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Journey of a DPT Student

Caseload Breaking Point

Published November 18, 2013 5:53 PM by Lauren Rosso

I just finished my second week at an outpatient clinic where I see a great variety of patients. I'd say it's split 50/50 between orthopedic and neurologic diagnoses. The caseload diversity is going to be a great learning experience. But until I feel up to speed again with my outpatient skills (especially my evaluation skills), I anticipate a few rocky patches and early breaking points.

As a student six months away from graduating, I know there are certain expectations about where you should be in the spectrum of clinical development, particularly with the orthopedic population. However I haven't completed a full ortho eval in about a year-and-a-half and to be honest, we hadn't even covered our entire musculoskeletal coursework at that point. So when I looked at my schedule for the week and saw shoulder, knee, low-back, and cervical initial evaluations, I felt completely overwhelmed.

I managed to tackle it all, but reflecting on the week I'm starting to feel like the caseload is getting away from me. I don't feel like I've had time to think about each of these patients or develop a plan of care that I feel comfortable progressing. It's always a tough situation to be in as a student because you want to be challenged and you want your colleagues to trust you with as many responsibilities as possible, but there's a very thin line between juggling those responsibilities and letting it all come crashing down.

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Going into my first day of my final clinical rotation, I was pretty nervous--a big reason for this being that I didn't know what would be expected of me when it came to caseload. I looked at the schedule for the upcoming week and noticed that 2 and sometimes 3 patients were scheduled every hour. There were also times when an initial evaluation was scheduled at the same time as a follow-up visit. By the end of my rotation, I was seeing all patients on the schedule by myself (which usually amounted to 10-15 patients). Not going to lie, there were several days (especially during the beginning of my clinical) where I felt completely overwhelmed. After a few weeks, I began writing down my schedule for the following day. That evening I would brainstorm treatment ideas for each of my patients so that the next day if I began getting overwhelmed by the volume of patients, I could go to these lists of ideas. I found that this really helped me to maintain my sanity and helped to keep my stress level down.

Emily March 23, 2014 10:35 PM

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