A Physical Therapist’s Many Roles

Hey there, everybody.  I cannot believe that January 2010 is over.

I hope everyone has had a wonderful start to this new year.  A lot has happened for me this past month.

I started my first clinical on January 4th, so today I am just past mid-term.  My clinical ends on February 26th.  Being out in the clinic has been such a wonderful experience.  It has been a total change of pace from sitting in class all day long.  What I have loved the most is all the interaction and face-to-face time with patients and colleagues that I work with in the clinic.  I have had so many wonderful opportunities to connect with patients…connecting with them as their physical therapist, as well as connecting with them just as someone they can trust and talk to.  Providing an environment where the patient feels respected and safe is of primary importance.

I have had some patients that, either due to chronic pain or due to troubling circumstances in their lives, really just needed someone who would listen to them, who was invested in them as a person, and who really cared about them.  Those times over these past four weeks have taught me more and meant more to me than anything.  Being a physical therapist does not just involve expertise in regards to anatomy, physiology, biomechanics, and physical rehabilitation, but also involves the ability and desire to really connect with patients, and, in a way, be an unofficial counselor to them, listening, validating, and encouraging them.

Throughout this experience, I have learned so much about the practice of physical therapy from my clinical instructor (CI) and from the other PTs that work in the clinic.  I have been working at a small private outpatient practice, which has been a great place to start out because of the slower pace and more opportunities to really talk with my CI and the other PTs.  I have been challenged throughout the course of my clinical, but have never felt overwhelmed because I have not been expected to perform any services to which I was unfamiliar or uncomfortable.  My CI has been such a great teacher, explaining her rationale and guiding me through circumstances or techniques to which I was unfamiliar.

I was incredibly nervous before the first day of my clinical just because I knew I had studied and learned so much my first year, but I didn’t know how that was going to translate to me actually putting it into practice in the clinic.  But the thing is, my CI and the other PTs know that I am just a student on my first clinical, so they have expected me to be just that: a student: to learn, to challenge myself, to try things out, and to develop a confidence in my abilities as a student physical therapist.  I have had wonderful opportunities to practice what I learned in school, as well as many unique opportunities to think outside the box in learning about different approaches to physical therapy that I had not been exposed to in class.

All in all, this has been a wonderful 1st month of the new year, and a wonderful first month of my second year as a DPT student at Elon.  I have already learned so much through this opportunity in the clinic, and am so thankful that I am able to be out in the clinic right now with the non-threatening opportunity to practice my skills as a PT.  I still have more to learn than I can ever imagine ☺ but I am developing confidence in myself as a physical therapist and have even a deeper motivation to really integrate the information I have learned and the information I still have to learn into my knowledge base so that I may provide my future patients with the best care possible.

I think one of the most valuable things I have really started to appreciate this past month is the importance of keeping your mind open to all the possibilities regarding my approach to physical therapy, motivated by my desire to find and implement the best and most effective care for my future patients.

Speed Up, Slow Down, Speed Up, Repeat

It’s hard to believe that the holidays have come and gone and I’m now officially in my final year of school (knock on wood).

Some people say that the first two years went by very quickly while others say time is dragging by.  I think for me I would sum it up by saying that the first two years have flown by in slow motion.

What in the world am I talking about?

Well, I’m glad you asked.

There are certain moments within the last two years that really stand out that even still seem like they lasted forever; those first few weeks adjusting to being back in school, completing certain projects, studying for certain finals, and opening my first student loan statement are all examples of moments where seconds seemed like hours.

In general, however, time is really flying by and that first day of class seems like just yesterday.  I’m only five short months away from beginning my final internship and then, for me anyway, it’s BACK into the real world.  Well, I have tests to study for so this will have to be all for now.  I can already feel time starting to slow down…

Clinical Confidence

Wow, November sure did come and go!  We just started back today after our Thanksgiving break…and we have less than two weeks until we are done with our first year!

I cannot believe it.

This next week is going to be busy – with research project presentations, practicals, and finals – but I know it too is going to go fast.  I feel like it is not really real that we are about done.  And I feel like it is not really real that we are about to be out in the clinic for two months.  While I feel very nervous about going out to the clinic, I know it is going to be exactly what I need – to prove to myself how much I actually have learned this past year, how much I actually do know, and to just give a boost to my confidence that, yes I can really do this.

