The hard part came along when I was trying to narrow down the employers that I intend to visit. There are over 60 representatives set to come and only four hours available for the career fair. Add that on top of the hundreds of students that will be fighting for reps' time and it's crunch time! It is especially difficult for me because I have a variety of interests and possess a background in a variety of areas-from sports medicine to wound care and geriatrics. These are very hard to come by within the same facility.

Thus far hospital settings seem to offer the best fit for me, however, since I am also interested in the inpatient and skilled nursing setting, then I will be visiting with those reps also. Needless to say my list is quite lengthy. I figured if I spend at least 10 minutes with my top 15, and five to 10 minutes with the others then I should be safe. The only unfortunate part is that I have to leave and come back right in the middle of the career fair to take a practical exam!!!

Well hopefully all goes well. I am very excited to be venturing onto a new stepping stone in my life-still worried, but none-the-less excited! Up next... individual cover letters and interviews!  

I think that it is very important for people to laugh.  More importantly, it is important to be able to laugh at yourself. In my experience, most of the PTs that I have worked with have had an excellent sense of humor. This is one of the most valuable attributes that I feel one can possess because laughter is more or less a healing tool for many. Laughter can help distract one from their pain as well as improve a mood, which can in turn affects function.

One of my favorite quotes is "The best way to cheer yourself up is to try to cheer somebody else up," so even when you are in the midst of dealing with an extremely difficult patient, just remember this quote and hopefully things will go smoother!  Long story short...Laugh, play, SMILE!!!

With such a progressive profession like physical therapy, it is important to stay aware of what is going on within the profession. It is also very vital for reimbursement purposes. There are both new and old biophysical technologies and other treatment interventions that are either not reimbursed or are scarcely reimbursed.

Awareness of evidence-based practice related articles can be vital when trying to convince an insurance company that a particular treatment is beneficial and worth covering. Journal clubs can be used in order to help support EBP. We hear so much about them, but I was curious as to how many people actually participate in journal clubs?

I find myself meditating and practicing my deep breathing techniques more often nowadays. One good thing that I have to look forward to will be the topics for my papers. I will be examining interventions in the NICU, predictors for diabetic foot ulcer development, etc. Hopefully I will be able to gather enough information to present in an in-service during my clinical!

Now comes the time again where there is just A LOT going on. Besides the loads of projects, papers and tests, we have a lot of events coming up. We have Massage-A-Thon coming around the corner, which was extremely successful last semester. Then we have senior farewell, which is certain to be a blast. And then there's career fair which is sure to be a success as well.

One of the most important events of all is career fair. Numbers upon numbers of facilities come to recruit Marquette's finest in physical therapy, nursing, athletic training, speech pathology and biomedical engineering. Now that I am finally in my 6^th year, this event will be very important for me to land a job after graduation. With this, it will be necessary for me to have a great resume.

I have worked various jobs and have been involved in multiple activities in school, making my resume almost look like a research paper. I'm sure that no one wants to read through the entire thing, so how do I know what I should and should not include in it considering most of my resume is consumed with academic and PT related jobs, volunteer services and national research presentations?

I question why this is. Is it our fault? Are we not taking a stronger enough stand? A poll was recently taken that a guest speaker came in and reported on stating that patients with back pain are more likely to seek OTC medications, athletic trainers, massage therapist, personal trainers, etc. before seeking physical therapy. I couldn't believe this!

I'm curious how is it that chiropractors have made it so high on the "totem pole" when they only focus on one part of the body and limited treatment techniques. Physical therapists work with the entire body-from the TMJ to the vaginal musculature (women's health) and everything else in between. We also work on multiple levels including impairment, functional limitation, and even pathophysiology (wound care works on the cellular level). We work with prevention, habilitation, and rehabilitation, a variety of ages from birth to hospice, and now there are even PTs who work with pets. It's amazing that such a phenomenal field gets such little recognition.

This week I was discussing the roles between PT's, PT students, and PTA's with my professor. I mentioned that, though I have had interactions with PTA's during my last two clinicals, it has been relatively limited in me directly supervising them. While talking to her I expressed my concern with supervising a PTA who has been practicing for an extended period of time. I hear lots of stories about new graduates having "disagreements" with PTA'S on how they practice (some illegal practices and others misinterpretations) and incidentally offending them.

Does anyone have any suggestions for new grads and students on how to avoid this?

While I was working in an outpatient practice I realized that it was not easy to handle situations where patients needed possible psychology/psychiatric consults. In hospitals and skilled nursing facilities recommending someone for a psych consult seems like nothing more than a quick word and a little paper work. However,  in outpatient therapy it is mostly only "appropriate" to discuss information with a patient's doctor only as it pertains to their direct care during PT treatment. Unfortunately in outpatient you must discuss the possibility of a patient seeking out psychiatric help with the patient or patient's guardian only, otherwise you risk violating the patient's confidentiality right.   This can be very problematic and cumbersome as most patients will deny that they need any type of outside help or acknowlege they never actually seek help even if you supply them with a million facilities.

