Toni Talks about PT Today

My NDT Course Wasn’t What I Expected

2009-11-18T13:02:00Z

Last weekend I finally got the chance to attend an NDT course. Even though some of the material was basic, it pulled things together for me. For the first time I feel like I might have a chance at passing the NCS exam in a year or two. Listening to the lectures made me realize how much of what we do goes back to NDT. I'd heard many of the things in other continuing education courses but called something different. I don't think she would mind. Berta would have minded. The class held some surprises...(read more)

The Pretty, Young Therapist

2009-11-12T13:10:00Z

Last week something was said during rounds that I'm still angry about. We were discussing a new admission. Since my case load was low, I asked if I needed to see the patient. In response, I was told the patient had been given to the young, pretty therapist because that was who he'd asked for. That statement is wrong. It's not just wrong, it's wrong in many different ways. I'm not referring to the inference that I'm not young and pretty, although I should resent that. I'm thinking more of the implications...(read more)

Preferred Patient Types

2009-11-04T14:19:00Z

This morning while doing the schedule board, we started talking about what type of patients each of us prefers to treat. It started when one of the PTAs asked to change one of her patients. She explained the patient in question was a back patient and she couldn't work with that type of patient. I had a similar request for a patient I had evaluated over the weekend. I asked she be given to a different therapist because she wasn't my type of patient. That led to everyone present commenting on what...(read more)

I Don’t Do Enough Exercise With My Patients

2009-10-28T12:21:00Z

While was doing research for a recent assignment I came across a statement that made me stop and think. In essence it said you can't get functional improvement without strengthening. My first reaction was "Doh! Everyone knows that." That's one of the first things I learned in PT school. Then I read a little more. The article talked about the necessity of strengthening exercises in treatment. I had to stop and think. All of my patients do exercises. When I stopped to think about it I realized I rarely...(read more)

October is PT Month

2009-10-21T12:30:00Z

Tomorrow morning my department is going to have a breakfast for all the PTs to celebrate PT month. The food will be provided by the OTs, STs and supervisors. Sometime next week the rehab unit is supposed to do something similar. I'll be surprised if that happens because no one seems to want to take on the responsibility of making it happen. Personally I would be happy if someone just brought decent coffee for us. The nasty tasting brown water provided by the hospital doesn't do much for me. It's...(read more)

My Patient Doesn’t Want to Work With Me

2009-10-15T14:32:00Z

Last week I inherited an interesting patient from a therapist who went on vacation. The patient is an 87-year-old Chinese female admitted with a diagnosis of right MCA infarct. She has a history of undiagnosed dementia. She lives with her husband and two caregivers 24/7. Prior to admission she was ambulatory household distances with assist and a RW. Except for her adamant refusal to participate in therapy, she isn't very noteworthy. What's interesting are the questions raised by the refusals. The...(read more)

The Annual APTA Questionnaire

2009-10-07T13:26:00Z

Last weekend I finally got around to completing the annual questionnaire sent out to members by the APTA. It's probably about 50 questions, excluding demographics, about the practice of physical therapy. There were the expected "how would you rate the following" questions about the APTA, the APTA website and the like. Another section covered progress toward Vision 2020. I easily answered those questions with a click of my mouse. Then came the one I had to think about. What would I like to see the...(read more)

Therapists Can Have Input Into the Technology We Use

2009-09-30T12:34:00Z

Last week I wrote about Dr. Craik's comments that many PTs aren't ready for Vision 2020. Those comments were only one portion of a longer talk on physical therapy. She also spoke about the future of physical therapy and her vision of what is possible for the profession. She encouraged therapists to begin to work with other disciplines such as bio-engineering and researchers. By working with these professions we would have input into the technology and machines we use for therapy. One of her examples...(read more)

MANY CLINICIANS AREN’T READY FOR VISION 2020

2009-09-22T20:56:00Z

Last week I had the pleasure of hearing Rebecca Craik, PT, PhD speak. She gave her perspective on the past and future of physical therapy. As she is the editor of the Physical Therapy Journal she is in a position to talk realistically about what's ahead for us. I can sum her 90 minute lecture into two sentences. The profession of Physical Therapy is making good strides in preparation for Vision 2020. The individual therapists who make up the profession are not. That sounds harsh. A few years ago...(read more)

Physical Impairment Doesn’t Equal Impaired Cognition

2009-09-16T15:48:00Z

Last Saturday, one of my patients complained to me about the nurses. He was frustrated that he was being spoken to like a child. His words to me were "I'm not stupid." The man isn't stupid, but on initial presentation he could give that appearance. He uses a w/c for mobility. He is mildly dysarthric and speaks slowly as a result. He has left facial droop and a flaccid left arm he keeps propped on his lap tray. His appearance is deceiving. As soon as you speak to him, it is obvious he is fully alert...(read more)

Knowing Drug Side Effects is Important

2009-09-09T15:36:00Z

My pharmacology class has barely started and I've already realized something. PTs don't pay enough attention to the medications our patients are taking. Because I practice in a hospital, I've always had the luxury of having physicians, nurses and pharmacists to keep tract of various medications and drug interactions that could affect my patients. When I looked at medication lists I scanned for the big red flags such as beta blockers, ACE inhibitors, Coumadin and the like. It never occurred to me...(read more)

Deciding When to Move On

2009-09-02T16:59:00Z

How do you know when it's time to start looking for another job, or in my case, another assignment? For the last two weeks I've been asking myself that question. I've experienced some things over the last few weeks that have made me start to wonder if that time has come for me. This morning the light bulb went off. It might be time to make a change. I looked at my caseload and felt overwhelmed before I even started. I don't mind working hard, but I'm tiring of not sharing the load equally. First,...(read more)

Workaholic or Hard Worker?

2009-08-26T21:40:00Z

Anyone in the profession of physical therapy knows there are several areas of contention surrounding the move to the DPT. Some I think are valid points. Others, I don't see the problem. One irks me to no end. I don't understand why a new grad DPT is able to leave on time. What is the point of leaving on time if you haven't finished your work? I don't think leaving work on time every day-no matter what-is a skill to be bragging about. I think completing your work, even if it takes a little longe,r...(read more)

A Matter of Perspective

2009-08-19T20:31:00Z

I went to a CEU course last week about motor control. One of the key points of the presentation was the influence of perception on movement. For example, a patient will move in response to the perceived environment. Therefore, if the patient perceives the environment to be unstable, the patient will move in a manner prevent falling. This will happen even if the patient is actually standing on a stable surface with support. That got me to thinking. Perception influences therapists as much as it influences...(read more)

How to Handle Incorrect Information

2009-08-12T15:23:00Z

I found myself in an awkward situation a few days ago. I had just finished an evaluation in the stroke unit. The OT was preparing to work with the patient, so I gave her a summary of what I had already done so she could be more efficient. I mentioned the patient was a pusher and that I'd already done the education. The OT began her evaluation while I was still standing there. She immediately repeated explaining what a pusher was and in the process, misstated the prevalence of pushers in the stroke...(read more)