A Day in the Life of a PT Student : Ethics & Legal Issues

The Benefits of Journal Clubs

Veronica Haywood — Thu, 22 Oct 2009 11:56:00 GMT

In one of our classes we frequently discuss the benefits of having journal clubs. Often times while in practice, people can fall behind in staying up to date with evidence-based practice (EBP). With such a progressive profession like physical therapy,...(read more)

Student Loan Debt

Veronica Haywood — Thu, 02 Apr 2009 11:36:00 GMT

So over the last five years I have accumulated a lot of debt... also known as student LOANS. It honestly makes me want to scream. I have had a few scholarships and grants, but nothing has compared to the federal and private loans I have. I know a lot...(read more)

Don’t Uphold Poor Standards

Veronica Haywood — Thu, 26 Mar 2009 12:40:00 GMT

I think a really good article to check out is the "Addressing Unequal Treatment: Disparities in Healthcare" by Gillian K. Steelfisher of The Common Wealth Fund. It hits a lot of the same points as the National Healthcare Disparities Report, but it also...(read more)

Disparities in Health Care

Veronica Haywood — Tue, 24 Feb 2009 16:48:00 GMT

Disparities in health care can be viewed from different perspectives. It can be viewed looking at the disparities when it comes to service and the disparities examined within each field. Now when I say disparities in service, this is more or less in reference to the services health care providers provide for the community. Some may feel as though no disparities exist, however, there is a large array of different disparities.

Disparities can be seen as 1) limited services to a certain community demographic whether it is based on race, class, employment status, religion, disease/disorder etc; 2) limited resources within a certain field such as lack of racial, ethnic, male or female presence; 3) unfair treatment in the field; or 4) unfair treatment in services.

One of the largest things discussed in the media relates to the limited services to a certain community demographic in reference to access to health care and quality of health care. Surprisingly, many don't notice how profound this is. I offer a challenge to anyone who thinks otherwise. Examine the differences in care you receive at your regular health care provider and then at a county hospital or local inner city clinic. One will quickly notice that staffing is often an issue as well as efficiency.

The following are examples provided by the National Healthcare Disparities Report accessible at http://www.ahrq.gov/qual/nhdr03/nhdrsum03.htm#Inequality. It's very interesting and I urge everyone to take a look at the site.

Inequality in quality exists

Minorities are more likely to be diagnosed with late-stage breast cancer and colorectal cancer compared with whites.
The use of physical restraints in nursing homes is higher among Hispanics and Asian/Pacific Islanders compared with non-Hispanic whites.
Blacks and poorer patients have higher rates of avoidable hospital admissions (i.e., hospitalizations for health conditions that, in the presence of comprehensive primary care, rarely require hospitalization).

Disparities come at a personal and societal price

Many racial and ethnic minorities and persons of lower socioeconomic position are less likely to receive recommended immunizations for influenza and pneumococcal pneumonia, the most common type of pneumonia. Once hospitalized, some ethnic and racial minorities, as well as lower income patients, suffer worse quality of care for pneumonia. These differential rates of vaccination and hospitalization present opportunities for provider-based and community-based interventions to reduce disparities.

Differential access may lead to disparities in quality

Many racial and ethnic minorities and individuals of lower socioeconomic status are less likely to have a usual source of care.

Opportunities to provide preventive care are frequently missed

Many racial and ethnic minorities and persons of lower socioeconomic position are less likely to receive childhood immunizations.
Many racial and ethnic minorities and individuals of lower socioeconomic status are less likely to receive recommended immunizations for influenza and pneumococcal disease.

Knowledge of why disparities exist is limited

Many racial and ethnic groups, as well as poor and less educated patients, are more likely to have report poor communication with their physicians.
Many racial and ethnic minorities and poor patients report more problems with some aspects of the patient-provider relationships.
Asians, Hispanics, and those of lower socioeconomic status have greater difficulty accessing health care information, including information on prescription drugs.

I will discuss the remainder of the points in my next couple of blogs!

WPTA Fall Conference

Veronica Haywood — Tue, 07 Oct 2008 15:46:00 GMT

This past week I attended the WPTA fall conference in Wisconsin Dells, WI. The conference was great--and not even because it held at an awesome hotel/water park! I had the opportunity to not only get to know my classmates better, but also other PTs, PTAs and students from all over Wisconsin.

It was nice to see so many people gathering to further their education and enhance their professional development. I had the opportunity to learn something that I had never even heard of before called retlouping (http://retlouping.blogspot.com/). Please check it out. It was amazing to see this actually work, and I know it wasn't staged because two of my classmates were used!

I also had the opportunity to sit in on an issues forum. Here they discussed a lot of topics that are both directly and indirectly affecting physical therapists, such as how massage therapist are seeking licensure and how the ATCs in Wisconsin are trying to change their practice act and the states who have achieved doing so.

