PT Ex Science Case Study 10
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Exercise Science/Athletic Training/Physical Therapy Alternative Questions – Ethics #10
1.
On Page 249 of the Butts and Rich Text, Nursing Ethics, Bolton lists seven stigmatizing
beliefs about mental illness. Use this guideline to create a professional atmosphere of
trust and co-operation among your client, other clients and employed office staff.
As a physical therapist working for Wellspan Health Inc. you have a new client who is a
16-year-old male athlete requiring post-op PT for a torn cruciate ligament. This football
lineman, Rafael,
is Hispanic with limited English capabilities. As you read his file you
recognize that he is obsessive-compulsive, with anger issues controlled by medication.
Several of the older clientele are fearful of not only of his behavior demonstrating
aggressive tendencies with the equipment but also the stares of disdain he elicits
towards other clientele who are doing their programs.
Your professional peers have mentioned that his presence and word choice is also
creating a hostile work environment.
Using Bolton, how would you explain to all that Rafael is NOT a threat to the those who
fear him during his therapy times?
2.
Analyze the following link for the APTA Code of Ethics -
https://www.apta.org/apta-and-
you/leadership-and-governance/policies/code-of-ethics-for-the-physical-therapist
Using the American PT Association (APTA)
Code as a guideline, you have been asked by
a Female Traveling Soccer (U-18) Club to provide medical assistance to the training of
their athletes, the care of injuries and the determination of individual readiness to
return to play, over an eight-week summer schedule. This is a PT paid position.
You are currently employed FT by UPMC following a medical model of diagnosis,
evaluation and recommendation for those athletes who seek consultation.
Outline how each of the Eight Principles would allow you to participate in the Soccer
position while holding down FT employment with UPMC.
Please address the topics of Boundaries, Privacy, Confidentiality and Privileged
Communication.
3.
On Page 256, the Tarasoff vs. Board of Regents Legal Precedent is presented.
Review the case and outline what your limits are as a Therapist when dealing with this
type of situation.
Dereck Ivey Case Study #10
As a Pragmatist, you should be all about duty, rules, protocol, and procedures. The PT profession has a
National Code of Ethics (as we have previously discussed) but leaves it up to the individual to stay on top
of legal precedents, continued education, state-certification and in most cases, professional conduct.
Like dentists, PT’s in private practice have great autonomy and will only be held accountable by the
offended party. Seldom does a state governing body or regional agency intervene in legal matters.
That is why in this response, I make a strong recommendation for further certification and public
accountability by your extramural education. It may seem trivial after all you have been through in your
professional training but it is essential.
20/20
Pragmatice ??
Exercise Science/Athletic Training/Physical Therapy Alternative Questions – Ethics #10
1. On Page 249 of the Butts and Rich Text, Nursing Ethics, Bolton lists seven stigmatizing
beliefs about mental illness. Use this guideline to create a professional atmosphere of
trust and co-operation among your client, other clients and employed office staff.
As a physical therapist working for Wellspan Health Inc. you have a new client who is a
16-year-old male athlete requiring post-op PT for a torn cruciate ligament. This football
lineman, Rafael, is Hispanic with limited English capabilities. As you read his file you
recognize that he is obsessive-compulsive, with anger issues controlled by medication.
Several of the older clientele are fearful of not only of his behavior demonstrating
aggressive tendencies with the equipment but also the stares of disdain he elicits
towards other clientele who are doing their programs.
Your professional peers have mentioned that his presence and word choice is also
creating a hostile work environment.
Using Bolton, how would you explain to all that Rafael is NOT a threat to the those who
fear him during his therapy times?
I would let them know that Rafael is most likely getting angry with the fact that is
injured and is not able to do what he used to do. He is probably angry and asking why
me of all people. He has a hard time controlling these thoughts and actions but people
should not be fearful of him. He will not lash out at them as they are not the cause of his
frustration. He is taking medication and has been proven to be safe in public by his
doctors.
Wellspan, A Chinese Company BTW, has a communal aspect to physical therapy in that patients
often participate in programs in the same “open” room. Here are some ways that “fears” need to be
reduced. Presented here are some strategies to offset or misdirect any “fear” in a PT/ATC setting:
1.
Always be prepared to document any concerns which arise on a daily basis.
2.
Check with physician anyways to see status of medication status especially drug
interactions; interactions with food stuffs, hydration levels and use of OTC medications.
3.
Schedule Rafael at same time for each appointment with same PT or PTA
4.
Attempt to speak Spanish at least for general conversation (Gracias, Buen Hecho, etc.)
Reduce boundaries by asking Rafael for positive word explanation (ie. I am proud of you …
Estoy orgulloso de ti) and have him work with Professional who feels comfortable using this
language.
5.
Keep it light…conversation can be about, movies, clothes, sports, etc.; something he likes.
6.
Introduce Rafael to ONE select client during that time who would appeal to his nature. This
often is an older person who illicits a parental and supportive feel to the session.
7.
STOP sessions, take a break or reschedule of Rafael if session has behavioral problems.
8.
DO NOT share any private information about Rafael to any client…HIPAA Violation.
9.
Share at outset, in private, about any abuse or misuse of language in a public session.
Document any aberrations
10.
Double up with a PTA and/or house staff to buffer his physical presence to other clients
11.
Do not alter the routine status due to his OCD tendencies. Have Rafael repeat the exercise
to be done; the amount of weight; repetitions and recovery time between exercises.
12.
Confront outbursts with a calm, soothing, non-reactive voice. Never admonish to private.
