We all know the old plus (+) sign, that normally indicates a hospital or health care facility. But does that normal sign indicate what actually happens inside the hospital?, what happens before and after consultation sessions? Or what exactly it takes for the practitioner to deliver the best possible care for to the patient without causing any conflict or doubt in their abilities. But take a closer look at the picture above, it has wires on bars as you get closer to the centre. Think of the centre as the patient, and the bars as the therapists’ method of approach to the patient, each bar can represent ethical behaviour, professionalism and clean state of mind. Now the wires present hindrances/restraints in the therapists’ attempts to reach the patient.
On the second last week of my second block this year, at an NMS placement. I went to my clinician to ask for assistance with a patient I had been treating for the previous four weeks with no sign of progression, only deterioration. The patient had low back pain with radiculopathy on the Right right leg, she was even limping. All clients with similar symptoms that I had been treating had good improvement except for her. So at that point I was feeling helpless because I had done all the research I could and treatment options were all similar and nothing was working.
I had always updated my clinician on this patient, and she gave suggestions but on the day which I seriously needed help, she turned on me, mind you this was in the morning, meaning I still had patients to see more on that day. She told me things that made me feel worthless as a student/ potential physiotherapist. She told me that I didn’t try hard enough, that what I had been doing with the patient was clearly useless, that I was basically wasting time in that placement because I know nothing. She even told me I had no care whatsoever for my patient and I was only doing it for marks. What she said that day I will honestly never forget, it tore me in half. My colleague was next to me as I was being humiliated and there was really nothing she could do.
Tears filled up my eyes, ready to burst out, but in my language there is a saying that goes “indoda ayikhali” which directly translates to “a man does not cry” meaning no matter what, my emotions would be bottled inside and I would pretend to be fine. And fact of the matter was, I was not fine at all.
That interaction with the clinician started a whole downward spiral on that day until possibly the end of the block. In a state like that, you lose all patience and you want to get everything over with. I remember seeing an extremely rude patient and I failed to remain professional, which I really regret. Even my performance in treating the patients I had for the rest of that day, everything was just scrambled up completely. More experienced practitioner are able to identify and separate their emotions from practice (LeBlanc, 2009) but I seem to have not developed that skill yet and that impaired my session with my client, understandably since I don’t have much experience in clinical practice.

Upon research, I discovered that occupational stress (stress acquired from work) as in my case can manifest in different ways; Physically, behaviorally and psychologically (Beru, Kilelo & Rotich, 2015). I saw a shift in my behavior to more anger and unwillingness to be in that environment, anxiety, headaches and social withdrawal due to low self esteem.

I researched methods on how to manage stress and anxiety and came across a wide range of strategies (Brown, 2018). I found taking a break from the actual work that is stressing me to be effective (being careful not neglect my work) but simple things like taking walks and playing video games with friends seemed to work and still is effective now. i also used the “acceptance-orientated approach” (Brown, 2018) to basically admit that there is nothing I could do about the clinician bringing me down, all I could do was accept and move on. Unfortunately, I had to accept that I could not treat the patient successfully as I had hoped. There are many strategies from (Brown, 2018) and other resources which individuals can use to cope with stress that may compromise their performance at work.
The health and clinical practice curriculum should include sections on stress and stress coping methods for students and practitioners. Experienced clinicians should consider the difference in experience level between them and a student.
Now the question remains, how is an upcoming student supposed to treat a patient in that unstable state and still be effective?

References.

Brown, A. (2018). 62 Stress Management Techniques, Strategies & Activities. Retrieved 8 August 2019, from https://positivepsychology.com/stress-management-techniques-tips-burn-out/

Beru, M., Kilelo, H., & Rotich, K. (2015). OCCUPATIONAL STRESS AND CONFLICT MANAGEMENT IN ORGANIZATIONS: UNDERSTANDING THE ORGANIZATIONAL BEHAVIOUR. International Journal Of Economics, Commerce And Management, 3(2348 0386), 938-954. Retrieved from http://ijecm.co.uk/wp-content/uploads/2015/06/3659.pdf

Kozlowski, D., Hutchinson, M., Hurley, J., Rowley, J., & Sutherland, J. (2017). The role of emotion in clinical decision making: an integrative literature review. BMC medical education, 17(1), 255. doi:10.1186/s12909-017-1089-7

LeBlanc, V. (2009). The Effects of Acute Stress on Performance: Implications for Health Professions Education. Academic Medicine, 84(Supplement), S25-S33. doi: 10.1097/acm.0b013e3181b37b8f