Exercise: The Tough Sell
As a brand-new PTA entering the field of skilled nursing physical therapy, I have found that I definitely suffer from a rampant case of idealism. Having volunteered and had clinical affiliation experience in different SNFs in the past, I would not have considered myself completely ignorant to the vast differences of the inpatient experience compared to the outpatient sports clinic. In a word, skilled nursing is busy. There is always someone to treat or another therapist (or nurse) to assist. Due to my (slower) speed, as I'm still learning the ropes, I'm always behind in treating patients.
I've discovered certain patients must have PT in the morning or I'll miss my chance by the afternoon. Other patients do not want to be bothered until after lunch. For most patients, all bets are off by 4 p.m. By 4:30, if I haven't seen them, I've missed my chance. I've always thought I held the power of persuasion when it comes to convincing people of the benefits of therapy and completing one last set of LAQs. What I've humbly come to realize over the past two weeks is that... I really don't. Trying to convince a 93-year-old man with portable O2, CHF and myriad other debilitating conditions to get out of bed and stroll down to the rehab gym with me is a hard sell.
I cheerily give him the list of positive benefits of upright mobility, in general. His response is that he aches all over, his wife does not recognize him anymore due to dementia and he would rather die... so, no thanks kid. This is a hard argument even for the most optimistic of us out there. I pause and tell him the reason I keep exercising - my head. All exercise regulates anxious feelings and stress, not to mention promotes a solid night's sleep. He just sighs and agrees... I think to shut me up. He ultimately obliged my request and participated in therapy with me. He quietly mentioned he felt a little better but his relief to be back in bed at the end of the session was practically palpable.
In many cases, I will be the last therapist these patients work with. As I forge ahead in this career and with this fragile-yet-brave patient population, I will have to find a more confident voice that can educate and appeal to rejections and arguments I'll no doubt face. I'm finding my compassionate and charming style will only take me so far...