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Since starting my masters degree in Pain Management at the University College London (UCL) the biggest change in my practice has been the diversity of people I should be able to work with and provide equal care in a safe environment. Almost everyone will experience pain at some point in their life and some of those do not know how to deal with the pain or it is chronic pain needing someone else to help them in order to cope through daily living. Since my graduation in 2017 as an osteopath I have been actively educating myself in pain science and trying to understand how can I help people in pain the best way possible. I always thought that I should consider every person in pain as a person and have non-judgemental attitude no matter what is the ethnicity, religion or status. I never considered how also environmental factors inside the clinic might affect the quality of care as well. I always that giving the best care for a patient is all about the behaviour of the practitioner. So I have been patient, respectful and allow time for people and I would just listen and validate the persons feelings. However since starting my master I have come to realise that this all is important but what if one day I have a person who is neurodiverse? I have now learnt that neurodiverse people are predisposed to chronic pain (ref) and they experience barriers to get the care due to environmental and communicational factors. I should be able to communicate in non-verbal ways such as writing. I should be aware how to make the environment for this person as comfortable as possible to avoid anxiety. This would be to allow space to move, no extra noises, no vibrant colours etc.. Not all of this can come from listening and speakin, I need to pay closer attention to things around me to make the environment least stimulating as possible (NICE CG170)
If I work with a person who is LGBT (lesbian, gay, bisexual, transgender) I need to know how they want to be called for example maybe rather using the person’s name than pronouns (Mr/Mrs/Miss/Ms) to respect the person. I need to be able to make them comfortable and understand them as population. LGBT population suffers more with mental health conditions which is correlate with predisposing factor for pain. They also find barriers accessing healthcare due to limited access for their needs, negative experiences and lack of knowledge from the provider (ref). My aim should be able to provide the best possible care for everyone in a respectful manner. Thankfully since starting my master, this has been covered and I have gained a lot of new information.
I have noticed how I am more conscious about my own body language during the appointments. I no longer want to sit other side of the table with a screen on front of me in order to type everything down what the patient is telling me. I have noticed how I want to be more present for the patient and have no objects between us in order to show that I really am interested in their story and that I really want to help them to feel better. I have noticed how my history taking is turning in to educative conversations where my patients seem to start self-explore their health and take much bigger role during the treatment as they used to. I suppose this is because I have become more curious and this way I get more clues of “painful habits” which may be feeding in to the problem. I cut my finger one day and my family was worried how can I work if I cannot use my hand. That was a moment I realised my learning curve. I was more worried how can I type my essays if one of my two typing fingers is not in use. I was not worried about work at all as I might have studied to become an osteopath but I have found even more courage to rely less on manual therapy and more on biopsychosocial model, where we can learn all aspects of the patients environment and how to find the balance with homeostasis. There is so much out there for osteopaths as well than just manual therapy. I feel like I am finding much more active way of helping my patients mentally and physically.
I am feeling grateful for staring this master as it has so far widened my view on pain and society and I believe following through this master will only give me more knowledge and tools to be better practitioner practicing with the standards meeting the evidence based practice.