Final Post

I have thoroughly enjoyed my placement on the general surgical ward at Royal Perth. I have had exposure to a number of different surgeries; abdominal and bowel surgery, reversal of Hartman’s, breast mastectomies and many more. As I predicted, there was a file with all of the surgeries and post operative protocols in the physiotherapy office that I could consult prior to any of my assessment or treatment sessions. At the commencement of my placement I had approximately 6 patients to assess, review or treat daily. After each I would consult my supervisor as to my results, my analysis and my plan for the patient. This method of working enabled me to work independently with the patients, whilst my supervisor gave me feedback on my performance and guided my reflective thinking process. By week two my caseload had increased. I only consulted my supervisor on difficult patients, at the end of the day we would briefly go through my notes whilst I gave a verbal handover. By week three I had started to see some more complex patients of whom often had post operative sepsis or other post operative complications, and many had acute confusion and cognitive impairments. These complex patients challenged me particularly when it came to discharge. I was constantly required to use my lateral thinking and investigative tools to decipher the best possible discharge plan. I was constantly liaising with other members of the multidisciplinary team to come to common goals for each patient. All of my prior concerns were resolved during this placement. I became extremely comfortable with weaning patients off oxygen and often found myself advising the nurses as to what may be more beneficial for each patient. For example instead of leaving a patient in bed of six litres/ minute via Hudson mask, I would advise the nurse to transfer the patient into a seat, and position them in an upright, supported position on four/litres/minute. Identifying and handling attachments became an automated skill after the first week. My manual handling skills were constantly improving throughout the placement however my planning of my transfers is one area that I noticed a significant improvement. As I became more familiar with the different kinds of surgery and incision sites I could provide better verbal and tactile cues to the patient. Another area that I was concerned about prior to this placement was identification of medications. Throughout my placement I was encouraged by my tutor and my supervisor to take note of the medications as soon as I entered the room. I liaised with the pain team when my patient’s pain levels were interfering with their post operative rehabilitation. This has been an excellent placement. I feel have gained not only theoretical knowledge but I have enhanced my analytical and interpretive methods and gained confidence in my practical skills.