From “ugh therapy” to “I’m going to miss you”

“Ugh therapy”  “Not you again” “This is going to kill me” “I’m too tired for therapy today” “You told me two more two times ago” “What more do you got?” “Thank you” “I’m getting stronger” “I’m going home” “I’m going to miss you.”   From one spectrum to another we experience the emotional pendulum of a life in its most vulnerable state. We give hope, we give strength, we provide skilled intervention to move that pendulum towards health and life that once was.  Not to say every patient is a success story, but many of them are. As a Physical Therapy student you absorb each experience fully because each novel experience is shaping us and will shape how we interact, reason, and fundamentally function as a Physical Therapist post-December 2015.

 

The 53 students of DPT 2015 are scattered over the nation applying the textbook material and applying our individual lives into the lives of others. Since July 2014 a majority have tackled an 8-week clinical rotation in either a Skilled Nursing Facility or Inpatient setting. Now some classmates have taken an alternative route; some have chosen to have a clinical in Italy. Why one would ever want to travel and live there for 8 weeks is unknown to me…#jealous. In September we transitioned to an 8-week clinical in an Acute setting. Once again some classmates split the country for Belize or have selected a rotation in a different setting such as the ICU.

 

Each rotation has its own challenges, joys, road bumps, confidence builders, and educational opportunities. I’ve felt on top of the world and in over my head in the past weeks. As a DPT student you learn to take it day by day, hour by hour even at times. The clinical rotations make you that much more alert to how you are developing your own set of clinical skills.  I am sure all of us are enjoying life outside of the classroom but truth be told I do miss all 52 faces that I’m used to seeing all day…every day.  I wait impatiently to be reunited with friends at Elon in the beginning of November. From there we will proceed with further lecture, projects, and adventures in the vast city of Burlington.

Have problems with your Multifidus?? Don’t worry, I do too…

Module IV. The fall. The real deal. From the first day we started PT school, we’ve heard a lot about the module in which we currently find ourselves immersed. We heard it was busy. Check. We heard it would involve a lot of research. Check. We heard it would be a time of bonding and a time of surprising fun. Check. And we heard it would be a time where we might forget our right from our left. Double check.

What we didn’t hear as much about is that it would be a time of realizing that no human body is perfect. We all have faults! The good thing is, most of these deviations are harmless and the vast majority of them just make us unique rather than cause us pain. To prove my point, here’s a fun fact. Did you know that right this very minute as you’re reading this, one of the discs in your back could be slightly out of position? Well if you didn’t know that, then chances are it’s probably not causing you pain, correct?? And therein lies one of the beauties of the human body; it’s not a perfect machine by any means, but it sure is awesomely resilient and adaptable.

For those of you that do have pain that has moved out of the harmless realm, good news! Myself and about 50 other people will be graduating in approximately 2.5 years and will then be more than happy to treat you! All kidding aside, this module and its myriad amounts of information are helping us grow in our ability to repair the machine that is the human body. We’ve still got a lot to learn, but every new technique we practice is getting us to see the bigger picture and is making us more aware that there are a lot of pretty amazing ways we can help people with nothing other than our two hands. Now if only I could remember which one is my right hand and which one is my left….Cheers to Module IV!!

Earplugs are a girl’s best friend

Almost to midterm? Is that possible? It may seem impossible, but that is exactly where the 3rd year PT students are in their last of 4 clinical rotations. The first 8 weeks I was unsure I’d ever start to become more proficient in my documentation or multi-task well enough to instruct my patients, keep them safe, provide them with appropriate tactile cues for technique, and make notes regarding their progress all during their physical therapy session. Be sure you read that last long sentence carefully, I by no means implied that I am anywhere near proficient or that I have mastered the art of multi-tasking, I am simply stating, that I am BEGINNING to become more proficient at my documentation and am STARTING to become more capable of multi-tasking during my patients’ therapy sessions. The outpatient clinic that I am currently at is a far busier clinic than any of those I’ve been at before, and while the software system is meant to be user-friendly, it has been more than just a simple challenge for me to learn to navigate. I did not grow up with computers like most of my peers and my PT school BFF has told me that the one thing that shows my actually age is my decreased efficiency with technology. She has often told me that she forgets I am older than the rest until we start doing something new on the computer and that when my inability, or if I’m lucky, my delayed ability quickly gives away my age!

So, yes, I feel blessed to have this extra time to adjust, adapt, and try to figure out ways of doing things to help me along in these areas I find challenging. I have also learned that earplugs… not diamonds… are a girl’s best friend! Or at least they are in a busy rehabilitation clinic that houses physical therapists, occupational therapists, SLPs (speech language pathologists), cardiac rehabilitation specialists, several support personnel, and at times, many, many patients. I struggle with focus and maintaining attention in a quiet environment, but I believe this type of environment can make even the most focused person deviate from the task at hand.

