Welcome to Health Care POV | sign in | join
Raising the Bar in Rehab

Continuing Education Courses
by Lisa Mueller

A few years ago, I had the opportunity to teach a continuing education course on early mobility with three other physical therapists. We met for several weeks, reviewing the content along with the training and presentation materials. It took a lot of thought and effort to review every detail of the course to make sure it flowed well and the learning objectives had all been explained thoroughly.

Teaching that course was one of the highlights of my professional career. I loved sharing my enthusiasm and knowing patients would benefit from other therapists learning the skills and tools specific to acute mobilization. The 4-hour course was perfect to not completely overwhelm the course participants or cause any of the presenters to lose their voices! Afterward, several of the participants connected with me on LinkedIn and we were able to continue sharing our experiences and learning from each other.

Shortly after our course was completed, we were sent a message from an out-of-state hospital system asking if our 4-hour course could be expanded to a 16-hour, two-day CE course. Our team discussed the option and decided against it for a number of reasons -- logistically to travel with the needed equipment to another state, the time to develop the content to four times the original, and balancing that with our regular full-time jobs. Although we didn't say it out loud, I know I also thought that being responsible for a full weekend CE course was a little too outside my professional comfort level -- I was a PT, not a course instructor! Four hours were much easier to commit.

Looking back, I wish I would have said yes to that weekend course. I wish I had pushed myself to at least try. Even as I write this, the barriers we debated about the logistics and work don't seem to be the daunting challenges they were at the time. It would have been an awesome experience.

There are many times physical therapists have to consider making professional changes. We change employers, or change facilities or settings, or change the type of work we are doing. Only we know what is best for our own careers. What about you? Do you have any professional regrets? At what point in your career have you said, "I should have" or "I wish I would have?"

You Might Also Like...

Gaining Mobility in the ICU

How one multidisciplinary team initiated an activity protocol to decrease ICU lengths of stay.

Delayed ICD-10
by Lisa Mueller

Medicare and Medicaid announced recently that ICD-10 will go-live on October 1, 2015, which is the third time the change has been delayed since 2009. CMS states that several factors impact the delay of implementing the updated coding guidelines: software, staff training, updating policies and guidelines, as well as paperwork to reflect the changes.

Several of my former classmates were disappointed with news of this recent delay. Their employers provided ICD-10 training along with reference materials for guidance during the transition. Do these delays reward those who cannot meet deadlines? Do those who were prepared for the changes now have to repeat their training and undo their scheduled software updates?

This reminds me of a time when I worked with a patient who had a diagnosis I wasn't familiar with (I can't remember the diagnosis now for the life of me). I ended up doing a lot of reading and research on the topic to be prepared for the patient's next appointment, but was disappointed when the patient cancelled.

I felt like I wasted a lot of my time learning about the disease, and quickly realized that the time wasn't really wasted because I learned a lot that would easily carry over to other patients. Like many areas in my career, this was another example of how knowing more information related to my patients would empower me to be a more skilled and compassionate therapist.

I think the same way about the ICD-10 delays. Those who were prepared will have an advantage to know the changes better than others, and their prep work will only help them through the transition.

What do you think? Are you ready for the change to ICD-10? Have you been involved in training courses yet?

You Might Also Like...

Drowning in Documentation Requirements?

Modern systems can ease the confusion and minimize denied claims.

Limiting Therapy
by Lisa Mueller

A friend of mine recently asked for my opinion about how much therapy she would need following a knee arthroscopy. I talked with her for some time about her symptoms and which PT clinic she was going to work with. She then told me she was worried the physical therapist wouldn't be able to help her within the 20-visit limit of physical therapy her insurance company had for her annual rehab benefit. I reassured her that her physical therapist wouldn't need 20 visits to help her meet her goals, but she was clearly concerned.

I've thought about therapy caps from the perspective of the physical therapist many times, and my thoughts are usually surrounding the paperwork associated with requesting more visits. It can seem like one more barrier getting in the way of direct patient care, and that's what physical therapists love to do. However, what do these limits mean for the patients? Like my friend, does it mean fear that their injuries will continue if they surpass their limit?

While some physical therapists may be frustrated by third-party payers for adding these guidelines to patient benefit plans, I think there's also an underlying opportunity for PTs to demonstrate their effectiveness and efficiency within therapy visit limits. The American Academy of Orthopaedic Surgeons recommends patients find a physical therapist who averages nine visits per patient (there's no detail about whether this number is for surgical, non-surgical, or simply an average of orthopedic PT visits overall).

Is there an area for opportunity here? If a new patient is scheduled for physical therapy with a diagnosis of plantar fasciitis, could you anticipate the patient reaching his goals and continuing independent management after three visits? If so, can we share that information with the patient during his first encounter, to ease any concerns he may have about limits on physical therapy visits?

