Boy howdy! It has been awhile since I last learned some clinical lessons. Just a couple months shy of a year. Now I’m in my last year of PT school, which includes 38 weeks of clinical rotations. So in terms of book learning, I’m nearly complete (for the NPTE at least). We took a retired licensure exam right before this rotation and I easily passed so this truly is about refining clinical skills for me now.
In accordance with my school’s program, I am required to have at least one rotation in a rehabilitation in-patient setting and that is where I find myself now. Going in, I knew this was a task that I was less than enthused about. Part of it is probably anxiety related to a lack of experience. Apart from 15 hours of observation, that happened to be at this same facility, I’ve spent about four hours in any in-patient facility. I haven’t really had any close family and friend with prolonged illnesses and as such, it is a very foreign world.
This is where I will spend most of my waking hours for seven more weeks so I’m trying to learn and make the most of it. I’ve been requiring a lot of attitude adjustments already…
1. ) Patience should be a job requirement for anybody working with people who have hearing loss.
The amount of hearing loss in geris (geriatric/oldies/aged/seasoned) is a little ingratiating. I don’t like repeating myself, like ever really. I try to get there attention, look straight at them, try my best to enunciate, raise the pitch of my voice just a hair, talk a little slower and I still have to repeat myself. Dang near every time. For perspective, I would tell my mom to ask me about certain things later at the dinner table when my dad was around so I wouldn’t have to repeat myself.
2. ) FIM Scores.
Who are you and where did you come from? They seem legit and are fairly straightforward in scoring. I can see myself and anyone for that matter becoming proficient quickly in scoring without outside assistance. This is perhaps its greatest strength. I’m still curious about its reliability and validity stats and what it was tested about.
3. ) Remember your integ class.
Diabetes. Super prevalent. Venous issues. Super prevalent. Arterial issues. Super prevalent. Pressure ulcers DO exist. Yes, it does appear that nurses more often than not do most wound care these days, but there have already been multiple situations where my CI and I had to employ a simple fix to something. This was a big time saver for the system as a whole when considering the alternative of grabbing nurse to take care of it.
4. ) Practice with your equipment.
My CI has no doubt set up his patients in their wheelchairs and walkers thousands of times. It is a huge time saver. Further, It is extremely difficult to be seen as a credible provider when you’re too busy fumbling about trying to get foot rests out of the way to do anything else.
5. ) If appreciation for a patient’s person-hood doesn’t come immediately, at least latch onto your own experiences to grant them that respect.
Yes I like to nerd out reading patient charts. I think there are nuggets of information in a patient’s medical history that compliment and serve clinical reasoning when it comes to basic functional outcomes which is the absolute bread and butter of the rehab setting. On the days that are a bit more dreary, or if my own ruminations are clouding my mind, or if I’m otherwise observing my patients through a lens that obfuscates their struggles outside of tissue pathology then I am doing a terrible disservice.