Right now, I feel that I have so much information swimming around in my head, and so much information that I still need to get into my head ha☺, so I am very thankful that it is about time to go into the clinic and start putting all this stuff into practice every day.  It is going to be an incredible challenge, but I feel like it is exactly what I need right now.  So…despite the nerves, I am ready.   I will keep you posted on how everything is going!  I know I am going to have so many stories to tell.

Time Travel and Other Grad School Tales

Well, I’ve just finished my third clinical rotation at the skilled nursing facility that I spoke of in my last blog.  If you were to go back in time and to my first day in the program and tell ‘past’ me that ‘future’ me was going to have to do a clinical rotation in a nursing facility and that ‘future’ me was really going to enjoy his time there, ‘past’ me would probably just laugh at you and call you crazy.

Man, time travel is confusing.

Anyway, I really was surprised at how much I enjoyed the experience.  The patients that I had the privilege to work with were, for the most part, highly motivated, hard working and a pleasure to get to know.

From a personal perspective, I really established some great relationships and heard some amazing stories during my time there while working with the population that Tom Brokaw called “The Greatest Generation.” My CI and I will even be visiting a patient in the spring because he wanted to teach us the secrets that he’s learned on planting a successful garden.  I told him about my unique ability to kill plants just by looking at them. Funny, but he wasn’t deterred, and said he would take his chances.

From a professional perspective, it really was rewarding to see how quickly many of our patients progressed towards reaching their functional goals.  There were a few patients who progressed slowly, or even regressed,  but for the most part patients responded very well to therapy and many of them were discharged back home during my two months there.

Overall, I couldn’t have asked for a better experience and this rotation has opened my eyes to the possibility of perhaps deciding to work with the geriatric population after I graduate.  Again, ‘past’ me just wouldn’t believe it!  The moral of the story is to go into experiences with an open mind because you just never know…

Bring on the Board!

Since the last time I blogged, my life as a third year student has become extremely busy.  I have been working to complete my application for the board exam, have been filling out applications for jobs, have been going for interviews, all while maintaining my work schedule at UNC each day.  Whew!!

If I could give one piece of advice to the second and first year students it would be this: Do not wait until the last minute to fill out your board application, because it takes a lot more time than you would anticipate!

Sitting for the board exam is a huge process.  For those who are interested, some of the things the process entails include: filling out a form for Elon University to complete after you graduate, completing a paper application that has to be notarized with a current photo attached, paying for the exam with a money order, finding two people who can write character references for you and registering online to pay board fees which total approximately $500 this year.

So, if you want to take the exam within a nice time frame after graduating, you must complete all of this information in a timely fashion.  It takes 30 days to process your application, and you can’t schedule your day to sit for the board until that process is complete.

Now, on to the job search, which has been an exciting and time consuming part of this month.  The job search and the interview process can be very stressful.   Some tips that I would give for the interview process include:

1- Arrive at least 10 minutes before your scheduled interview time.  They may have other paper work for you to fill out prior to the interview and it is professional to arrive early.
2- Be prepared with at least 4-5 questions of your own that you would like to ask the interviewer.
3- Research the institution before you go for the interview.  They may ask what you like about their job facility or why you would like to work there.
4- Evaluate yourself before going.  What makes you a good physical therapist? What are your strengths and weaknesses?  Why should they pick you over other candidates?
5- Think back to your clinical experiences and what types of diagnoses you treated.  Were any of those out of the ordinary?  Was there a particular patient that you felt you really impacted his/her life?
6- Be prepared with several copies of your resume and a list of references.  You may interview in a round table setting with representatives from multiple disciplines asking you questions.

Hopefully, these tips will help out the second year student next year and give the first year student something to look forward to. October has been a very busy month for me. I can’t wait to see what my last three weeks at UNC bring.  The time is quickly approaching for graduation and it is a very exciting, busy time for all of the third year students!!!

New Kids No More

Hi everyone ☺  I cannot believe that another month has come and gone!  Everything is going well up here.

