My exam didn't start until 5:30, and I really hadn't eaten anything all day because I was so nervous.  (This is typical for exams, but even more pronounced for this board exam.)  Then, each time you check into the exam or leave to go to the bathroom, you are photographed, fingerprinted and asked to sign your name- just a little more pressure added to the pressure cooker. 

The exam is 5.5 hours long, it took me a little more than 4 hours to take it.  I'll be the first to admit that I'm not a great test-taker.  I can talk myself out of or into any variety of answers.   However, I think the hardest part of this test was simply its length- staring at a computer screen for that long takes its toll. 

I wasn't sure if I wanted to know my results or not- I walked out of the exam feeling like such a failure.  There were a lot of difficult questions with no clear correct answer.  I was tired and hungry through most of the exam which made concentrating difficult.  I was fairly convinced that I would have to take the exam over, and I was embarrassed just thinking about explaining it to my family and my employer. 

As it turns out, I couldn't wait to see my results.  The next morning I logged onto the FSBPT website and paid $57 to get my individual score report.  I PASSED! 

I'm so nervous.  I've basically been studying for this exam for 3 years- every single class, every lecture had compounded into this one exam I need to become a licensed physical therapist.  Obviously, this is more nerve-wracking and more weighted than any ACT or SAT or final exam I've ever taken. 

Things I need to remember: BREATHE.  Take my time in reading the questions.  Don't rush.  Even the littlest details in the questions will lead me to the correct answer.   

I've heard that I can go onto the FSBPT website the following day after my exam and pay $60 to get my score.  There's part of me that wants to know if I passed or failed as soon as possible, there is part of me that probably wants to postpone any chance of getting bad news.

Either way, you can probably bet I will be feeling both relieved and incredibly frustrated tomorrow night.  And, if you are reading this on Thursday, June 25^th, just send some good thoughts my way. 

1. Student loan payment;
2. Buy massive amounts of groceries;
3. Go to a Brewer's game;
4. Buy some work clothes!
5. Turn the lights on in my apartment, because I have money to pay my electric bill;
6. Pay someone to take my board exam for me;
7. Renew my APTA membership;
8. Go on vacation. I need one;
9. I think my stuff would look better in a Louis Vuitton purse;
10. Buy a house.

On the same note I also have benefits!!

1. I need a dental clean up;
2. New contact lenses would be bliss;
3. Start investing to my retirement fund.

I also bought a lottery ticket... tonight the numbers are revealed.  What would you do with a paycheck, or a lottery ticket? 

As a health care provider, I agree that changes need to be made.  Being forthright with our patients is key- transparency of costs, knowledge of available options, and determining the best provider based on outcomes measures. 

The beauty of the United States is the free-will and constitutional right every citizen has to make individual decisions.  By putting requirements such as forcing citizens to carry health insurance, or a government-based health care system, we are taking away a small part of our rights as American citizens. 

If everyone has health insurance, what's the point?  A MRI scan should cost the same regardless of the person, regardless if they are in-network or out-of-network.  Common sense. 

For the average person, health insurance companies are complicated and difficult to work with.  Finding answers to questions nearly requires persistence in knowing which questions to ask and who to ask them to.   Simplifying this process should be a priority. 

It will be interesting to see how this all unfolds.  I'm glad I don't have the job of finding a solution that will work for an entire country. 

I learned today that it is NOT an ideal way for a new grad to begin. 

First, there is no consistency of patient caseload.  I'm picking up odds and ends of other therapists.  (What this also implies is that my patients aren't receiving very consistent care--a separate topic to discuss.)  And, since I'm not in the same clinic each day, it's not like I am at least familiar with who the patients are and have a general idea of their plan of care.  And, since I'm not in the same clinic consistently, I don't know my coworkers that well.

I arrive to work in the morning and try to read up on as many patients as I can, but when my patients are back to back, I have 4 evaluations each day.... I don't have time to read all the notes of each patient--just the eval and most recent treatment note, if I'm lucky. There is a lot of stuff in between those two notes that happens, but I don't have time to read up on all of it.

In conclusion, I would never recommend a floating PT position to a new grad. Ever. 

Monday I begin with orientation at ProHealth Care, the hospital I will be working at for the next year. I'm excited to learn about everything I will have access to, all the opportunities I will have. I am really looking forward to working, to contributing to the physical therapy world. 

I've had a giant sense of relief the past week, knowing that I am done with school and my whole life in front of me.  I can't believe I'll have my nights and weekends free!  No obligations to flip through my notebooks, make note cards, or practice my skills on an unassuming bystander. 

Here are two quotes I find very fitting for this stage in my life. 

Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us.  We ask ourselves, "Who am I to be brilliant, gorgeous, talented, fabulous?"  Actually, who are you not to be?  You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won't feel insecure around you.  We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us.  It is not just in some of us; it is in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same.  As we are liberated from our own fear, our presence automatically liberates others. 

~Marianne Williamson, A Return to Love: Reflections on the Principles of "A Course in Miracles," 1992 (commonly misattributed to Nelson Mandela, 1994 inauguration speech)

You have brains in your head.
You have feet in your shoes.
You can steer yourself in any direction you choose.
You're on your own.
And you know what you know.
You are the guy who'll decide where to go.

~Dr. Seuss

I'm hoping I can take my board exam the second week of June. If that's the case, I will have three weeks to study beforehand. That way I can set up a calendar and focus on different areas each day until the test comes. 

I picked up my cap and gown at our school union today. I hung it up in my closet and I'm going to stare at it for the next four days until graduation. I can't believe I'm graduating. 

