5 tips to improve your practice: Physio
With so much hype in the media at the moment in relation to the NHS it is easier to becomecaught up in the political debates and in some areas heavy criticism of the NHS. With continuing demand and less resources to provide our services, we, as physiotherapists and healthcare professionals, need to dig deep to achieve our goals and continuing to help patients.
1. Smile, be friendly and polite: This is not usual something physiotherapists struggle with. At Therapy Expo earlier this year a speaker described that people changed physio because they had ‘a difference of attitude’. Not because they were not happy with the treatment or that is was too expensive but because they did not feel they were important to the practitioner. Now how hard is to walk out with a huge smile and greet a patient warmly.
1/3 of treatment effectiveness has been found to be placebo and connection between the practitioner and patient. This is an easy change to implement if you do not do so already.
2. Build rapport with nursing staff and other healthcare professionals. Working in a ward scenario is stressful at the best of times. Organise time to have meetings with the nursing staff to improve efficiency and find out systems that will help improve working dynamics. Ie When is it best for me to see Mr. X ? Why don’t I see Mrs Y while Mr. X has a shower with you guys. Try to be diplomatic and make an effort to arrange your day so that it is easier for everyone without being bossy and self-centred. The meeting should not be designed purely around your day, you will also need to compromise.
3. Manage expectation. Clear communication skills are paramount. Short term goals are useful and will motivate patients. We know that recognition is a powerful motivator so be sure to praise and recognize if patients have completed their exercises so they maintain motivation.
4. Time keeping: This is so easy and simple yet how many times are there patients waiting in the waiting room? Plan your 30 minutes (those working with 20 minute slots talk to your manager – I fail to understand how you can adequately treat someone in this time and must reflect on patient outcomes or sessions needed and stress of the physiotherapist). This is a skill you need to develop and can be difficult with patients who want to tell you their life story. Some practices/hospitals use a gentle bell system, which is explained to the patient prior to treatment, providing a 5 minute warning so the patient has a cue that the session will be coming to an end. If you don’t have time for all treatment techniques be sure to write them in your note plan.
Maintain your manual therapy skills and if you are choosing any hands off treatments explain why you are doing so to the patient. “Ie With CRPS the nerves are sensitised therefore we need to adopt this approach to encourage stimulation the parasympathetic nervous system and re-organisation of the brain” – When describing acupuncture/mirror therapy/. We will gradually progress you to tolerate different tactile stimulus such as… which will involve using different materials etc.
I work in both NHS and the private sector and my biggest compliant from patients who have seen physio’s in the NHS is ‘They didn’t do anything, they didn’t touch me.” Now you and I both know if they had followed they exercises program most probably would have improved.
We know the WAY we give our treatment is important and that it is estimated to attribute 1/3 of a treatment’s effect. Therefore by being positive, smiling and developing a rapport (easier to achieve in 30 mins than 20!) with your patient you will gain better patient outcomes.
5. Endeavour to be a life long learner. Working in Africa has given me valuable experience in the dangers of practitioners who are qualified but were allowed loose without continual professional development. They were provided with a false confidence and monitored by people who didn’t know if they were talking complete rubbish. I will never forget the response to a question I had asked a little too bluntly in my frustration “Why are people with shoulder injuries being given squats?” “Exercise!” he had responded enthusiastically. “We promote exercises! “
Learn. Share. Develop. In any way you can through videos, images, courses, experienced seniors, enthusiastic students. Continue to keep an open mind, absorb like a sponge and realize you can always learn something new.