Like I said in an earlier blog, this fall module is all about getting us ready to go out on our outpatient clinical right after Christmas, so we have been learning about the spine and the lower extremity, and now we are about to begin the upper extremity.  I cannot believe that after these few weeks of upper extremity material, we will be sent off on our own to the clinic – wow!

Another exciting thing is that we just received the list of DPT students starting in January!  We were all assigned to be a big sister or big brother…so I am so excited ☺  I honestly feel like I was JUST in that same position, getting everything in order to move up here, and wondering what it was all going to be like.  So, now I am excited to be able to be the person that knows a little bit about how things work up here, and to be able to help everyone just starting out.  I know when I was about to start and when I was talking with students who were just about to finish their first year, I was thinking that it would be nice to be where they are, to have learned what they have learned, and to be getting ready to go out in the clinic. I thought that seemed a long way off. But here I am.

All I have to say for anyone about to start PT school or if you are thinking about starting PT school is this: try not to rush your time. It might be tempting at times to just wish you were over and done with school because of all the work that you know is ahead of you, try not to rush it – because it goes fast enough as it is.

When I get tired and worn out, I just try to remind myself how much of a blessing it is to be in this program here at Elon and how I will never get this time back – so I must make the most of it and soak up this incredible learning opportunity!

The other day I called the lady who will be my clinical instructor for my first clinical.  I was nervous before I called, but after I was so excited.  She told me it is normal and OK to be nervous, that we were going to have a good time, and that she was excited about me starting – and I was so encouraged!

Next time I talk with you all, it will be around Thanksgiving time…yay!  I look forward to letting you know how my first weeks of learning about the upper extremity are going and how I am feeling about being a few weeks from starting my clinical.  Talk to you soon ☺

Moving Right Along

Time is moving quickly, as I am currently in week 17 of my 24 week internship.

Lately, most of my effort has been geared toward finalizing and presenting my inservice project for the physical therapy department at UNC.  The topic of my project was: The Reverse Total Shoulder Joint Arthroplasty.

My presentation included: refresher information on the anatomy of the shoulder, the steps involved with the procedure, a comparison to other similar surgeries for the shoulder and outcome measures. The presentation went very smoothly and the information provided to the rehabilitation department was well received.

I continue to enjoy my time at UNC Hospital on the surgery team.  For quite some time now, I have been working independently each day, carrying a full caseload.  It is very exciting to be able to make decisions for evaluations, treatment sessions, and discharge destinations, independently, with only the approval of my clinical instructor.  I enjoy going to work each day, and I would love to work in the acute care setting with orthopedic and trauma patients after graduation.

As the time passes, I continue to study for my board exam, and I enjoy working with my patients each day.  I look forward to the start of my amazing career, which is quickly approaching in December!!!

Super Septuagenarians

So, things are much different since the last time I checked in.

This time last month I was working with critically ill patients in the ICU at a hospital in Savannah, GA.  I’m now one month into my next clinical rotation at a skilled nursing facility close to home here in North Carolina.  I have to say that two months of working in the ICU with patients connected to everything from ventilators to chest tubes has made the patients I am working with now (mostly 70+ years old) seem indestructible with superhuman-like strength and endurance.

It took me a few days to adjust to being able to walk with a patient without needing 15 minutes just to make them ‘portable’ first.  The lesson here is that it’s all relative!

So far my experience is going very well.  I’m really enjoying working with this population much more than I anticipated that I would.  The patients I work with are, for the most part, eager to participate in therapy and a pleasure to be around.

For example, one of my patients is sharp as a tack at well over 85-years-old and we’ve really developed a great rapport together.  Here’s an example of a recent exchange we’ve had:

Patient: “Well hello, there!  How’s your day going?”

Me (in an overly dramatic theatrical way): “Oh, you know, treated some patients, ate some lunch, treated some more patients.  How ‘bout yours?”

Patient (equally as dramatic): “Oh, you know, had some therapy, ate some lunch, had some more therapy.”

I’m glad that this program requires us to gain clinical experience in various settings because you really never know where you might find your niche.  If there were no restrictions on where we did our clinical rotations I probably would have focused on the outpatient setting and I would have missed out on some great experiences that have really opened my eyes to other options that are out there and that will make me a more rounded clinician regardless of where I ultimately end up.