Meanwhile, I had a chance to meet Allie, the PT I will be working with in the research lab at Marquette as part of the neurological residency program.  It was interesting to see how many opportunities I will have during this residency--working with neuro patients and some very nice lab equipment.  

Finally, I got to see my weekly schedule during the residency program; working at the clinic 30 hours a week, research five hours a week, TA in Neuro Rehab four hours a week, and one afternoon set aside for preparation time and other learning opportunities as they arise. 

Next week I have a boards review course at school for two days, and then a "mock exam" our school administers.  I haven't taken a standardized test since the ACT, so I really need to get into the swing of taking an exam like that.  You know, time management, etc.

Next week I will also be meeting a few of the people I will be doing research with as part of the residency program- I think the research is aimed at interventions for patients with strokes, but I could be wrong.  Either way, I will have some research experience throughout next year. 

I am still in disbelief that I'm graduating.  Six years later, wow. 

As I write this blog, I am kind of amazed at how much has happened in the last two months since I arrived in Phoenix. As far as physical therapy goes, I have met and worked with some amazing patients, learned a lot from my CI and had some memorable moments with my coworkers. Personally, I met people in Arizona who have blessed my heart.  

It is going to be very weird adjusting to having a real job. I don't know how to explain it, but thinking about "asking off" for vacation, or being responsible to go to staff meetings and in-services just seems so very grown-up. 

But for now, I need to finish packing and listen to some good music as I get ready for the long drive home. 

(I know a lot of these things sound ridiculously cliché, but trust me in that they are all genuine.) 

• Late nights studying
• Early mornings studying
• Midafternoon studying
• Practicing techniques on my classmates
• Laughing and laughing with my classmates
• Great professors
• Even better friends
• Typing countless study guides
• Watching patients conquer the impossible
• Learning that the best parts of being a PT can't be taught in a classroom
• Meeting great people, great therapists on each of my clinicals

And, for the record, I'll warn you that my next few posts may be a little emotional or sappy or something.  It's not really my style.  But, a lot has happened over the past six years, and I cannot believe it is finally coming to an end. 

(Let me just cover my bases before you read below- I love my clinical, couldn't be happier with my CI, and am truly enjoying every minute of my experience in Arizona.) 

Roses are red
I can no longer lie
I can't stand my clinical
Or my CI.

I can't be myself
I can't stand old people
I hate dealing with urine
And everything fecal.

I can't wait til the end
It can't come soon enough
These last three weeks
Will surely be rough.

I am worked to the bone
Yet do not get paid
It's the life of a student
I sure got it made!

I can give it my best
Yet can do nothing right
The light at the end
Does not seem so bright.

But in a few weeks
I shall be free
I can treat how I want
Once more, I'll be me

• What do you do when a therapist responds to a text message in the therapy gym, in front of a patient?
• What about when a coworker helps a patient with a transfer, meanwhile exposing their backside to the entire department?
• What do you say when another therapist has 90% of their patients perform the same recipe card of straight leg raise, long-arc quads, and ankle pumps for their therapy session?
• A coworker who doesn't consider the emotional journey of a patient's hospital experience?
• A therapist who documents one week after the day services were provided?

Basically, what do you do when you disagree with the style or methods of another therapist?  I'm not sure if I could be confrontational in these kind of situations.  I mean, I'm honest and at times quite blunt, but remarking on another therapist's responsibilities can be tricky. 

Maybe it's not my place.  Maybe I should just focus on my own business and let everyone else do their own thing.  Or, maybe, we should challenge each other to be better therapists, and invite feedback from others into our practice. 

I have twice experienced working with patients with expressive aphasia.  The first patient, at my last clinical experience, was a recent CVA (within three weeks from the time he was admitted to the rehab department).  During his rehab stay, he increased his verbalizations greatly- saying fragmented sentences and increasing his vocabulary daily.  The first few days of therapy he would nod or shake his head appropriately, and towards the end of my clinical he would say "I used to work with trucks," or "I'd like to walk."  It was very interesting to see such drastic improvement in a considerably short period of time. 

Fast forward to my current clinical...I had an evaluation yesterday with a woman who was 8 years post-stroke, and essentially nonverbal.  She makes a "Choo-choo" sound, similar to a train, when she is trying to express herself, but otherwise can make no understandable sounds.  She nods and shakes her head appropriately to questions, and does a fairly good job of using gestures throughout the session. 

So, what can you do? For the lady, is there any chance she will talk again?  You look in her eyes and can see such a warm heart, desperately trying to communicate with others.  I think that's the hardest part for me, that there is virtually nothing I can do for her, except put my arm around her and say, "I know this is hard, but I will do everything I can to understand what you are trying to say."  And after I say that, she cries.  

If you have any tips, ideas or past experiences you would like to share...click on the little "comment" link below and leave a message.  I'd love to hear what you have to say!

So, I realized something today at work- I have a tendency to get anxious and worked up about my documentation.  Seriously, I stress out about it.  I had THREE, count ‘em, THREE evaluations today - that's a lot for me.   And, as I was in the middle of my second evaluation, I thought to myself, "You have so much documenting to do. You are never going to get it done.  You should start worrying about this immediately because it is a HUGE deal."  I was starting to get very uncomfortable knowing I had work to do but hadn't done it yet. 

I hate having things on my to-do list.  I can't imagine a time in my life when I will ever procrastinate.  It drives me nuts knowing I have something to take care of. 

Anyway, today was the first time I ever realized that there is nothing more I can do than my best.  I will finish my evaluations as thoroughly as possible, and I will be as efficient as I can with my documentation, but if I can't get it done, I will get it done later. 

Worry isn't an effective means of becoming a good therapist.  I need to focus on my patients and the rest will come together on it's own time.