Laurie's Blogs.

By Laurie Edge-Hughes

As rehab practitioners, we need to realize that the human interaction component of what we do is often just as important as the physical direct treatment part of what we do!  Today’s blog is inspired by,  http://www.themanualtherapist.com/2018/01/its-going-to-be-ok.html, and the concept revolves around the importance of telling patient’s “It’s going to be okay.”

When we are discussing human healthcare, the correlation between what you say and patient outcomes is more direct.  After all, the client is the patient and vice versa.  With human patients, therapists are required to really think about what they say and how they tell patients about what is ‘wrong’ with their body.  The wrong message can cause fear and anxiety and an over-focusing on pain or dysfunction.  

Now, as a caveat, it is important to first be certain that when you are giving reassurances to a patient, that you truly have determined that there are no significant injuries, illnesses, or sinister pathologies (but that doesn’t mean you have to x-ray from stem to stern looking for tumours or the like).  But if after your evaluation, you find there to be a problem that is reasonably treatable, then how you communicate your findings goes a long way in not creating ‘mountains out of mole hills’.   

Research has even been conducted on the subject of using medical reassurance.  It is a complex process that needs to take into account the patient’s emotions and illness behaviours (and I would add, general understanding and overall knowledge).  And as a provide, we need to be competent in determining the importance of timing and having developed trust through empathy and compassion before injecting our medical knowledge and using persuasion techniques to calm a person’s fears.

In the animal healthcare world, there is a slight complication – the patient and the client are not the same!!  However, I have found that the client has a significant impact on how a dog progresses from an injury or illness.  If an owner believes their dog is in distress and/or THEY (the owner) has distress over seeing their dog limping, medicated, stiff, weak, swollen, etc., they may have a tendency to ‘baby’ the dog a bit too much.  And while this is safer than the owner who wants to throw the ball for their dog who is 1-week out from a TPLO surgery, being overly cautious can absolutely have a deleterious effect on outcomes as well.

What to do? I have found that owners appreciate reassurances.  And they appreciate them on a regular basis.  Often times, THEY don’t know what constituted progress in a situation (i.e. a neurologic dog showing signs of volitional movement, or a post-op dog weight bearing taking a bigger step with an affected leg, or a dog with neck pain who is willing to shake their head after a treatment).  So, talk to your clients.  Explain to them what you’re seeing.  Tell them of other cases and how they did.  Tell them what you’re looking for, and cheer on their dog you see improvements.  Get excited for them.  And when you feel it to be true, tell them, “It’s going to be okay.”