I've seen what the other end of this spectrum can look like -- patients with no payer limits on physical therapy who may develop an unhealthy dependence on physical therapy. Who, when ready to be discharged independently, report symptom exacerbation and require more physical therapy to manage their symptoms in what seems like an unending cycle.

What do you think? Are therapy caps a barrier to your practice as a physical therapist? Can your practice effectively work well within the guidelines of payer benefits?

You Might Also Like...

Coping With Therapy Caps

What physical therapists need to know -- and do.

Are Leaders Doers?
by Lisa Mueller

I was talking with a friend of mine about being a supervisor in rehab and about leadership and management of companies. We were comparing the differences between being a physical therapist and supervising a department. I've written about this previously, analyzing some of the traits and characteristics that cross between physical therapy and managers.

My friend said something interesting that I haven't been able to forget -- "People who are promoted are usually good, or the best, at doing things. But being a good leader isn't about doing things. It's about helping other people do things. You have to transition from a ‘doing' mindset to a ‘coaching' mindset, and that's where most leaders fail." Hearing her say this was like an "aha" moment for myself, because I found the words to be very true.

I'm very interested in the idea of hiring people for their strengths and putting them in jobs with tools to make strengths even stronger. In my friend's description, many doers who are promoted to leaders can be evaluated on skills they lack or areas they need to improve. Sometimes, doers have the best role in continuing to do good work.

I think I'm really good at doing things. I keep my work organized and prioritized. I can dissect a project to all of the milestones needed for full success. I visualize the full picture and zoom into details when needed. But, I'm not sure how to measure my success in coaching others, or in enabling others to do their work well. Perhaps this is where engagement surveys are effective to measure the impact leaders have on motivating and engaging their teams.

Do you see a difference between doers and leaders? Where do you see yourself fitting? Are you a doer, a leader, or do you have qualities of both?

You Might Also Like...

Bright Ideas

A look at physical therapists who've followed their dreams to entrepreneurial success.

Changing Policies
by Lisa Mueller

When I was in PT school, we didn't discuss organizational policies and procedures very often. Even as a student, my clinical instructor would show me how to do something but I don't recall ever seeing a printed policy or handbook on what to do. Actually, I do remember seeing one master binder that had a ton of documents in it, but it wasn't easy to search for a document in the stack of papers.

Regulations and laws regarding every aspect of healthcare are constantly changing. The billing information needed by a third-party payer may change when benefit plans are reviewed. Changes to how we use rehab equipment may happen when the manufacturer updates the model. We change our treatment approaches with information on the patient's response and new evidence supporting our plans. Things change -- but how do we keep up?

If you are part of a large physical therapy department, or a clinic that has more than one location -- how are changes to your work communicated? How do you find out if a process is updated? Is it the responsibility of the physical therapist to find the information? Leaders to provide announcements and training? What's the best way?

I'm interested in this topic for a couple reasons. First, because physical therapists typically prefer to spend their time with patients, not administrative tasks, so our communication on policies and procedures is most effective when it's efficient. I think staff engagement and job satisfaction is tied to having the information to perform our jobs effectively. Second, I wonder what the impact would be to our patients and their payers if we aren't able to adjust our operations to accommodate changes.

Tell me about your organization -- how do you find policies and procedures you need for your job?

You Might Also Like...

A Move to the Cloud

This transition means instant access anywhere to information you need.

Connecting Complaints to Satisfaction
by Lisa Mueller
I read an article last year about the top 10 reasons why people make an appointment with their doctor and was surprised to see skin issues as the number-one driver. What an interesting topic to consider; why do we make decisions to see the doctor? Even more, how can we use that information to capture patients at the right time and provide them with the service they need? In this example, plopping a medical clinic in the middle of a busy city with no onsite dermatologist could result in many patients being turned away.  

I did a lot of research last year in an effort to establish an updated questionnaire for patient satisfaction surveys relating to physical therapy. I found questions like, "Did your condition improve as a result of physical therapy?" and "Did your physical therapist communicate with other members of your healthcare team regarding your condition?" Many of the questions I found or developed were about topics such as ease of scheduling appointments, friendliness of staff, and cleanliness of the facility. I was happy with a lot of the content within the patient survey.

At every clinical rotation I had during physical therapy school, I learned something about the patient feedback or complaint process. Each clinical instructor I had taught me about the importance of listening to patients and being a part of any needed solutions to prevent a complaint in the future. Developing these skills to understand active listening, timely follow-up, and even conflict resolution were critical so early in my career. My fellow ADVANCE bloggers have described many situations with dissatisfied patients and families and we are all equipped with the communication tools to help our patients understand our role, their goals and the plan to move forward.

