise for your initial argument; which you did do but i felt that it may have more densely discussed so that we can unpack the specific components that you deal with as a physio dealing with other than physiological problems. Does it make your treatment more effective, less effective or the same? Should health practitioners strive to achieve a report with their patient or distance themselves as much as possible to allow the psych consult to do their job in isolation and thus contributing to an efficiently functioning healthcare team?
I felt that your conclusion was very concisely put and put an objective parameter to an otherwise very subjective piece (I liked this because it is functional when it comes to real world issues) I however felt that the preamble could have been more dense to create revolutionary new system! (although i know the subject chosen is a continuous loop)
Its been lovely to read your pieces this year and your ability to put what you feel to keyboard.