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Role Play 39

Role Play Card

Interlocutor Role Play Card

Patient Setting: Home Visit

You are a 64-year-old who underwent a left total knee replacement three weeks ago. At the time of discharge, you were advised to use a walker and to adhere to the recommended physiotherapy exercises at home until your follow-up appointment in a month. You stopped using the walker yesterday evening.

Tasks

  • Tell the nurse why you stopped using the walker (makes you feel disabled/old. can now walk independently, knee healing well).
  • Insist you have been compliant with the recommended exercise regime and you do not want to be dependent on anything for routine activities.
  • Admit it is sometimes painful it you put weight on the knee for extended periods of time.
  • Reluctantly agree to use a walker until your follow-up appointment

Candidate Role Play Card

Nurse Setting: Home Visit

You are visiting a 64-year-old patient who underwent a left total knee replacement three weeks ago. This visit is to monitor the patient’s progress before his/her follow-up appointment scheduled in a month, the post-discharge instructions included using a walker for mobility and compliance with the recommended physiotherapy. During your visit, you notice that the patient is not using the walker.

Tasks

  • Find out when and why the patient stopped using the walker (try to know if the reasons are valid; ask gently).
  • Advise the patient on the importance of physiotherapy and using the walker (e.g. physiotherapy increases range of motion/strength. Walker assists with balance, reduces risk of falls, lessens weight/Pressure put on weakened muscles of knee, etc.).
  • Find out if the patient has been experiencing pain (if he/she does, know the frequency, intensity, triggers, length).
  • Encourage the patient to use a walker until his/her follow-up appointment (for reduction in pain, shortened recovery time, etc.)

Sample Role Play

Nurse: Good morning, Erika. My name is Nurse Sarah, and I’m here today to follow up on your recovery progress after your recent left total knee replacement surgery. How have you been feeling since our last visit?

Erika: Good morning, Nurse Sarah. Overall, I’ve been feeling better, thank you.

Nurse: I’m glad to hear that. Today, I’ll be assessing how well you’re adapting to your post-surgery care plan. This includes checking your mobility with the walker and ensuring your physiotherapy exercises are effectively supporting your knee’s recovery.

Erika: About the walker… I actually stopped using it yesterday. It made me feel old and dependent.

Nurse: I understand it might feel that way, but using the walker is crucial at this stage. It helps maintain stability and reduces the strain on your healing knee. It also supports the exercises prescribed by your physiotherapist, which are vital for strengthening your knee muscles and improving your overall mobility. Can you tell me more about your exercises? Have you been doing them regularly?

Erika: Yes, I’ve been diligent with them. I want to regain my independence as soon as possible.

Nurse: That’s excellent to hear. Consistency with your exercises will definitely accelerate your recovery. Now, regarding the discomfort you mentioned, how has your pain been recently?

Erika: It’s been manageable most of the time. However, if I’m on my feet too long or if I overdo it, my knee starts to ache.

Nurse: It’s common to experience some discomfort during this phase of recovery. Using the walker can actually help alleviate that pain by providing support and reducing the pressure on your knee. It’s important to use it consistently until your follow-up appointment to ensure your knee heals properly and you achieve the best possible outcome.

Erika: I understand the importance of it now. I suppose I can start using it again until my next appointment.

Nurse: Exactly. Think of the walker as a temporary aid that supports your recovery journey. It’s designed to help you move safely and comfortably as your knee continues to heal. If there’s anything specific about using the walker that you’re unsure about or if you have any concerns, please feel free to ask.

Erika: Thank you, Nurse Sarah. I appreciate your thorough explanation. I don’t have any other questions at the moment.

Nurse: You’re very welcome, Erika. Remember, we’re here to support you every step of the way. Keep up with those exercises, and I look forward to seeing your progress at your follow-up appointment. If anything changes or if you need further assistance, don’t hesitate to reach out.

Erika: I will. Thank you again for your help and guidance, Nurse Sarah.

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Case Notes 39.1

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