With the national board exams a short month and a half after graduation, my classmate’s CI (clinical instructor) has been generously hosting a Wednesday night study group session and has opened her home to any third year students wishing to attend. She has been bringing the review material to life as she gives us examples of patients that present with the very symptoms, diagnoses, and impairments were are studying. I am confident that her stories and examples will be most helpful when trying to figure out the correct answer to the board questions in January, as they are making a more lasting imprint in my mind compared with reading and memorizing facts out of a textbook.

Aside from treating patients, documentation at our clinical sites, and working long hours with limited to no downtime, my classmates and I have other responsibilities. We are also enrolled in DPT 809, a research course focused on producing a case report with desired end result being publication. We are very fortunate that there are several professors that lead this course allowing for our class to be divided up into groups of roughly 6-10 students per professor. We regularly have portions of our case report due throughout the six months that we are involved in this course. As we gather information, implement interventions, and assess the progress of our patient, we are able to complete the appropriate sections of our case report that are due, roughly each month, in a more manageable way. As part of our DPT 805 clinical experience, we also have work that we’re required to submit throughout the time that we are at our affiliated clinical site. The biggest, most time consuming, thought provoking, and somewhat stressful assignment that we must complete occurs at mid-term and at the end of our experience is known to all Elon PT students as the CPI or Clinical Performance Instrument. This is an assignment that requires us to investigate the guidance we require from our clinical instructor, our ability to perform simple and complex tasks, the quality with which we provide care, the proficiency of our clinical abilities in simple and complex situations, the proficiency with which we accomplish these tasks, and our overall rating for 18 unique criteria. For some this may not be as daunting a task as it is for me, but I will admit, that this thought provoking task that requires time for reflection and evaluation of self, can feel a little overwhelming to complete at times. I try to complete portions of it as I go along throughout my weeks at the clinic, but regardless of how good my intentions are, I still find myself at my computer for hours the week or two before it is due adding, changing, and completing the final product. With that said, it’s time for me to get back to work addressing the next criteria of my CPI as we are quickly approaching midterm!

To Our Donors, We Say Thank You

Imagine, if you will, spending 2 days a week (and sometimes more) with someone for 7 months. What do you think you’d be able to learn in that amount of time??  Hopefully, if you got along well with said person, you might become good friends and/or you might learn some really impactful things from them. Now imagine that this person is actually a human cadaver who has donated their body so that you could learn from them……totally different right?? Maybe not as different as you might think.

Allow me to explain. In the 7 months spent in anatomy lab, our donors imparted invaluable knowledge upon us, just as you would expect would happen when getting to know a living, breathing human being. They taught us about life and death. They taught us about what makes up the portal triad of the liver. They taught us about the popliteal and cubital fossas. Perhaps most importantly, they taught us what a mind-bogglingly intricate and amazing machine we’ll be trying to fix and mend for the rest of our careers as physical therapists.

One thing you might argue is that the metaphor certainly must break down when you introduce the idea of friendship. Indeed, while friendship is a term that can’t fully be applied here, I for one felt a bond with my donor, a bond built from a sense of thankfulness and the same kind of bond that a student might feel with a teacher. In addition, friendships were certainly formed with my lab partners, and I credit this largely to our donor bringing us together to implement teamwork and strategy in ways that are completely unique to this experience.

At the end of our last day in lab, I had the sense that a great relationship was coming to an end. I think that the gift that our donors gave us is often underappreciated, and I found myself realizing that I had at times taken our donor for granted. However, as I reflect on the experience, I can say that I am incredibly thankful for this one of a kind experience, and I can definitively say that I will carry the lessons learned in the anatomy lab with me for the rest of my career. So here’s to our donor as we thank them for their wonderful gift.

Turning my frown upside down

The only words to describe my reaction when I learned that my DPT 805 clinical rotation had cancelled was extreme disappoint and fear. This was the last rotation of my career as a doctor of physical therapy student! I vividly can remember back to when we submitted our request for placement and within just two short days my first choice responded with a “yes.” Yes, they would be willing to take me as a student for six months; I was ecstatic! I was the first student to get a reply, and while many other students soon received replies many of the responses they were getting were an answer of “no.” Then just a few months before I was to start at my first choice private practice outpatient clinic, I received the e-mail that everyone dreads, the e-mail I was all too familiar with (as three clinical rotation facilities had cancelled on me for previous rotations).  The e-mail read: “Stop by my office at your next earliest convenience as I need to discuss your 805 clinical rotation with you.”  While this e-mail stated nothing that would lead one to believe this meant that the clinic had cancelled, I recognized the familiar words from the past and immediately got a sinking feeling in my stomach.  Of course, I checked this e-mail late on Friday afternoon and all the professors were gone for the weekend, which left me two and a half days to mull over what this meant and I what my options might be.

