- Our CVP lecture/lab concentrated on the physio role in palliative care. We had a guest lecturer from Dunedin's hospice describe the philosophy of assisting people to live a quality life right up to their death... not prolonging death or prolonging life. The hospice works with the patient and their family to plan how the patient wants to die. The physio role is to keep the person as well functioning and with the least amount of symptoms as possible (if the patient wishes for this service). During the lab we watched a local Dunedin person's documented life leading up to his death and the involvement of the hospice and hospital. This tugged at a few heart strings. Our second lecture of the week saw an oncology physician talk to us about cancer. Thus, in our lab we also covered lymphatic drainage for lymphoedema, post mastectomy management, and care for people with other end stage disease and cancer.
- Integrated studies lectures had two guest lecturers, the first was a clinical educator from the School of Physio clinic in Dunedin, the other a clinical educator from the School of Physio clinic in Christchurch. These two lecturers were experts in the area of occupational health. In New Zealand, physiotherapists can specialise in Occupational Health... this has a large overlap with the work done by Occupational Therapists... (so that's neuro rehab, hand therapy and occupational health that physios and OTs share similar roles in patient rehab!) The first lab was case based and looked at different factors that affect occupational health (such as workplace layout, biomechanical analysis, environmental/individual factors, organisational/policy, and psychosocial factors) and putting together a rehabilitation plan (return to work plan) for a patient. The second lab was more hands on, this involved setting up work stations (chairs, tables, correcting postures etc) and recapping strategies for lifting/transfers (then problem solving for different occupational demands).
We had the first lecture in a series from ACC (accident compensation corporation) representatives for PHTY355. ACC is New Zealand's 'insurance' system whereby everyone (including visitors to NZ) are covered by the government if they are injured as a result of an accident. It's a 'no fault' system, removing the right to sue (therefore, less psychosocial factors and generally people recover quicker). We looked at how a client is entitled to compensation under different categories of the 'Accident Compensation Act, 2001' such as 'Personal injury caused by accident' (PICBA) and 'Work related gradual process, disease or infection' (WRGPDI). The lecture took the form of case studies; we split into small groups and were given case studies to debate whether it was reasonable for the patient to be entitled to compensation, and if so under which cover policy (if any... there are some legal requirements and medical 'grey areas' to interpret).
So I've now finished my last clinical placement for the year. I must admit that it was probably my favourite placement of my undergraduate degree so far. Without saying that one area of physio is more important or better than another (each area is equally awesome), here's why you might enjoy this placement.
- If you like responsibility, making semi-critical decisions, complex health conditions, medical jargon and monitoring vital signs then cardiorespiratory physio is for you.
- If you enjoy seeing a transformation of the patient from their most vulnerable health status to a threshold where the patient can usually resume or cope with their life demands, and know you've played a large role in their recovery, then cardiorespiratory physio is for you.
- If you enjoy taking patients for walks around the ward in their PJs (or hospital gown), giving out red socks with grippy bits on them, or drag-racing people in wheel chairs (in slow motion) then cardiorespiratory is for you.
- If you don't mind rogue mucus missiles, practitioners stealing your patient, decrypting handwriting, holding your patient's pants up as they walk, frequently washing your hands, teaching people to breathe or having the same patients' most days of the week, then cardiorespiratory might be a well suited option for you.
During my placement I got to treat people with pulmonary fibrosis, pneumonia, COPD as well as those having undergone CABG and lung lobectomy. Most of my clients were discharged upon finishing my placement - everything appeared to be running smoothly. Interesting points of this placement included CT imaging of a patient with subcutaneous emphysema caused by a CPAP/drainage accident following a pneumothorax, an xray of the pneumothorax itself, the effectiveness of physiotherapy techniques are easing work of breathing, and normalising SpO2 with principles of physiology (such as ventilation-perfusion matching, minute ventilation etc). For example, one person I saw had a blood saturation (of oxygen, SpO2) of 90% in sitting. The person had pneumonia in the right lower lobe and a non-productive cough. The combination of left side lying and diaphragmatic breathing increased the SpO2 to 96%. Magic (science)!
Right now (as I think ahead and start dreaming about future employment) I feel that an ideal job would be to work as a physiotherapist in a hospital during the work week 8:30am-5pm (cardiorespiratory ward would be great thanks!), then run musculoskeletal clinics in the evening 6-8pm and work as a sports physio on the weekend... oh and then start a petition to have the 7 day week extended to a 10 day week so I can have some time to go tramping (... is there an outdoor recreational activity that involves both physio and tramping? Adaptive outdoor neuro-rehab and/or chronic disease adventures through exercise perhaps?).
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