Clinical Countdown Begins

Hi everybody ☺All is good here at Elon.  Not too much is new this month.

School is trucking right along and going well.  I feel like I am definitely learning a lot – but also still have A LOT to learn.  About two weeks ago, my classmates and I took on the challenge of our first hour-long practical in which we were presented a scenario and told to take the patient’s history, do an examination and begin an intervention.

It was the first of three similar practicals this module, working to prepare us for the real world when we are really in the clinic in January on our first clinical!  All my classmates and I made it through the practical, proving to ourselves that, while we still have a lot of learning to do, we are making progress toward our goal.

Right now in addition to our normal classes, we are also beginning to prepare and get things in order to go out on our first clinical when we get back from Christmas break!

We are getting our confirmation cards for our clinical sites and getting ready to call our sites to find out more information about how to prepare.  I cannot wait to know what my schedule is going to be like and get a little information about what a typical day might look like.  I cannot believe that before I know it I am going to be treating patients in an outpatient clinic.  This just seems like such a long time coming, so I cannot believe it will be here soon!

I will keep you all up to date on how classes are going as well as how my anticipation and preparation for my clinical are going ☺  I continue to learn and appreciate more every day the wonderful opportunity I have here at Elon and the commitment of the institution and professors to support my classmates and I as we pursue this incredibly challenging, and yet incredibly rewarding, goal.

Up to the Challenge

Hey, everyone.  Last time I wrote I was getting done with a whirlwind of final exams and getting ready for a much-anticipated 2-week break.  Today, as I write, I am back in the swing of things with classes – 3 weeks into a new module: module IV.

By the way, if you are wondering if I like having a module schedule instead of a semester schedule, the answer is yes – the module schedule allows us to really focus on a set of classes for 2 or 3 or 4 months, check those off our list, and move on to a whole new set.  With everything going on, it leaves little time for boredom – before you know it, you are preparing for midterms and then finals – but that has been how this past 8 months has been here – at first 3 years of school sounded like a lot, but I see more and more each day how fast time goes here!

When I came back to campus after break, I knew that this module was going to be totally different than the past three.  For the first three modules, we focused on the basics of everything from anatomy to physiology, research to PT science (where we learned basic techniques)…and for all of those classes, the basic routine was to read, study and just learn the material.  Now, we are taking it to a totally different level in that just reading and knowing the material is not enough – we need to know how to interpret it – how we would actually use it to make decisions in the clinic.

This module is known as the musculoskeletal module, so our professors are preparing us for being able to go out and practice in an orthopedic setting (back pain, knee pain, ankle pain, etc).  Our first major topic we started with was learning about patients with low back pain.  About 2 weeks ago, our professor told us that in about 8 DAYS, we would be ready to take a patient’s history, do an initial examination, and start an intervention – and all I could think was, “What?  I am not so sure about that.”  Well, 2 weeks after she said that, I am quite surprised to say that, yes, if I were in a clinic today with a patient experiencing low back pain, I would not be completely lost ☺  I for sure would not be perfect, and I would definitely want a PT around to help me out, but I do feel confident that I would at least know how to start!

Our professors have made it quite clear that practicing this stuff is the only way we will begin to feel comfortable and really grab hold of the problem solving that is required…and that is so true…at first, thinking about trying to run through a pretend case study was very intimidating – but after just trying it out once, I began to feel a new confidence that I can do this…and it is OK not to know it all right now…but to just give it ‘a-go’ and see what I know.  That is what it is all about – learning, practicing, making mistakes and learning more.

While everything can definitely feel overwhelming – and while you question yourself as to whether or not you can really soak up all the information that is thrown your way – you can…and when you actually challenge yourself to try some of this stuff out, to try to put the information into practice and reason through it, you see that you know much more than you thought you did.

All in all, I can definitely say that I am being challenged physically, mentally, and emotionally more than I ever have been in my life – and while I would be lying if I said that I do not struggle with this at times, I know that it would not be worth it if it was easy.  This is why I am here – to be challenged to become the best individual and physical therapist I can be – and I can say without a doubt that I am in the process and am being molded to become just that.