Early Monday morning I knocked on my professor’s door only to receive confirmation of what I, in my heart, already knew: my clinical rotation site had cancelled. My only option now was to make my selection from a list of sites that agreed to take a student, but that none of my classmates had taken the offer on. This, from my perspective, was like getting to choose from the left-overs, the rejected sites, those sites that nobody else deemed worthy to accept. So, I did what I thought was best; I began to closely investigate each of the sites by looking at their website, but more importantly looking at comments left on the Moodle site from students that had done a clinical rotation there in the past. Randolph Hospital stuck out like a sore thumb, but in a good way! Every review and comment about this facility and its staff was positive. It seemed as though the students that had been there had nothing but great things to say about their experience. The only problem was, this site was roughly an hour away from where I live. Would the commute be worth it?

Currently, now three weeks into my clinical, I can answer that question with an astounding “yes!” Not only is this clinical rotation as good as I had imagined my first choice to be, I can honestly say that I think it is much better! Despite the commute and the long hours, that often make for a 12+ hour workday, I can’t imagine that any placement could possibly be better than Randolph Hospital. My clinical instructor is more than just an outstanding physical therapist; he truly is a clinical instructor. What I mean by that, is that he is my instructor, my teacher, and my mentor. He shares information with me that is very useful to my clinical practice, he quizzes me and asks me thought provoking questions throughout the day, and he asks me things like: “what do you think went well with the patient” and “what do you think you could have done better or improved on with the patient.” He takes personal time each day to do these things and it is evident that he cares about the experience he creates for his student. In addition to having one of the best clinical instructors possible, the other rehabilitation staff members at the hospital are also amazing. They made me feel at home from the very first day and three of the physical therapists at the hospital are even Elon graduates! Another component of this experience that I am grateful for is the fact that I am blessed to have the experience to work with some really exceptional patients; I am seeing a variety of patients and my patients have been such a pleasure to work with.

It’s only been 3 weeks, but I feel confident to say this is going to be a life changing experience. To think back to how devastated I was when my original site cancelled to where I am now, I want to leave you with this thought: If you find your travel plans on the road of life to change on you unwillingly, take a deep breath, keep your head up, and remember it may be more of a blessing than a curse!

As Long As I’ve Got My Suit and Tie….

It’s been a busy yet exciting June and at the beginning of the month, we got the chance to go to the NEXT conference in Charlotte (one of the many great things about Elon DPT is that our program helps provide the means to give us these awesome opportunities)! NEXT is a yearly Physical Therapy conference where PT’s, PTA’s, and PT students can come together and network, discuss current issues facing our profession, and learn about exciting new research. Even though some of the information presented was a little over our heads as first years, it was still an awesome opportunity to learn some new things and realize that a lot of the groundwork courses that we’re in right now are preparing us to be able to synthesize the kind of information we encountered at NEXT.

One of my personal favorite moments, other than hearing one of my own first year classmates give one of the most rousing Oxford debate audience-contributed speeches of all time (#freedomisntfree), was getting to hear the Maley lecture. Dr. Andrea Behrman gave an awesome presentation regarding some advances in the treatment of spinal cord injuries in children, and it was amazing to be reminded of the incredible works of healing that we will be able to contribute to during our careers as PT’s.

Hopefully NEXT was the first of many conferences that I’ll be able to attend during my time as a PT student, and thanks to Elon DPT for making it happen! Happy summer!

The end is in sight

After a wonderful week off, I hit the ground running this morning! Today started the first day of last clinical rotation for the class of 2014! This clinical is unlike any of the previous for several reasons. To begin, our past clinical experiences have been 2 months in duration and this final one is 6 months. This is the only clinical rotation in which we are also taking another course: DPT 809 Directed Research II.  During this rotation, for the first time, we are expected to be at 100% caseload for a new graduate.  We may also choose to begin studying for the national physical therapy board exam during this experience. So, while this is an exciting time, it is also a very busy time for us!

In preparation to begin our studies for the board exam, we took a practice exam the week before last. This gave us all an idea of the content that we knew well and other areas in which we would need to focus our attention on. After completing this practice exam, I can confidently say that Elon does a phenomenal job of preparing us for this important component of our education. After answering just over 150 test questions, I was relieved to discover that there were only about 2 questions that I was unfamiliar with. This does not mean that I knew all of the answers, as we were told not to study or prepare for this practice exam in advance, but what it does mean is that I had been taught the information and had been exposed to this content at some point in my career as a student at Elon. I am not sure that students from other programs can boast the same of their experience.

In the weeks and months to come my biggest challenge will be to juggle a full time career as a student physical therapist, finding time to take care of myself through adequate rest and an appropriate amount of exercise, and setting aside time for course work and preparatory studies. It will be a challenge, but there’s no doubt that if we’ve made it this far, we will reach the finish line!