day 22

Today i recieved an email from Jo reminding me about the only three reasons to break confidentiality – pt at risk of harming self or others, threat to the wider community or in case of court order.

Back to the discussion on confidentuality a few days ago, I believe i did act in the best way due to the fact in the first case the patient had injured herself and I could see her bleeding through a tissue and it didn't look like it was going to stop and she wasn't going to report it herself as she felt like she was going to hassle people. In the second case, I realluy think i acted well as what the resident told me made me believe she had the intention of harming herself physically. If i was to turn back time i would have done the same thing.

Jo also told me to reflect more on my performance and skills.
So i'd like to bring forth a case of a lady in the nursing home. This client (Mrs V) is in her late 90's and bed bound. Tim and I do passives to her daily. Since the second week, Tim and I have started taking cases separtely mainly to optimise our own learning experience here and also to cover more patients in a day.

When I have Mrs V on my own she doesn't respond to me well as she would if i was with the other PTAs or Tim. She moans and only yells NO! when i talk to her.
For example:
Me: Hello Mrs V!
Mrs V: Nooooooooooo!

Me: How are you feeling this morning Mrs V?
Mrs V: Noooo!

Me: You look pretty in pink!
Mrs V:...mmm.

I'm fairly sure I've always been polite and never hurt her or ignored her in anyway. These passive movements are very important for the residents in the nursing home as they don't move around at all except to be repositioned to prevent pressure sores. So it wasn't like i could just not do her or only give her to Tim. Instead I decided to watch how other carers talked to Mrs V and approached her. I talked to the supervisor who just said that it could be anything from the colour of my hair to the sound of my voice. One thing i did pick up on was that Mrs V was rather religious in her youth and enjoys singing... so i said to myself, "You know many songs and you have a gorgeous voice" so yes i did sing to Mrs V the next day. I also approached her differently. Rather than approaching her first and saying hello, I walked confidently into the room and said loundly and enthusiastically "Good Morning Mrs V!". I received a positive response from her (Mrs V: Yes...) and even a sentence (Why is there a couch on the wall?). This was amazing as she was talking! (incoherently yes, but still talking!). This case taught me a lot abount communication and figuring out different ways to approach people. It also showed me that if something doesn't work one way, don't give up instead try again. By just doing some little research and observing other people, I was able to find common ground on which I could build rapport with Mrs V.