13.
Prepare each session by reviewing the rules of decorum before commencing. Rafael must
attempt this prepatory exercise along with you as you work together talking about
expectations.
14.
Have success rewards for completion each week outlining what the achieved goal is. This
could include Candy or Drink Chest, coupons, punch cards, monogramed pens/pencils,
keychains, mini-flashlights, zipper pouches, stress squeeze balls,
15.
Have music selection day for certain times for attaining goals.
16.
Be satisfied with “good enough” on tough days.
17.
Celebrate Birthdays in creative ways including post-workout “Pasteles de cumpleanos!!”
18.
Make him VIP for a day with staff recognition of his presence.
19.
PT/PTA join Rafael with a “wear your favorite hat” session.
20.
Walk or go for a stroll outside or in the Hallway as needed.
21.
Homemade treat from the PT/PTA
22.
Certificate of Progress Presented.
23.
Small awards like bag of chips, gum, jolly ranchers, drink packets, ear buds (dollar store),
etc.
24.
Takis…I have been working with “Latinos” for years and they love this snack.
25.
Anything computer (dollar store) like phone chargers, selfie sticks, tiny speakers, retractable
USB mouse, Neoprene tablet sleeves (make sure the WELLSPAN name is on them!!!)
2. Analyze the following link for the APTA Code of Ethics - https://www.apta.org/apta-and-
you/leadership-and-governance/policies/code-of-ethics-for-the-physical-therapist
Using the American PT Association (APTA) Code as a guideline, you have been asked by
a Female Traveling Soccer (U-18) Club to provide medical assistance to the training of
their athletes, the care of injuries and the determination of individual readiness to
return to play, over an eight-week summer schedule. This is a PT paid position.
You are currently employed FT by UPMC following a medical model of diagnosis,
evaluation and recommendation for those athletes who seek consultation.
Outline how each of the Eight Principles would allow you to participate in the Soccer
position while holding down FT employment with UPMC.
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Please address the topics of Boundaries, Privacy, Confidentiality and Privileged
Communication.
Keeping someone’s personal info private is something all medical professionals are supposed to
do.
(It can be complicated, so check out what we talked about in past submissions)
What is
discussed between us will stay between us unless it can impact play.
I will be able to provide adequate support for both groups. I can help the UPMC through online
instructions and give them a program to do while I am away. If they have any questions or concerns
they can reach me through email.
(Very tricky..Check out SAFESPORT USA for guidelines for Minor
to Coach/Trainer/Medical Personnel exchange and use of the e-mail process. These are important
RULES to follow to avoid complications especially over POWER an DOMINANCE you have as an
Adult towards a Minor).
For the traveling soccer team I will be on the road with them giving them the best possible
treatment. When a new consultation comes up I can either take it over a
video conference or I can travel back to meet them. By working with the soccer team I can bring
my knowledge of evaluations to help them stay healthy. I can do my best to keep them from
getting injured and treating injuries when they arise.
The following are some tips to help with the Parental Side of your involvement with youth sports:
https://www.jerseywatch.com/blog/dealing-with-parents-in-youth-sports/
As a potential PT/ATC with the team you need to be there to educate the youth, coaches, officials
and parents on some simple safety protocols. As a Pragmatist you shift the responsibility over to
these people once you have shared your professional insights. The following all “front-brain stuff” to
the PT but is “Gold” for the rest of those who support the team:
https://axespt.com/injury-prevention-in-youth-sports/
It all begins with PREVENTION. Here are some major guidelines to follow:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625797/
3. On Page 256, the Tarasoff vs. Board of Regents Legal Precedent is presented.
Review the case and outline what your limits are as a Therapist when dealing with this
type of situation?
We are allowed to notify safety officers and police about a possible threat to others. If we have
on good justification that
out patient may
harm someone, we contact the authorities in order
to protect said person(s). An example would be if a patient said that they were to make an
attack on a social movement rally than that would have to be reported. The patient is stating
that they plan to hurt people so the authorities must be notified. If not I can be held liable for
not speaking up
I bet you have no idea what the SAFE SPORT ACT is? Check out the following:
Safe Sport Act
The
Protecting Young Victims from Sexual Abuse and Safe Sport Authorization Act of 2017
codified the U.S. Center for SafeSport, a 501(c)(3) nonprofit, as the nation’s safe sport
organization. It gave us the scope and authority to resolve abuse and misconduct reports for
more than 11 million individuals throughout the U.S. Olympic and Paralympic Movement—from
whom we are fully independent.
The Act also charged us with developing and enforcing policies, procedures, and training to
prevent abuse and misconduct. The Center’s
SafeSport Code
governs all participants in the
Movement, and our oversight authority helps us ensure all Olympic & Paralympic national
governing bodies (NGBs) adhere to
Minor Athlete Abuse Prevention Policies (MAAPP)
that
support athlete safety.
Most PT’s have no idea about this important Federal Mandate. The Background Check on you
alone will involve fingerprinting and inspection into your background by the FBI, State Police,
Department of Juvenile Justice and in some cases the Local Health Agency. You must foot the
bill yourself.
Once cleared you MUST begin SAFESPORT Training which is done on an annual basis. This is
accomplished ON-LINE but it is often mandated by most sponsoring agencies.
https://uscenterforsafesport.org/training-and-education/safesport-courses-for-all/
It does not matter what your professional standing and training is. The SAFE SPORT training is
mandatory. If there were an organization (Ie. Church group, YMCA, etc.) who did not have these
measures, I would NOT work with them. The liability is too great.