This reflection explores my increasing independence in clinical practice within a stroke setting, particularly in relation to discharge planning, assessment, and intervention. It highlights the development of my clinical reasoning, decision-making, and ability to contribute to safe, patient-centred care.
Throughout week 4 I began to see more patients independently and develop my learning surrounding clinical reasoning and appropriate intervention techniques. I was able to shadow an access visit to assess the patient’s home environment and suitability for discharge. This allowed me an opportunity to be involved in the discharge process more thoroughly and understand the importance of assessment for discharge both within the hospital and within the home as both are interrelated. I measured doorways and steps within the home for accessibility on initial return and to inform future planning in order to achieve a seamless transition.
I was also heavily involved in leading wash and dress assessments for discharge. This allowed me to work independently and take responsibility for assessing any additional support requirements when returning home. I made informed assessments based on reading of previous notes and careful observations of patients in function. This was then reported back to my educator and notes written up independently. It was decided that one of the patients was not yet ready to return home based on their current needs and abilities. I communicated with the patient and discussed possible options available before returning home and provided necessary reassurance. When discussing with other therapists, a joint decision was made to involve the community stroke team to further assess the individual within their own environment and provide necessary equipment.
This experience allowed me an opportunity to become more involved in the process as a whole, specifically within discharge planning. In future I would aim to employ further clinical reasoning and independent discharge planning before discussing with educator. This was also reiterated within my halfway point meeting with university where my educator was extremely positive but suggested to further my experience employing a greater degree of clinical reasoning before hand and following patient assessments when planning further interventions.