Patient Outings

A patient I have been treating throughout my prac. requested a day visit on the weekend to a family members home. She was able to transfer sit to stand independently, however still required help for step around transfers (2 x min assist in physio – due to weakness of left LL). She gave us a weeks notice, and after chatting to our supervisor we decided that given medical clearance and her family being able to transfer her, she would be able to go. We arranged a wheelchair and a bed pan with OT, as well as a time with the family to teach chair to car transfers.

We thought that a slide board transfer was the best and safest way to go, and easiest for family members; however on seeing the car, and the massive gap between chair and car seat, had to change to a step around transfer. After demonstrating the technique to our patient’s daughter, and having her practice on us, she tried to transfer her mother. The technique worked transferring to the car, however coming out of the car the transfer was towards the hemiplegic side. A three person transfer was then required – as one person had to hold the unsteady wheelchair and one to place the foot. The daughter was unable to bend her knees to complete the transfer, so risked injuring herself and the whole thing just didn’t look quite right.

After a chat with the supervisor we decided the transfer just wasn’t safe enough, and recommended a wheelchair taxi. Understandably the family was very disappointed as they felt that it was safe, so we requested they came in again the next day for the senior physio to assess the transfer. The next day the family said after some thought they agreed with us and had booked the taxi… however unbeknownst to us a bed had become available at another rehab hospital, and our patient was to be transferred there that afternoon. The other hospital then said that she would most probably not be able to go on day leave… and it just goes to show the best laid plans…

So advise for similar situations would be to go with an instinct feeling, and not get caught up in family emotion, at least we knew that there weren’t going to be two patients coming back to hospital, not just one!