Life with a New PT Grad

Background in Physical Therapy

2009-11-19T12:22:00Z

A friend of mine is an MD, and he often does other work using his MD education as a basis for other jobs. He serves as an "expert opinion" in some court trials, does consultation work for medicine companies, and teaches lectures occasionally. Although he isn't practicing medicine, he indirectly uses that background in other career opportunities. The physical demands of a PT job can be strenuous depending on the practice setting. There are few PTs practicing over the age of 50 (according to a Minnnesota...(read more)

Packers Games and Patients

2009-11-12T13:17:00Z

Last Sunday was my first experience of working during a Packers game. The other times I have worked on Sundays, the Packers have played at 3:00 p.m. By 3:00, I'm nearly done with my schedule and only have one or two patients left to see. With a noon game, however, there are over three hours of my workday when patients prefer to watch the game. Three patients refused therapy sessions on Sunday. All three patients had visitors and family members in their room to watch the game. I felt like an intruder,...(read more)

H1N1 Virus

2009-11-05T15:19:00Z

Well, I hate to jump on the media wagon with more commentary about the H1N1 flu virus, but I'm wondering how other health care systems are tackling this nation-wide problem. I got the H1N1 flu shot today at work, but many of my coworkers are declining to have a flu shot. Mostly, they haven't gotten the flu in previous seasons and don't feel any increased risk with the H1N1. Some are afraid of needles. Several cannot take the nasal mist version of the vaccine because they work with transplant patients....(read more)

Clinical Judgment and Lab Values

2009-10-22T11:52:00Z

Many times before a treatment session I will speak with the RN and discuss if the patient is appropriate for skilled therapy. Literally 99 percent of the time, the RN will say "Oh yes, please go get the patient out of bed." Occasionally a nurse will ask to hold the pt due to uncontrolled pain, fatigue, or unstable vital signs. The problem occurs when I look at the chart and see a glucose of 345, or a hemoglobin/hematocrit reading of 7.1/23 percent. Prothrombin time of 45 seconds. There is a fine...(read more)

Learning Experience

2009-10-15T12:26:00Z

A few nights ago I picked up an extra evaluation at the end of the day. It was a very active 88-year old woman admitted for a GI bleed. She volunteers weekly and is completely independent at home. No device used. Upon introducing myself and my purpose for visiting her, she stated she didn't need physical therapy but was agreeable to our evaluation. She had a history of falling, both mechanical, not balance related. By the time I saw her, she hadn't eaten any food in nearly 30 hours in preparation...(read more)

Mandatory Lunch Meetings

2009-10-08T16:57:00Z

At our hospital, the baseline for productivity is 75 percent. In acute care this is attainable on most days, but on some days can be difficult. Other tests/procedures, medical hold due to unstable lab values, dialysis, and simple patient refusals often make for a rather wasteful day. Add to this mix: mandatory lunch meetings. The policy at work is that these meetings are built into the 25 percent of unproductive (non-billable) time at work. I don't think this would bother me as much if I felt as...(read more)

Is Detox the Same as Skilled Therapy?

2009-10-01T13:26:00Z

The hospital I work at is in urban Milwaukee. It is located a little south-west of actual downtown Milwaukee, but it is by no means a "suburban"-type establishment. The Milwaukee Journal Sentinel published an article in today's paper citing Milwaukee as the 11 th poorest city in the nation. (Poston, B. City is 11 th Poorest in Nation. Milwaukee Journal Sentinel. 28 Sept 2009.) Needless to say, we see it all. On my schedule today I had three patients admitted for alcohol withdrawal, one of which was...(read more)

Code 4

2009-09-24T18:47:00Z

Several weeks ago I was at our daily OFT (Outcome Facilitation Team) meeting when we heard over the speaker system, "Code 4. 5 th floor. Room 12." A Spanish-speaking patient had passed out and became unresponsive, and a code was called for the Stat team to her room for resuscitation. As the nurse would later describe, she was attempting to fix the patient's IV as the patient sat at the edge of the bed. The patient said a few words (in Spanish), and proceeded to fall backward onto the bed. It was...(read more)

Perks of Being a New Hire

2009-09-17T12:30:00Z

Last week I wrote a depressing blog about how awful the world is when you are a new hire, or a new grad. This week, I'd like to focus on all the reasons why it's so great to be a new hire. 1. I have lots of fresh ideas. Having recently graduated, I had many assignments that involved researching new treatment techniques and was able to investigate effective interventions. While experienced therapists know what works, many also don't have the luxury of unlimited time to read up on these new trends....(read more)

Low Man on the Totem Pole

2009-09-10T13:33:00Z

I'm a new hire, and a new grad on top of it. I try not to cross any lines at work. There are situations and policies I disagree with (strongly), but I bite my tongue and convince myself there will be a better time to voice my opinion. The people I work with have been there longer than I have, and been practicing longer than I have, so they probably know more about these things than I do, anyway. However, there are some instances when it really, really sucks being a new hire. 1. There is no reason...(read more)

Frequent Flyer

2009-09-03T11:33:00Z

A patient came into our Emergency Department last week with chest pain, shortness of breath and a generally malaise-type feeling. The patient couldn't point to any specific cause, and had a significant family history of heart disease. The patient was classified as "obese" by her BMI and was a smoker. The patient was hooked to a 12-lead EKG and admitted for observation on our cardiac floor. I left out a vital piece of information in that introduction. This was the 24 th ER visit from this patient...(read more)

A Big Problem

2009-08-27T18:51:00Z

I had a patient on my schedule today who weighed, no exaggeration, 450 pounds. This woman had been bed-ridden for some time and was admitted to acute care for treatment of cellulitis. During a co-treatment with OT, we were able to mobilize this patient to the edge of the bed and place a bariatric recliner in front of her. The back of the recliner had two metal bars to act as a transfer bar, and the chair itself was a wonderful method of providing anterior knee block support. In two trials, the patient...(read more)

PT = Exercise

2009-08-20T19:58:00Z

As physical therapists, we teach our patients every day the importance of remaining active, of increasing our endurance, the never-ending benefits of exercise. But, do we practice what we preach? On average, I ascend between 17-25 flights of stairs every day. I run between several floors to treat patients, and it is more convenient and much faster to take the stairs. Likewise, I am also on my feet all day. I sit during my documentation time, but otherwise I spend my day doing a fair amount of manual...(read more)

Isolation

2009-08-13T15:48:00Z

In the acute-care hospital setting, words like MRSA, VRE and C-diff run wild. Many patients are in isolation, and many require specific sanitizations prior to and following patient interaction. Droplet isolation is, for the sake of argument, fairly easy to accommodate with a facemask. Contact isolation, however, requires significant planning on behalf of the therapist. For a given patient in contact isolation, I gather all possible materials I may need; clean sheets, gown, slideboard, walker, and...(read more)

Patient Inconsistency

2009-08-06T11:41:00Z

On acute care, every day is different. There are days when my schedule works perfectly; other days, every patient is at a test or procedure, or refusing therapy. Likewise, there are days when my patient requires total assistance for mobility and the next day performs all transfers and ambulation with supervision. What's the deal? I think a big part of it is motivation. If I asked my friends to come to a tour of religious and architectural influences in modern day Madrid (which exist, by the way),...(read more)