Friday, April 17, 2009

Challenging behaviour

Yesterday i saw a patient who really got me upset, however i have personally reflected with other OT's and have learnt alot from the situation.

I met the patient and introduced myself, then did all the things i usually do...discussed the OT role (in this case to ensure the patients home environment was set up to facilitate a safe and successful discharge home. I then got consent and asked if he had ever had OT input before (and he had not).
I began the initial interview and right from the start i obtained cues from the patient that he wasnt comfortable with the questions i was asking him - it was like he didnt understand why i was asking them, and he was very rude to me e.g. "why do you need to know that" and "i wish all of you would stop talking about that i havn't had a fall in a week" From here it was obvious that building therapeutic rapport was very unlikely to happen. I decided to continue and alter the types of questions i focused on (which didnt work either) he was not interested in talking about his "life" his "occupations" and how he spent his day. It didnt matter what i asked him he was not very compliant. I tryed emphasizing what it was that i was there to do and how i could help him return home (which he wanted) but he became more and more frustrated with me and was quite aggressive. In hind site i should have just finished the converstaion and left but for some reason i stayed and battled some more until i just froze after one of his comments and said "i am going to go now - i will come and see you at another time". I realise now that it was a bad idea to say "i can see you are frustrated so if would you like me to go and come back - as this just made him sarcastic saying "you can go if you want or stay if you want" After about 10 mins i had left and hadnt got any information that i needed - it was really pointless staying there other than the observations that i was able to gather e.g. behaviour and personality.

In supervision today we talked through the situation and i have taken away some key learning:
(1) You will always have people that you come in contact with that are similar to this man - thats just reality
(2) The importance of observing and altering communication style throughout an interview
(3) That its ok to discontinue the interview or session if you feel at risk
(4) The importance of knowing how much you can cope with and what your boundaries are
(5) The importance of support as a new graduate
(6) The importance of REFLECTION
(7) Not to take things personally
(8) To learn from mistakes - identify what went wrong and work through different solutions

All in all - a horrible but good learning experience where i had great support from my team members and OT colleagues

No comments: