Student Post

How CE 1 Helped Me Get My Spark Back

Callan is a second year student, originally from Silver Spring, MD. Her background before school was dancing professionally and teaching pilates. In her spare time, she enjoys hiking, biking, climbing and traveling.

 

callan

 

Clinic, that magical place that we dream of as students, where we get to actually treat patients instead of fellow students and paper cases. After almost a year of grad school, Monday through Friday 8-5 pm, (which I started two weeks after finishing up 3.5 years of undergrad) I could not wait. I needed to be back in the real world, interacting with people outside of my class. Long story short, PT is my second career. I had danced and taught for a number of years prior to school. I needed to remember why approximately 7 years of school was a good idea in the first place as I had developed a serious love – hate relationship with PT school that was unfortunately going towards the latter more and more. This was frustrating to me as I love to learn and had really enjoyed undergrad. The more the year of dragged on, the worse place I was in. What I realize now looking back, I was missing context. CE I gave me this context.

I was placed in inpatient rehabilitation at Littleton Adventist Hospital. At rehabilitation hospitals, every patient needs to be able to tolerate at least three hours of therapy a day from at least two of the three disciplines of PT, OT and SP. The patients I worked with generally fell into one of three broad categories: someone with a neurological problem/incident, complex orthopedic (think non-weight bearing on at least one limb) or medically complex (people who had many comorbidities as well as what had brought them to the hospital this time). In this case, the PT’s job was first and foremost functional mobility, starting with how someone was going to move in their bed, transfer safely and get around. This starts with compensatory strategies mostly (assistive devices, etc.) and moves towards remediation. The blessing and the curse of this setting, is that it is a beginning step on people’s path to recovery. So you will likely never see someone return to their prior level of function, but you will get to see people make incredible gains in a short amount of time. Some went from being barely able to take a few steps with maximum assistance, to being able to ambulate with a front wheel walker (moderate assistance) in the span of a week or two.

Which leads to all that I learned from my time there. While I had volunteered extensively before school for different PTs in different settings, but nothing is quite the same as “being” the therapist. This change in roles as well as all the encounters I had with patients during CE I started to show the larger picture, giving me context to all that we had learned in the classroom over the past year and why “it depends” was the most likely answer to any question. A few snapshots of the many unforgettable moments are the following. One of my very first patients really wanted to go home from the hospital, but kept saying “I don’t want to” to the simple proposition of standing up, a task they were unable to do for very long. Facing someone who was apraxic and aphasic, trying to figure out what they understand and are capable of, which contrasted with teaching someone who is toe touch weight bearing on a lower extremity and fearful of injuring themselves further how to ambulate with a walker. Or when I walked into a patient’s room to do an evaluation and they needed to use the restroom and got out of bed even though I had just asked them to wait for me to grab the gait belt and equipment to keep them safe. I had patients use obscene language with me and be so dismissive that I questioned what I had done wrong. These are a few of the many situations I found myself in during my first clinical, and while some were more pleasant than others, I would not change any of them (well, except maybe what I did during these situations).

This all leads back to that idea of context. All of a sudden, the Brunnstrom Stages were not just a list of things to memorize, I had a visual right in front of me. I was able to actually know what spastic, rigid, or flaccid limbs felt like to move. I saw what true weakness looks like – people who cannot tolerate standing for more than a minute without their respiratory rate going up and needing to sit down. I learned the importance of monitoring vitals so you can safely help build up people’s tolerance to physical activity. I learned that the numerical pain rating scale is subjective, one patient may report a 7/10 as they are calmly doing exercises, while another may report a 3/10 through gritted teeth. However, despite how subjective scales can be, it is necessary to have a standardized objective measure to be able to communicate to another PT, other healthcare professionals, how the patient is responding to treatment, as well as to justify your care.

My three big takeaways from clinic that I would like to share are the following:

One, communication, in all forms, is important – from body language to written documentation. Find your own style, but figure out how to be as clear and concise as you can be. Direct what you are saying to your target audience. Don’t just say everything you know. This means you need to be listening to yourself and have the self-awareness to cut yourself off if you are droning or to elaborate/explain more if you are getting a blank stare from your patient. Be diplomatic when you ask questions and always thank people for feedback, positive or negative, as they took time out of their day to help you improve. Basically, all the things we are told about communication in school need to come to life when you have a real patient in front of you. Don’t try to always say things a certain way just because that way is what works for someone else. Own what you say and how you say it, so that you are able to adapt it to your patient. Become comfortable with it so that you don’t have to think as much about what you are saying in the moment. It’s okay to be a little “structured” in the beginning to make sure you remember to say everything or ask all the questions, but make sure it is in a way that makes sense to you.

Number two, be nice to everyone. This is a big one – from fellow therapists, to different personnel of the clinic, to patients and to their families — everyone. A smile, a hello and an introduction go a long way. Everyone deserves this kindness, regardless of whether or not you will see them again, or of how they treat you back. This seems obvious but it is easy to forget this when you are trying to provide the best technical care you can or make sure you have taken the best history you can, or are rushing from one patient to another to stay on top of your schedule. Remember, patients are putting up with you learning as a student in a time when they are vulnerable, clinicians are giving their time and wisdom to help you improve, and so many other exchanges are occurring. This does not mean you are Pollyanna all the time, but just acknowledge people with kindness and you never know how you may affect them.

The last one is figure out how to make corrections early. Be proactive and don’t take a “wait and see” attitude. This is where I went wrong with school, and what I knew I did not have the luxury of doing at clinic due to limited time. In my experience, my clinical instructors (CI’s) were always very positive with their feedback and I felt they were holding back. My first week I was actively asking for corrections, telling them what I thought needed to improve, asking their opinion and always thanking them for corrections. After the first week, when my CI’s and I were reviewing how things were going, I told them that I thought they were holding back with constructive criticism. Some of it comes down to style. My CI is a naturally a positive, polite, and diplomatic person while I am a little more direct, so we had different expectations. While I would always prefer to receive mainly negative feedback, they were not going to do that, so while this was not really resolved, we at least both understood each other and the difference in personalities going forward. So if you are not happy with something because it does not make sense or it conflicts with something else you learned, be proactive. Try to find an answer or a solution that you can live with, which may be as simple as asking a question or looking something up online, or it may require you to adjust your expectations. You are not going to change the system in a day, but simply doing nothing will only frustrate you and leads, at least in my case, to disinterest, which we have all worked too hard to accept.

So now, as I head into the end of this clinical and get ready to go back to school I am happy to report I have regained much of my enthusiasm for school. This is still what I want to do and I still think I will be good at it (eventually anyway).

Post written by Callan Curtis 

Post published by Rachel Troup

Student Post

5 Things I learned In My First Clinical Experience

David Treichler, SPT Class of 2017
Hometown: Minneapolis, MN
Undergrad: Iowa State University

Congratulations! You have made it through your first year of coursework. You’ve learned how to measure with a goniometer, complete a basic lower quarter screen, and how to properly perform a PASSIVE straight leg raise (not active, as I was corrected during a practical).

With all this newfound knowledge, you are now headed off to your first clinical! As you prepare for your first day you may be feeling a whirlwind of emotions: excitement to work with patients, curiosity on how you will handle the daily patient workload, and maybe a bit of nervousness to prove to your clinical instructor, professors, and yourself that you didn’t just forget everything from the first year of classes. So, to help prepare you for your first day here are 5 things I learned after completing my first clinical.

1.  Do not expect to know everything

This is something most students burden themselves with, especially in the first clinical. We have spent the better part of the first year of school soaking up information from our professors, much of the time in sheer awe of the knowledge they have concerning physical therapy. Remember this: our clinical instructors and professors have spent years honing their craft, learning and growing in their knowledge of PT. They have seen thousands of patients but still experience times of uncertainty. Strive to learn as much as you can, but know PT school is just the beginning of a lifetime of learning.

2.  PT needs to be fun for kids

Physical therapy can be a scary place for kids. They are at your clinic most likely due to some sort of injury or post-surgery treatment. They are worried about being able to get back to their previous level of function. Make therapy fun. Kids are active, so keep them interested during the treatment session. Make games that help achieve therapy goals. I was able to watch my CI create innovative ways to help children perform exercises in a way that was fun. Use your imagination to maximize the child’s ability to recover.

3.  If you give 10 home exercises, your patients will pretty much only adhere to icing

Patients do not want to go to therapy to be given a grocery list of home exercise programs to be performed twice a day, every day. Remember, in addition to going to therapy, your patients have jobs, kids, activities, errands, meetings, etc. Give your patients exercises that will clearly help with any limitation they have and explain to them the need for it. I learned not to give more than 3-4 exercises to a patient. This helped keep them focused and increased their willingness to do their exercises at home.

4.  Strive to be an advocate for physical therapy and prove to your patients you can help them

I can remember a few patients coming back from their initial evaluation appointment with a look of amazement on their face as they explained, “I left the last appointment thinking physical therapy will never work, and you know what, I was wrong! I did the home exercises and they have actually helped!” Patients often come to physical therapy as a final resort because everything they have tried before has failed. Others are there because their doctor told them to go. It is our job to advocate for the physical therapy profession and prove to our patients the value in our work. Strive to positively impact every patient that comes through the door. Create patient buy-in the very first visit so they have proof to know we can help.

5.  Relax

Remember, this is your first real experience with patients while in school. Your professors and clinical instructors believe in you. They want you to succeed. Work hard, trust yourself, take a deep breath, and enjoy your experience.

Student Post

What Makes A Good PT Student: A Personality and A Dream

Matt DeStefano, SPT Class of 2017
Hometown: Glen Head, Long Island, NY
Undergraduate: SUNY Albany
Degree: Psychology

What does it take to get into PT school and become a PT student? Well that would be: good grades, PT experience, worldly experience, letters of recommendation, interest in physical therapy, certainly good interview skills, and other traits akin to what makes a good candidate to any other medical program. Throughout PT school I have been beat down many times by the stress and rigor of medical school, but a common thread is weaved throughout the fabric of my student being: I have continually picked myself up from my lowest places and turned distress into eustress. I want to share with you what I believe MAKES a great PT student.

Getting good grades is great. The feeling of mastering a concept makes you feel like you’re becoming one with the cosmos (OK everyone is different). But here is one lesson I have had to accept: you can’t learn everything! And you certainly won’t remember everything you’ve learned in school. Instead of hopelessly trying to remember every vibration that enters my auditory canal, or every photon that graces my retina with its presence, I have begun to focus most of my attention on the exact things that make me most excited about PT, and the things that are most related to my area of interest (Outpatient Orthopedics – Sports PT). I understand that we are working towards a degree as a PT generalist in order to serve our future patients in a variety of settings. Here is my student life-hack: Instead of trying to remember everything, which is impossible, I focus more intently on the things that make me tick as a PT student. This helps me retain the information way easier, and it also adds to the positive feedback loop of learning through excitement. If you’re stoked on what you’re learning about, it doesn’t really feel like work, and it reminds you why you came to school in the first place. In addition, by focusing on these things that interest you, it helps to add context to your education which is a HUGE bonus, which makes retaining the information a whole lot easier (“Why did Paul Mintken tell me in lecture to put my hands here again?” – Duh, because if you actually put it into the clinical context, you’ll remember that any other hand position simply hurts!)

Another question I ask myself to stay motivated is this: Why did you come to PT school in the first place? For me, I was interested in athletes and sports physical therapy. When I take a step back and remember why I’m excited about PT, and I start filling my time reading and learning about sports-related topics, student life seems to make more sense. I also notice my stress levels decrease. PT school is a daunting road, but when you take the time to focus on things that actually make you smile, you’ll find it’s a whole lot easier to travel down the road and continue learning 🙂

Finally, I wanted to talk about another aspect of my academic career that has allowed me to survive and prosper as a PT student.

School consumes your life. There is no questioning that. Sit in class for eight hours per day, five days per week, read papers on your bus ride home, get home, eat dinner and maybe eat your papers too. There is ALWAYS something to do as a PT student, most of which is self-directed study, and because of this can make a student anxious to always be studying. I want to encourage all of you when you get in this state of anxiety to remember you are not defined as a student, but a complex individual who has many passions. For me, I have a passion to climb.

I’m a climber. I love to climb and I use it as a release from school. It keeps me sharp, clears my head, and keeps me from burning out. As a successful student, it is imperative that you have an activity that you enjoy, UNRELATED to school, that you can turn to a few times per week to unplug and show yourself some love. For me it’s climbing, but for you it might be hiking, mountain biking, or maybe just reading comic books. Whatever it is, make sure you completely disconnect from your student brain, and fully engage in your extracurricular activity. And DO NOT let yourself feel guilty for taking some time off.

I’ll be honest with you, I probably take more time away from schoolwork than most students, but my mental clarity is top notch as a result. There have even been times right before a comprehensive exam or even a final exam when I have dropped my books, grabbed my climbing shoes, and headed for the climbing gym, only to feel very confident in myself leading into the test. And it has paid off every time! You’ll be surprised how beneficial some “you time” can be, especially in those stressful moments of “Oh no I need to cram for this exam!” Put the book down and go have some fun! You deserve it, and your brain will thank you too.

You might be asking, “But where do you find the time?” The answer is that the time is always there, you just have to make it. Because school is so time-consuming, you have to hold yourself accountable by telling yourself, that you will have x, y, and z finished by a certain time or date in order to go play. By doing so, you can then enjoy your activity guilt free, and reap the majority of the benefits. However, sometimes I don’t meet my self-administered deadline, but I still go play. Trust yourself. Your brain needs it, and your body needs it. Go have fun and all is well. Don’t sell yourself short. Throughout my whole academic career in PT school so far, I have promised myself that I would climb at least twice per week, and I have held myself to it with excellent results.

What does this look like? I have a routine to climb in the gym a few times per week or I make plans to go climb outside on the weekends, and take trips to various climbing areas around CO, UT and CA. By making climbing a priority, I’ve become a more efficient student, but if nothing else, I’ve become a much HAPPIER student. I also share my passion for climbing with my girlfriend, so taking time for myself also affords me time with the person I love, adding a double bonus to my extracurricular life. Do what makes you happy and do what you love.

The bottom line to all of this is simple: follow your true interests within the PT curriculum, and make time for yourself to let loose from school and have fun. We are human after all, and it is not healthy (at least for this human) to bury yourself in school work all the time without taking time to get out and play. It’s a delicate balance, but it is possible. You just have to tell yourself it’s possible, and that it’s important, and everything else will fall into place. In school, we are feeding our brains, but don’t forget to feed your mind, body and soul. You’ll thank me later.

Thank you for reading 🙂

Sincerely,

Matt DeStefano

Instagram: @basebklyn1 & @theclimbingpt

Where is Matt now? – I wanted to share a little extra information related to my musings above. All of my extracurricular attention to a sport that I love, has really started to pay off. I am currently collaborating with two other students to partake in an independent study elective looking at rock climbing injuries and PT interventions related to climbing. Additionally, I have started to teach some injury prevention classes at local climbing gyms in my area. I am also using my business project assignment to research how I can make a personal dream come true: To become “The Climbing PT”. Before starting school, I worked at a climbing gym in San Diego, and my dream is to return there as the in-house PT. By allowing myself the time to climb during a stressful curriculum, I’ve been able to dream big and put my education in perspective related to my future. I have fostered the energy and the determination to put my education to work for me in setting the foundation for making a dream a reality. PT school is not all about the books. It’s about finding yourself and paving a road that YOU want to travel. Follow your passions and make time to have fun!

Student Post

Combined Sections Meeting 2017- A Student Perspective

Sarah Poinski-McCoy, SPT Class of 2017
Hometown: Tallmadge, OH
Undergraduate: University of Cincinnati College- Conservatory of Music
Degree: Dance

What were you hoping to get out of CSM? Did you achieve that?

I hoped to be re-invigorated and excited about what we can accomplish as future physical therapists. Yes, I definitely accomplished this, and I discovered new avenues of PT I hadn’t thought about before.

How did CSM benefit you as a student?

It is really great to see the scope of the profession before we graduate to give us ideas about the many possibilities of our future. Since our courses are divided into Neuromuscular, Musculoskeletal Conditions, and Medical Conditions, it’s easy to see the world of PT as a student in just these three areas. CSM is like going from the basic box of crayons to the 100 color box of crayons.

Previous post-graduate classmates and now PT students at Duke and University of Missouri

What was your favorite lecture and why?

I got really excited about ALL the lectures I attended. The one that was the most inspiring personal journey was the Shumway-Cook lecture: You can let go of me now: Harnessing Neuroplasticity for Good and the Road Not Taken by Dr. Andrea L Behrman, PT, PhD, FAPTA. The most excited I got about policy and advocacy was after the lecture Love Global Health? Then Care About Policy! featuring our own Dawn Magnusson, PT, PhD and three of her public health peers, including Ira Gorman, PT, PhD, MSPH of Regis. I could go on, but those two stuck out the most for me.

Why should future students attend CSM?

Students should attend CSM to get a break from the daily grind of school and be reminded of how big and beautiful our profession is. It is also exciting to discover the new growth our profession has achieved. It’s like an active rest from exercising. You are still focusing on your future as a PT, but in a whole new setting.

What advice would you give future students when attending CSM?

Don’t spend too much time in the Exhibit Hall as it can be overwhelming. When you do, go in with a plan, visit the APTA section booths or poster presentations, and get out before too long. Educational sections are one of the best ways to spend time at CSM. Use twitter while you are there and follow the hashtag #aptacsm to avoid FOMO of all the other lectures, since people tweet about the cool key points often. Use twitter also to tweet about the cool stuff you are learning as well! Don’t be afraid to check something out that looks interesting if none of your classmates or peers are going to attend. This is the best way to reach out and get to know the PTs and fellow students who have the same interests as you!

Student Post

Working While In Physical Therapy School

Michelle Stauffer, SPT Class of 2017
Hometown: Phoenix, AZ
Undergraduate: Northern Arizona University
Degree: Exercise Science. Minor: Chemistry and Health Wellness Coaching

I work as a waitress roughly 25 hours a week (3-4 shifts) outside of being a full-time PT student. Seem crazy? I agree. Do many recommend doing this? No, definitely not; however it works well for me.

Background:

Since I was 15 I have always worked one if not two jobs while going to school. I got my job immediately after moving to Colorado (and a kitten, hello overload), prior to the start of my first semester of school. I decided to get a job to maintain a consistent schedule in order to stay on task. Without a job I would have weekends free making it easier for me to be unproductive with school work. For the first few semesters I started out with fewer hours (ranging from 10-15), but as I gained a better understanding of time management I slowly increased my hours.

Why:

I love having a job that enables me to get away from the stress PT school creates. At work I worry about catering to my customers rather than remembering hand placement for an inferior shoulder mobilization. Plus, as a waitress I can interact with my community and feel more connected (the friends I have made through serving I wouldn’t trade for the world). My job gives me an added purpose to be here in Denver. I also meet great people outside of school who can inform me about all Denver has to offer (sweet hole-in-the-wall restaurants, where to go hiking, CONNECTIONS, etc.). In addition, waitressing provides a passive income for me that is interest free! It is a personal goal of mine to borrow the least amount of student loans while in school and one way I do this is by working. As I mentioned earlier I got a kitten upon my arrival in this great city and she has not been cheap. Unexpected vet bills can be paid for through work rather than adjusting how I budget dispersed student loan money.

Recommend it?

If you never worked a job unrelated to your field of study while attending school I would not recommend getting a job that doesn’t pertain to PT. Many of my classmates work as caregivers working less than 10hrs a week and they really enjoy it. Personally, I would recommend completing your first semester (maybe even 2nd semester) before getting a job so you can create a foundation for your life during graduate school. When you feel ready to start working start slow with minimal hours and see how you do as you can always increase from there.

If you want to ask me more questions about having a job during physical therapy school I am more than willing to talk with you. You can contact me via email: michelle.stauffer@ucdenver.edu