Nurse-led Physiotherapy Clinics for Senior Patients
This short article, compiled by Veterinary Nurse Sally Ward from the Tilehurst Veterinary Centre, relays the journey that she took in setting up Physiotherapy Clinics in her practice, and the many rewards (some of which were unexpected) that this brought to Sally, her patients and their owners.
A Focus on mobility problems
Introducing a new nursing clinic to the practice can be challenging, as there are many aspects involved in considering how you will turn your initial idea into something that will benefit your patients, clients and your practice (Kerrigan,2015).
After undertaking CPD in the area of increasing nursing practitioner skills, I still felt I needed to hone in on my target patient group – seniors, and wanted to particularly focus on their mobility problems.
Are arthritic patients under-diagnosed and treated?
The prevalence of osteoarthritis in pets over 8yrs is estimated to be around 80% so it is a big sector of our patients that may be under-diagnosed and treated (Ackerman, 2012). I had completed a hands-on physiotherapy weekend many years ago but, although very well-run, this mainly focused on post-op physiotherapy for complex orthopaedic surgeries, something which wasn’t relevant to me at my practice. I was also keen that my feline patients should benefit from physiotherapy, using similar techniques available to treat dogs (Sharp, 2012).
CPD with group seminar-style learning
I found the ONCORE CPD course on Physiotherapy in Geriatric Patients, which was just what I was looking for – so I signed up and I couldn’t wait to start. The group seminar style of learning on the course was really informal and encouraged lots of discussion within the group, allowing for lots of personal experiences to be shared as well as gaining a wealth of knowledge from not only your own questions being answered, but from other learners’ questions and answers as well.
The tutor provided two short lectures, and then steered us effortlessly through the various tasks on the course and we were all able to learn at our own pace and so this made it really easy to fit around work and home-life. Working part-time and looking after a 2-year old son makes ‘traditional’ CPD courses, even some on-line ones, daunting if they have too big a workload or are just lots of long video seminars to watch.
I learned the fundamental skills of physiotherapy that could be applied to all my senior patients, (and also that could be demonstrated to owners for them to perform at home, which is another important aspect), created a patient plan template and a client information leaflet for my coursework, and was then ready to start my clinics.
The whole team were behind the idea of the physiotherapy clinic
My practice was very supportive of my idea and the whole veterinary team is behind the physiotherapy clinic, from reception staff handing out the information leaflet I created as part of the ONCORE coursework, to the vets and nurses recommending me to clients they see who would benefit from the service.
Client base is increasing
It’s been several months now since I started my physiotherapy clinic and it is going from strength to strength, my client base is increasing and it is becoming second nature for the vets to offer my clinic to patients they are trialling on pain-relief medications for arthritis. I have one consulting day a week and can offer morning, afternoon and evening appointments, as well as one Saturday morning a month.
My clients benefit from my clinic being a more affordable option for those with financial constraints or who cannot refer externally for other reasons – perhaps they cannot travel easily to the local hydro/physiotherapist, or just prefer to come somewhere they are familiar with and see staff that they already know and trust.
Clients value being a part of the process
Building a rapport with the clients and their pets is one of the most rewarding parts of running the clinic, and the easy conversation and informal setting (a lot of the time we are all sitting on the floor together!) helps the client to ask that question that maybe they’ve been putting off.
On several occasions I have discussed with the clients if they feel their current pain-relief medications are working as well as they would hope, and involving the vet if the pet does not seem to be improving as perhaps we would expect, allowing them to intervene earlier, rather than wait until perhaps the 6-month review to ask if everything is going to plan.
The clients also value being part of the physiotherapy process at home and they frequently report feeling that it is quality time with their older pet, that theymake time for them even in a busy household and other pets, because they have a reason to and can see the improvements in them.
Tailoring the treatment plan is vital
Knowing each client and their time constraints at home is important to tailoring a home care plan specific for their pet, it is not always possible for them to manage all the lovely physio techniques we would like them to carry out and it is this informal setting that allows me to ask, “Realistically, how much time can you set aside each day? Let’s focus on just this technique for now.”
Making such a difference to my patients has increased my job satisfaction enormously
My job satisfaction has increased enormously since starting my physiotherapy clinic because it is genuinely making a difference to my patients wellbeing, they are more comfortable and when I hear that they have played for the first time in years or slept comfortably through the night for once it is so rewarding.
I really feel that basic physiotherapy techniques should be a core service offered through nurse-led clinics, as they have the scope to make such a massive difference to our patients, and also to our clients, as they feel that they are doing the very best for their pets and can be involved in their therapy.
To find out more about our course: An Introduction to Physiotherapy for the Geriatric Patient; please visit the course page on our website here.
Ackerman, N. 2012 Chapter 19 Senior Pet Clinics in: The Consulting Nurse, First Edition. John Wiley & Sons Ltd.
Kerrigan, L. 2015. How to conduct a nurse-led senior clinic part1 – preparation and planning. In: The Veterinary Nurse April 2015. Vol 6 No 3.
Sharp, B. 2012. Feline Physiotherapy and Rehabilitation. 1. Principles and Potential. Journal of Feline Medicine and Surgery (2012) 14, 622-632.