Before going I actually thought I would be bored out of my mind, but after sitting in on it I found some of the topics to be quite interesting and enlightening. Overall I was very happy that I attended the conference, and even though only one is required, I'm considering attending the conference in the spring as well.

A Turf War

Veronica Haywood — Tue, 26 Aug 2008 16:53:00 GMT

This year has definitely been different than I expected in many ways. But one main thing that stuck out for me is what appears to be almost an ongoing battle between health care professionals--PTs, ATCs, chiropractors, and MDs--in what appears to be a turf war. I understand each organization's role in supporting their own professionals, and I think that that is great, but I don't understand the continuous competition between the parties. Isn't our ultimate goal the same...to help the patient and do all that we can in efforts to maximize their healing process?

Because of all of this, I have had particular difficulty finding where I stand as both an ATS and SPT. I have constantly felt as though I have to choose... do I want to be an ATC or a PT? I have found that many of my classmates share this same feeling, and it makes me wonder if other SPT/ATS students feel the same way.

Throughout my undergraduate career I was always told what I could and couldn't do as an ATC with balance. However, during my first 6 months of PT school, all I was told was what I couldn't or shouldn't be able to do as an ATC. Now, I understand that as a PT one must support the practice of physical therapy, but it honestly made me feel as though I was being told that I just wasted 4 years of my life.

Then on the flip side I was being told that as an ATC we should have more rights and responsibility than has been allowed in the past... the same thing that PTs are fighting for. I'm not sure that there is any answer to this, and since I have only newly been exposed to all of this and my understanding of all of it is limited, I can not begin to supply one. But, what I will say is that I think all organizations need to work more toward supporting each other. I am certain there is a way this can be done without compromising one's own professional affiliation. Besides, isn't our main concern our patients?

Motivation Makes a Difference

Veronica Haywood — Tue, 19 Aug 2008 14:25:00 GMT

So I am officially a rehabilitation aide! After hours of orientation and shadowing, I will pick up my first real shift by myself in a few days! In the one week that I have been at the hospital, I have been able to gain a whole new appreciation for PTs, PTAs, OTs, and OTAs and everything that they all do for patients. Having to deal with patients and their complex diseases and disorders can be stressful as is, but what if patients refuse you? I have already seen patients refuse just being taken to therapy, refuse therapy for the day, and even refuse having a gait belt on. While refusing a therapy session doesn't quite apply to me yet, refusing being taken to therapy sessions and refusing the use of gait belts does. So what do I do?

After contemplating this I came to the realization that every situation will be different. While I can not force a patient to go to their therapy sessions, I can work to do my best to convince the patient that it is in their best interest, highlighting the importance of therapy like helping to increase strength gains, decrease pain, and increase independence and quality of life. In a few days I have come to realize just how important encouragement and motivation are to patient care. Just a few seconds of one's time spent explaining why they need to go to therapy can make a difference. Also, a little encouragement and reassurance can be the difference as to whether a patient will walk 20 feet to the bathroom or around the entire unit.

Another thing that stuck out for me today was one patient's refusal to use a gait belt. One would think that a patient would be more concerned with their safety versus anything else, but I suppose some may consider it embarrassing. Now I know therapists would rather continue their therapy session without the gait belt versus not working with the patient at all, but the thought of me doing that at this stage honestly makes me feel uncomfortable. My greatest concern (like every ones) is the patient's safety followed by standard policies to help cover myself liability wise, so I looked up the policies for my facility concerning the use of gait belts during ambulation and found the following:

13. Gait belts will be used during initial gait training sessions and until the patient has demonstrated independence on appropriate surfaces.

a. Explain to the patient that the purpose of the gait belt is for his or her safety as well as the therapist's.

b. Place the belt comfortably but firmly around the patient's waist prior to having that patient ambulate.

c. During gait training, apply a steady, firm grasp on the back of the belt. However, do not interfere with patient's desired activities.

d. At the completion of the gait training session, remove the gait belt and return it to its proper storage location. Policy #3000_10605 Page 3 of 4 5/2/2008

16. General rules for safe transfer techniques:

a. Explain to the patient clearly what you are going to do and what you want him or her to do.

b. Always use a belt around the patient's waist with transfers or ambulations that require more than standby assistance.

c. Care must be taken to follow appropriate precautions for specific diagnosis.

Since I don't currently feel comfortable enough to transfer a patient without a gait belt, then I will continue to use one, and if the patient refuses then I will ask the treating therapist for their help. I would encourage other students and aides who feel the same way to do the same...it's better to be safe than sorry. Also, I think it's important for everyone to check to see if their facility has specific policies and procedures for refusals just to be safe!