Round Two Initial Entry

My second practicum is a cardio respiratory placement at Joondalup Hospital. I expect to be predominantly assessing and treating older patients with COPD exacerbations and pneumonia as well as general surgical patients with prolonged hospital admissions. I expect there will be a large emphasis on subjective assessments as this will allow concise discharge planning to begin immediately. Objectively, I expect Chest X-ray and Arterial Blood Gas analysis to be critical as well as auscultation, oximetry and mobility assessments to be common. I expect treatment sessions to be on average 15-30minutes in duration, with an large emphasis on education and mobilization, however I also expect to regularly perform airway clearance techniques such as coughing, ACBT, positioning and percussions/vibrations.

I believe that after the first couple of days of orientation and observation, I will then be given more independence and by the second week I expect to have an independent case load of roughly 6-10 patients a day. Although I expect to be working independently by the beginning of the second week I am confident I will be in a supportive environment and will be encouraged to seek assistance where required. I expect to be working within a strong multidisciplinary team, where communication with other members of the team such as occupational therapists, social workers, nurses and doctors, will be vital for thorough discharge planning.

My third year placement at SCGH involved a considerable amount of cardio respiratory physiotherapy and because of this I am relatively confident prior to beginning my placement at Joondalup. I am reasonably confident in performing specific cardio respiratory assessments such as auscultation as well as specific cardio respiratory treatments such as ACBT. However, I am anxious about analyzing chest x-rays as I have difficulty differentiating between pathologies. One concern I have is related to patients with attachments, specifically the potential for dislodging an attachment and causing more harm then benefit. Similarly I am anxious about managing acute patients and possibly having to perform suctioning as I have very little experience with this; however I am sure I will be given plenty of assistance and encouragement.
Overall I am excited about my placement at Joondalup and having already completed one placement I am approaching this placement with a great deal more confidence.