This summer I saw a 13-year-old patient who had very obvious signs of self mutilation in the form of cutting. She had some marks that appeared at least a year old and others that appeared to be inflicted that morning. When the patient was asked what happened, she replied that she did not know. Later, the mother was asked if she was aware of the marks; she replied that she was aware and that the she was "seeing someone." Now, for some of those marks to be as fresh as they were, either someone was in denial or the patient may not have been adhering to her treatment. At this point, however, the only thing we could do is offer our assistance and express that we were willing to help.

I am convinced that our classes are even longer than they were in previous semesters. I mean, I love all of my teachers, but after three hours in the morning I'm really not compelled to come back to the same teacher later in the day.

The one good thing about this semester is that my classes at least cover very interesting topics. There's cardiopulmonary, evidence-based practice (with a more clinically-based approach this time), pediatric interventions and neuro-rehab. Then I also have an elective in wounds and an independent study with a project in the realm of biomechanics.

Needless to say, this will be a very busy semester, however I am very excited for it and even more excited for my clinical and LAST YEAR OF SCHOOL!

Then she proceeded to discuss how she felt as though there wasn't a big difference in what PTs and ATCs did. Now I'll admit (and I think I mentioned this before) I used to feel the same way until I started taking more and more PT classes. But I realized that as an ATS, I absolutely would not have felt comfortable treating patients with complex medical diseases or anything else outside of sports-related injuries (including non-sport related orthopedic problems) after graduation.

I am curious, are there any PT/ATCs who feel differently?

It's amazing how attached one can become to a place. While it's not so surprising, as I have been at MU for almost 6 years, I do find it amazing how much I miss my patients and the staff that I worked with for just 10 weeks at my last internship and four weeks at the first.

I spent so much time with some of my patients that they were comfortable sharing information about their families and personal lives with me and a part of me misses that. I even had one patient who wanted to "hook me up" with his nephew...all I could do was laugh and politely decline.

For some reason, I am having the hardest time choosing my last two clinicals. I know that one has to be an acute care rotation, and at some point one must focus on wound care, but if I choose my wound care and acute care rotation as the same clinical then I am left clueless.

Since I have never done an acute care rotation, this is making things even harder. What if I choose acute care for both and HATE it? Then I'll be stuck doing something that I don't like for 16 weeks!

I don't know why I am so much more concerned about these rotations than I was with the others...I suppose it's all the pressure from the thought of graduating...for some reason it just really scares me. Maybe I'll just become a professional student...on second thought maybe not.

People often times ignore proper hand and instrument hygiene, not because they don't know about it, but because they get too caught up in their daily schedule to think about what they are actually doing. There was one time that I saw a doctor use a pen to help take depth measurements of a wound infected with MRSA, and then he stuck the pen in his pocket and left. The first thing that came to my mind was GROSS! Then I couldn't help but think...What if he uses that pen and spreads the infection across someone's chart...What if he sticks food in the pocket...What if he uses that pen in a non-infected wound?!

This one mistake can easily cause ill health to other patients, providers and that doctor's family. I was baffled as to how careless the person was, especially since it is estimated that the prevalence of hospital-acquired MRSA effects 46 of every 1,000 patients (Association for Professionals in Infection Control and Epidemiology, 2007).

This fatal problem can be eliminated with proper hygiene. Now I'll admit sometimes things can get repetitive and I don't always follow proper hand hygiene when I'm not touching my patients often, but one is supposed to wash one's hands or use an alcohol-based hand sanitizer (which is shown to kill more germs than soap and water as long as the hands are not visibly soiled) before and after every patient encounter--even if you only touch the equipment that the patient used. Facilities should be stocked with hand sanitizer everywhere--at the least--to decrease the spread of infectious diseases...but then again it still won't help if people don't use it.

I can't believe how fast time has flown by these past three years. Reality is starting to set in...for the first time in 18 years I will no longer be a student--well that is if I don't pursue my PhD. I still can't believe it.

I have started trying to narrow down the geographic region that I intend to stay in. I realized that the type of job, job market and climate are not the only factors that I must take into consideration, but I must also take into consideration the cost of living, available resources, housing, etc.

It's hard for me to believe that I will soon be completely on my own. Honestly, I think my largest concern is, ironically, health care coverage. I will be covered on my mother's insurance until I either graduate or turn 24, but after that I have no clue of what I will do! I have a few chronic pre-existing health conditions and dread that thought of paying outrageous premiums just to be healthy. I don't know if I'm ready for this yet. Boy I'd give anything to be 5 years old again!

I have been extremely fortunate to have two great CIs thus far. Though very different in their approaches, they have both contributed greatly to my nurturing development. I would just like to take the time out to thank the both of them... Diana Correa and Amy Patel.

They were both very supportive, offered constant constructive feedback, and were just excellent to work with. I felt the need to write this even more after hearing CI horror stories. Sometimes it is difficult when two people have conflicting personalities or the expectations that one has for the experience are too high or low--both which I was fortunate to not have to experience.

My only advice is to put it all out on the table in the beginning with finesse. That way you decrease any tension before the pot boils over.