Week 2 - monday

Today i was asked to prescribe a patient with an incentive inspiratory spirometer(IIS). I was fairly confident as my supervisor gave me a good handover and i felt i understood the reasoning behind using the spirometer well. I felt confident prescribing the treatment because i had previously developed rapport with the particular patient which made the Ax and Rx less confronting. I discussed the importance of the IIS with the patient and made it clear why the doctors hace prescribed and how it relates to his smoking and increased bed rest. I remembered to assess the patients cough which was dry and clear. I taught him how to use the IIS which is incredibly easy and challenged him to use it in a few different ways. I also provided the instructions to the patient to read as he has excellent cognition. To improve the treatment i could have combined the IIS with other deep breathing exercise such as the huff or TEE's. I could have also discussed how patient positioning can be combined with the IIS to improve its effectiveness. Next time i see this patient i would like to discuss these Rx modifications with him.

A second incident that occurred today involved the multidisciplinary team. There was a problem because a patient was discharged before the OT had arranged a home visit and for equipment to be fitted out in the house. This was a major problem because the patient was not fully independent and was unsafe. The problem occurred basically because of a lack of communication. This was an excellent learning curve and really demonstrated the importance of the TEAM approach to patient care.