Topic One: Communication/Assessment

Situation: Today there was a new patient admitted to the stroke-rehab ward and therefore required an initial neurological assessment.

Task: The task set by my supervisor was to conduct a subjective assessment with this patient as there were gaps in the medical notes in regards to history of presenting complaint, past medical history and social history.

Actions: I spent the afternoon conducting a subjective and objective assessment of the patient.

Result: After conducting the assessment I gained an insight into the patient’s history leading up to admission to hospital. I also had an understanding of the communication strategies that I needed to use to conduct a time effective session.

Evaluation: I feel that I conducted an adequate subjective assessment and extracted the information that I required. However the patient’s responses to my questions were quite long winded and tangential. I found myself struggling to refocus the conversation to my subjective aims without interrupting the patient and seeming rude. On completion I felt that I had the information that I required although it took a lot longer than I had intended. On reflection it was positive that the patient felt comfortable to talk to me unreservedly although I feel that it wasn’t a time efficient method of conducting a subjective assessment. I need to remember that although I want the patient to feel comfortable and at ease in a patient-therapist relationship, I also have a role as a clinician to extract the necessary information in a timely manner to ensure that further assessment and intervention can be conducted.

Strategies: In future sessions with this patient I will endeavor to use closed ended questions. I will also try to be more assertive with refocusing the conversation and time questions when there is a pause in a response that I feel is going off track. In doing this I will need to be conscious of not coming across as being rude and insensitive to the patient's response. I also believe multi-tasking during the session will be beneficial such as allowing the patient to continue talking however continue with the objective assessment or intervention whilst doing so.