Lessons Learned: Clinical Education 2, Weeks 3 and 4

 

Now a biweekly series. Either I’m getting wiser and don’t feel like there’s as many lessons to be learned, or I’m too dumb to recognize them.

1.     Family Management is tricky.
I’d imagine family support is a huge factor in successful outcomes. A supportive and visiting family can dramatically shift a mood for a patient in a place that can have a big city feel to many of these more rural folk: surrounded by a lot of people bustling around, but with little meaningful interaction. Luckily I haven’t encountered family that has been more encouraging of taking it easy and doing less rehab. Most of them seem to really appreciate the value we bring, perhaps more so than some patients themselves.
What I have found to be most challenging is having return to home discussions. I don’t want to tell a son that his dad may need to use a wheelchair when he is going out into the community. I have not yet figured out a way to tell the determined wife of a man who had a severe stroke that even though he has improved, he may not be able to live safely at home. They look to me for answers. If I say, “This is my first rotation in an in-patient setting and I really have little clue how to answer your question,” then I hurt my credibility for the rest of the treatment session. I try my best to patiently answer, provide reasonable expectations and keep patient and caregiver safety at the forefront of my mind.

2.     Be thankful for the good ones.
Now I’m not going to say there are bad patients…well maybe. Some are certainly more enjoyable than others and when you’re spending 1.5 hours with them everyday it makes a difference. Luckily I’ve had somebody that I pretty well enjoy being around on my caseload everyday. There’s nothing quite like a hug and a kiss goodbye from the great great grandma that you’ve helped learn to walk again. I miss the hell out of that woman. And her sassy grand daughters.

3.     Sometimes it really is that simple.
I was doing car transfer training for the first time into a GMC acadia with a woman who wasn’t even my patient and who had a lot of fear issues going on despite being quite physically able at this point. My CI wasn’t around, but I figured I’d give it a shot. Didn’t go too well. I had to go back inside and tell him the situation. He grabbed a stool, came out with us and boom. A damn stool. Come on Sam. We gotta do better bro.

4.     Working without pay sucks.
This just really affects me on a profound level.

5.     Use your ortho brain or lose your ortho brain.
There is no doubt that neuro people contribute enormously to the field of PT. While we see a variety of patients the care is often quite comparable. Sometimes I feel like I’m getting trapped by the FIM scores and overall function of the patient regardless of some of the physical ailments that I would treat completely differently in an outpatient setting. It is difficult to justify taking this treatment route because we have limited time and if fixing the impairment doesn’t lead to a functional change, then no beuno on multiple levels. I am determined to get my goni out in the next couple weeks. I’ve tried talking to some of the other PTs about some of the etiology behind some of the diagnosis and impairments and they seem fairly lost. I just feel so rusty all ready in some of these areas and it feels gross.

Half. Way. There.

Ramble on,

Sam

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