If you have seen a physiotherapist before, whether in a hospital or a private clinic, there is a high likelihood that you have worked with a physiotherapist assistant or support worker. The role of a physiotherapist support worker is to assist the physiotherapist in the delivery of your care. The College of Physiotherapists of Alberta has Standards of Practice which include expectations that the physiotherapist must follow when a physiotherapist support worker is involved in your care.
The key expectations are:
- Consent to have services delivered by support workers must be obtained by the physiotherapist and must be specific to the treatment plan proposed.
- The physiotherapist must monitor your progress and the physiotherapist support worker’s services.
- Regular physiotherapy reassessments are required to ensure your physiotherapy services are effective and addressing your individual needs.
This article is going to review certain scenarios relating to interactions you may have and will provide information about what you can expect when working with a physiotherapist support worker.
The characters in the scenarios:
- Hassan is a client who recently had a stroke and is recovering in hospital.
- Vin is a physiotherapist who works in post-stroke care at the hospital.
- Troy is a physiotherapist support worker who works at the hospital.
Informed Consent
It is important for the physiotherapist to obtain your consent to assess and treat you for your injury or condition. It is also important that they get your consent before assigning a physiotherapist support worker to work with you.
Vin enters Hassan’s room a few days after his stroke. The physiotherapy assessment is completed and Vin discusses the goals, care and the treatment plan with Hassan as he recovers in hospital for the next few weeks. Vin introduces Troy, the physiotherapist support worker, and Vin turns to go work with another client on the hospital unit.
Hassan is unsure about working with Troy so he stops Vin and asks what would happen if he didn’t agree to working with a physiotherapist support worker?
Vin realizes that he should explain Troy’s potential role in Hassan’s care and ask if Hassan has any questions. After the explanation he also needs to ask if Hassan consents to working with Troy.
Vin explains to Hassan that he has the right to refuse care that involves a physiotherapist support worker. Vin also explains that the frequency of treatment is an important part of recovering from a stroke and that because of Vin’s duties he is available to provide treatment less often than Troy would be. He highlights how he and Troy communicate and work together to provide physiotherapy care. After the discussion Hassan agrees to work with Troy now that he understands Troy’s role better and feels it will be best for him to get home as soon as possible.
As a patient working with a physiotherapist, you have the right to decline care from different staff members such as a physiotherapist support worker. However, there may be limitations to what the physiotherapist can accommodate regarding your treatment. It is important to weigh the positives and negatives before you make a decision.
Troy is off sick today, so another physiotherapist support worker comes into Hassan’s room in the morning, introduces himself, and tells Hassan it’s time for physiotherapy.
When someone new is working with you they must also get your consent. Consent provided at the start of your care does not automatically apply to all the treatments being provided nor does it apply to all the people who could be involved in your care. If you consented to working with a physiotherapist support worker to do bed exercises, that does not mean you automatically consent to going for a walk. If you consented to working with one physiotherapist support worker, it does not automatically mean that you consented to work with any physiotherapist support worker.
Hassan should be given the option to provide his consent to work with the new physiotherapist support worker.
Monitoring and Reassessments
Two weeks have passed since Vin assessed Hassan. Vin discussed Hassan’s care with Troy after the first week, but he has not been back to check in on Hassan. Today Vin is reassessing Hassan’s progress.
When your physiotherapist assigns tasks to the physiotherapist support worker there should be ongoing monitoring of your care and your progress. You should have an opportunity to ask questions or express concerns to the physiotherapist. Your physiotherapist should be discussing your progress with the physiotherapist support worker and with others involved in your care. In Hassan’s case this could be the occupational therapists, nurses, and physicians.
A few more weeks have passed, and Hassan is feeling like he is not progressing as quickly as he should be. His exercises are getting easier, but he hasn’t had a chance to talk to Vin about progressing them or to talk about going home.
Vin arrives to reassess Hassan and talk with him about his concerns. After assessing Hassan, Vin explains that he has no concerns and that Hassan is progressing as expected. They discuss the next steps and decide to increase Hassan’s exercises. Vin also discusses Hassan’s potential return home and any concerns that Hassan may have as there is a discharge planning meeting next week.
Monitoring and reassessment are two aspects of receiving care from a physiotherapist that you can expect. When a physiotherapist assigns tasks and treatment plans to physiotherapist support workers, they are still responsible for checking in with you. The frequency of reassessment can look different depending on your condition or injury, your needs, and the practice environment. A physiotherapist working with someone with a chronic condition may only check in occasionally as there can be limited changes within a few weeks; however, someone who has recently had surgery may need the physiotherapist to check in more often as progress or concerns may change quickly.
Many variables dictate when a reassessment is necessary. It is best to talk to your physiotherapist if you have questions or concerns regarding your condition or your treatment plan.
For more information on working with physiotherapist support workers, click here.
When you are working with physiotherapist support workers keep in mind the following:
- Your physiotherapist must seek your consent before having a physiotherapist support worker provide treatment.
- Your consent is specific to the treatment and to the provider.
- Your physiotherapist must be checking in with you and giving you an opportunity to ask questions and express any concerns.
- Your physiotherapist must be reassessing your injury or condition as needed to provide quality effective care.
