Psychosocial_Reflection

Running head: PSYCHOSOCIAL REFLECTION Psychosocial Reflection Trisha Smith Maryville University Psychosocial Reflection Client Background: P.M was first seen at the local hospital in Vandalia but he was in too much pain and needed to see a specialist in order to reconstruct his hand and thumb. He was flown by helicopter to a hospital in a larger city which was able to treat him for his injury. P.M’s two injured fingers were non-repairable and so he was left with his thumb which was reconstructed by doctors. His index and long finger sustained no severe damage except for swelling. P.M stayed in the hospital for four days before being released to return home. Current occupational performance strengths and deficits: P.M is six weeks post-op and sees Milliken Hand Center twice a week. On his last visit, February 24, 2010, he reported being able to eat a hamburger with his injured hand. When looking at his chart I saw he was unable to eat with the injured hand the visit prior to this visit which was 5 days earlier. I also noticed in his chart that his mother had changed the dressings on his injured hand for the first four weeks; he can now change the dressing on his own hand. P.M. is very concerned that he cannot help his brother on their farm. They have to hire extra help to accommodate for his absence. He is also worried that he cannot move his thumb as of yet and that the other two fingers are still swollen and move only about fifty percent of what they should. Not being able to drive himself to the city twice a week for therapy is also a concern for P.M. P.M was telling me how difficult it is on him that he is unable to work with his brother on their dairy farm since he is the eldest of the two brothers and has always been the person in charge. He was always the one who made all the important decisions pertinent to the company. His brother mainly did what P.M asked him to do. After his injury P.M would have to turn that responsibility over to his brother. He told me how tough that was for him. I could see by the look on his face, as he shook his head and looked down, how saddened he was about it. He mentioned that he has over a thousand acres of land and how that was not much for a farmer in that area. Although he owns only thousand acres, he knows it is too much for just one person to manage. When the therapist at Milliken asked P.M if he had been doing the exercises she asked him to do, he stated that he had. He said that he is doing everything in his power to get back to work as soon as possible. He mentioned that he has nothing else to do but his exercises and watching television. P.M demonstrated how he was unable to move his thumb and asked the therapist when she thought he might be able to get it moving. As the therapist had P.M do his exercises she noticed that his DIP was moving albeit slightly. She told him that it was moving, but just at a slower pace than he might expect. She told him as long as he did his exercises it was more than likely to start moving more. He smiled as he tried again to move it. When the therapist asked P.M if he could return again on Friday he said he could. She went to look at her schedule and said the only openings she had was either at 8:00 am or 4:15 p.m. P.M shook his head from side to side with a grin on his face and told the therapist those times were bad for his driver. He did not want to make the driver get up at 5 in the morning to get him to the city early and the later time was too late. He stated he wished he could drive himself and that he did not like having to rely on others taking him to the city. He told the therapist and me that he would take the later appointment because he needed therapy and would find someone to bring him. He told me he did not want to risk driving himself to the city because the highway was much busier than he is used to in a small town. He did not want to take the chance of hurting himself or others. Reflection: P.M is lucky in the sense that he still has his dominant hand but I could see the excitement he displayed when he told the therapist he could finally eat for the first time. I think him being able to see the small steps he is accomplishing is a positive part of his recovery. P.M told me he used to be independent in running his farm. He now feels very confident in having his brother run the entire dairy farm. He said he does not tell his brother what to do or how to do it, unless he is asking for advice. He wants his brother to be able to run the business to the best of his ability. He said it feels good to let his brother learn the ropes. He wants his brother to be able to run the farm the way he feels it should be run and not how P.M thinks it should be ran. P.M said he likes to go down to the barn back to the environment that he knows and loves just to see his brother occasionally to see if he can somehow lend a hand. Although, he said within a few hours he is ready to go home and rest. He is amazed at how tired he becomes doing such small things. I believe it is good for P.M to interact with his brother in the barn, an environment in which he was used to spending almost an entire day. Also, by letting his brother run the diary farm as he sees fit is also a good sign that P.M is not trying to take on challenges that are beyond his abilities anyway. This leaves his mind open to getting rest and the proper exercise to heal as quickly as possible. Because P.M is not working on the farm seven days a week he now has time to go to church with his mother. I think getting out into the community and spending time with his mother is also very good for P.M. This may give him the opportunity to realize all the things in his life he is missing by working 7 days a week. In turn this could change the amount of time he spends working on the farm when he gets back to it. Not being able to drive does have a negative impact on P.M. He stated that he hates to rely on others to drive him to the city. If this were to continue for a long period of time P.M may get depressed and not want to continue his therapy which could lead to detrimental consequences for the sake of his farm and his mental state of mind. When I saw P.M it was on a Wednesday. He was supposed to return on Friday at 4:15 p.m providing he could find a ride. Unfortunately P.M did not show up for this scheduled therapy session. The therapist said that was the first time that had happened. Perception of this assignment: In doing this reflection I think I sparked something in my supervisor that she must not have been doing for a while. After I finished asking E.W the questions I had for him she asked me if I found out anything interesting. I said he really likes to play soccer but he is scared that the ball will hit his hand and cause pain or injure his hand during healing. I also told her he was having trouble tying his shoes and that was something he was really wanted to be able to do. The next time E.W came in to see the therapist she asked him when soccer season started. He said in a month or so. She told him that I had informed her that he was worried about playing. She asked him what he was most worried about while playing soccer and he responded “getting my hand hit by the ball and hurting it”. She said she would ask the doctor if he could use a special splint/glove while playing soccer. His eyes lit up and I could tell he was very happy. He thanked her again and again.