It’s easy to get overwhelmed as a newer OncoPT
It’s easy to get overwhelmed with the sheer amount of treatment patients undergo for breast cancer, especially when we’re first starting as OncoPTs.
There’s surgery, radiation, chemotherapy, hormonal therapy, immunotherapy, & a whole lot more on the horizon for many of these patients. Plus, they’re likely on multiple medications to help manage side effects & diagnoses they may have had previously or even developed due to their breast cancer treatment.
So how do we keep it all straight & cut through the chaos to understand potential impairments our patients can face?
By using a proven framework to guide our process & save ourselves (& our patients) time, frustration, & wasted effort to gather necessary treatment history info. And that framework is exactly what we’re diving into in today’s episode.
Why a framework
When I’m working with a patient for the first time, I use a framework to ensure I get all the important details without getting lost in the weeds. I would encourage you to take my framework & use it in your documentation, in your patient interviews to avoid spending 45 minutes of your session just gathering patient history info.
If you laughed just now, stick with me. It’s so easy as a newer OncoPT to spend an exorbitant amount of time during the eval inquiring about a patient’s cancer treatment history:
- Sometimes you’re struggling through the information
- Sometimes your patient is struggling to remember their own history
By using a framework, we streamline the process of acquiring this information, making sure we don’t miss anything major.
As we get more comfortable & more experienced as an OncoPT, you may find you don’t need as structured of a framework. But in these early days, anything you can do to ease the mental load of remembering everything you’re supposed to remember, means that you can show up with more energy & focus for the patient in front of you.
Do not try to memorize every treatment type out there.
There’s more than 100 different chemotherapies used for cancer treatment these days.
There’s new immunotherapies coming out all the time.
Every surgeon has their own approach, protocol for after care, etc.
I say this not to scare you or make you feel inadequate. I say this to give you permission to not know it all. We shouldn’t. A) it’s too much brainspace that could be devoted to something else, like what intervention should I use for blah blah impairment. B) If you think you know everything there is to know about cancer treatments, you’re missing something.
Again, there are new immunotherapies coming out all the time, including for breast cancer treatment. New chemotherapy regimens & dosages are being researched for patients with breast cancer every year.
There will be changes & updates, so embrace the constancy of getting to learn something new every week.
And yes, I said every week, not every day, because sometimes it’s all you can do to stay afloat in those early busy days as an OncoPT.
Steal my framework:
First up, I do not start my evals with the history taking. I take the time first to listen to my patient’s complaints, how their impairments are bothering them, & what they would do if they didn’t have their impairments. This demonstrates I care about them as a person, not just the chemotherapy they’ve been on.
I like to take things chronologically. It gives me an opportunity to understand my patient’s path to get to me today, as well as start to understand what treatment likely caused which side effects for my patients.
Take this template below & put it into your documentation system. I use Jane App for my clinic management & documentation system (which I LOVE), & it is super easy to create templates with this framework with Jane App.
- Surgery:
- What procedure (lumpectomy, mastectomy, what type of mastectomy, immediate reconstruction)?
- When?
- Any complications?
- What side effects did you experience after surgery?
- Pain, swelling, difficulty moving, etc.?
- Chemotherapy:
- What regimen(s)? For how long?
- When?
- Any complications?
- What side effects did you experience with chemotherapy?
- Numbness/tingling, falls/balance problems, swelling, pain, fatigue, etc.
- When did these start?
- Repeat as necessary for multiple regimens/rounds of treatment
- Radiation therapy:
- What approach (external beam, brachytherapy, etc.)? How many rounds?
- When?
- Any complications?
- What side effects did you experience with chemotherapy?
- Pain, burning, skin discoloration, difficulty moving, swelling, fatigue, etc.
- When did these start?
- Hormonal therapy:
- What treatment?
- When started? (When ended?)
- Any complications?
- What side effects did you experience with chemotherapy?
- Joint pain, muscle pain, difficulty moving, weight gain, etc.
- When did these start?
- Immunotherapy:
- What treatment?
- When started? (When ended?)
- Any complications?
- What side effects did you experience with chemotherapy?
- Flu-like symptoms, reactions to treatment, etc.
- When did these start?
- Other treatment?
Even if you don’t fully understand how a cancer treatment can potentially affect a patient, you can always take down the information & look it up later. I recommend you reference Ep. 206 How to Use Chemocare.com for a fabulous tutorial on this amazing resource.
BONUS POINTS: Use this hack to save even more time in your eval
Do all this research before the eval.
Need help with your eval documentation?
Grab your downloadable Document Evals Like an Expert.
Conclusion:
While gathering cancer treatment history for our patients with breast cancer can seem daunting & feel frustrating, using a simple framework to guide your process can make the eval easier for you.
In general, patients really appreciate when you are trying to be thorough in your information gathering. The worst thing is showing up to an eval & making them retell their entire cancer experience because you didn’t take the time to prepare for their visit.
Until next time, this is Elise with TheOncoPT. And remember you are exactly the physical therapist that your patients with cancer need. So let’s get to work.