This Was a Learning Experience
Recently I had the opportunity to work with a different PTA on the rehab unit. She'd worked there off and on over the years and more recently has been filling in as needed. For some reason I hadn't met her previously. I'm sorry to say I wish I would have missed this opportunity as well. Before I go further, I must say I'm not picking on PTAs. Over the years I've worked with many wonderful ones. This woman was the exception. I mention her because I learned from her mistakes.
I knew there would be a problem almost immediately. She tried to rearrange her schedule with an abundance of orthopedic patients. It wasn't that she wanted to change the patients. It was that she came in after many of us had already started our day. Making changes would have been difficult for us. She was scheduled to fill in one day. When you fill in, you take what you're assigned. Later she tried to help me transfer a patient. He was a larger man with a dense hemiplegia. I'd been working with him for a few days and had a transfer technique that worked. As soon as she came into the room she wanted to do everything differently. I don't mind someone making suggestions. I do mind someone coming in and telling me how things should be done without asking me why I was doing them differently.
By lunch I'd decided to stay out of her way. She obviously had her own way of doing things that worked for her. She'd made it clear earlier she wasn't going to change. Then she brought up evidence-based practice. She was tired of hearing about it. She missed the days when you could do whatever you wanted. She didn't think she should have to do anything different. She'd been doing the same things for years and had good results. I can't even describe all the things that went through my head.
This woman is an example of one of the challenges facing PT as it moves toward 2020. She is stuck in the "old way" and is refusing to move forward. The DPT can be debated on end. Having treatment interventions supported by research makes sense. Medicine has been using evidence for years. Having evidence to support what we do is a necessary part of practice. With evidence we can defend interventions to third party payers, to other health care professionals and support our requests that patients receive continued therapy or defend why someone is ready for discharge.
After listening to her I realized how difficult it's going to be to move our profession forward. She couldn't even tell me what she meant when she said evidence. I can't imagine her doing a literature source for answers. In her world she has no reason to do things different. She believes her treatments have been successful. She is one person. Now multiply that by the number of PTs and PTAs out there who feel the same way. All the education in the world won't do a thing if those therapists don't buy into the vision of what we want to be. I'm beginning to think that Vision 2020 is going to be Vision 2030 because the only way those individuals will change is when they retire.
As I said, her presence was a learning experience for me. I saw firsthand what we're facing if we want direct access, autonomy and the like. Now I have a better understanding of how someone on the other side of the issue sees things. I also understand why someone might think Vision 2020 isn't that important. Whenever she's back I'm going to talk to her. I won't try to change her mind. Instead I'll try to explain my thoughts and hope for understanding.