I'm beginning to wonder what the best way is to balance our focus on patient complaints and the drivers for patient satisfaction. A patient may complain about food at a hospital, but later reveal on a satisfaction survey that the quality of food minimally impacted his experience compared to the quality of care, safety and professionalism of the staff. Patient feedback may give us insight into an inefficient process or attention to a facility we weren't aware was broken. Knowledge is power -- how do we take all this information from our patients and turn it into an improved patient experience?

What do you think? How do you field patient complaints at your facility? Do you see themes of common complaints? What is more important to focus on, the things that make patients happy, or the things that make them upset?

You Might Also Like...

What Patients Want

Innovative uses of patient satisfaction data in quality improvement and clinical management.

Continuous Improvement
by Lisa Mueller

Over the past several months, my role as rehab supervisor (overseeing a department of 25 people) has offered me a multitude of opportunities to become involved with other areas of our organization's business. I've been able to participate in our accreditation efforts as well as our quality committees and providing support to new clinic implementations. I love the diversity of my job and being able to see how each part connects to provide the most value to our patients. These recent experiences led to me applying, interviewing and accepting a new position -- continuous improvement leader!

There are often bursts of time where my fellow ADVANCE bloggers will write about their contemplation of careers outside the realm of traditional physical therapy, and my own journey is a great example of how skills as physical therapists can easily be applied to other roles. The purpose of continuous improvement (often referred to as "lean" or "six sigma") is to solve problems and remove barriers to provide the most value to all customers, both internal and external. In the healthcare industry, Wisconsin-based ThedaCare is a leader in establishing sustainable management systems built to drive quality and reduce waste. This type of work involves utilizing and teaching others the scientific method of root-cause methodology to identify the basis of problems, implement a solution, reassess and adjust.

Compare each of those points to the role of a physical therapist. Do we solve problems? Yes, every day. Do we remove barriers to provide the best value to our patients, colleagues, and payers? Absolutely. Do we drive quality and reduce waste? Yes! This is one area of physical therapy I'm most proud of -- our dedication to outcome measures and efficient lengths of stay. Do we use a scientific method for root cause analysis? Of course, in every evaluation we identify the etiology of our patient's deficits.

Every talent I've practiced in my career as a physical therapist -- assessing a patient's problems, educating patients, adjusting plans of care etc. are now being carried over into the same mindset on a larger scale. Continuous improvement means making all areas of the business work better and daily assessment of areas needing attention.

This career decision didn't come easily. I had to consider a lot of factors, the most important one being my time away from patient care. In my new role I'll have opportunities to work as a physical therapist, but not on a regular basis. I also thought a lot about this blog -- which I will continue to write but with a new spin on some of my topics. All in all, I'm very excited for this opportunity, and challenge you too to start thinking about the skills you have as a physical therapist and consider other careers to which those skills apply.

What do you think? Have you ever thought about a job outside of physical therapy? What stops you from making a change?

You Might Also Like...

Ergonomic Emphasis

PTs can play a prominent role in educating patients on proper ergonomics at work and home.

Let's Talk About Problems
by Lisa Mueller

In my role as rehab supervisor, I frequently prepare small presentations to share with others. Sometimes the leaders of my healthcare organization request updates or other times our sales team needs more information on physical rehabilitation to be able to better sell our service to clients.

There are situations when I will spend time working with IT, for example, to better understand their type of work and processes, so they can in turn help the rehab department in terms of software or other systems support. In each of these situations, my tendency is typically to focus on the victories of rehab. Yes! We can do that! We accomplished this! We exceeded our goals! I get so excited about the progress our department makes and the end result of the patient experience that my focus doesn't instinctively shift to anything else.

I recently heard a speaker give a contrast between GM and Toyota. He explained that the focuses of each company's executive reports took a drastically different approach -- GM on their accomplishments and Toyota on all of the problems with the hybrid model. The following year, GM filed for bankruptcy while Toyota watched the sales of their Hybrid model continue to grow. The lesson? We need to talk about problems. Problem-solving in groups and collaborating on solutions is the best way to drive progress, better outcomes and an improved customer experience.

I think it's important to point out that identifying problems and giving attention to their causes is different than placing blame. Likewise, it's equally important to appropriately recognize the good work done by a person or team.

Physical therapists are built to solve problems. What's the cause of your pain? Why is your strength impaired? How can we improve your gait pattern? We dig deep into the anatomy and physiology of our patients to find the root cause and help implement a solution with an effective plan of care. Many times, we probably don't even realize how ingrained problem-solving is in our profession because it's such a critical and subconscious part of our work. But do we carry the same attention to solving problems for our department, our organization, or our profession of physical therapy?

How far do you carry problem-solving into your world? Is problem-focus part of the culture of your department? Do you believe an emphasis on identifying problems and teamwork to find solutions, instead of accomplishments and accolades, is effective in the healthcare world?

You Might Also Like...

Details, Details

Using better documentation to sidestep claim denials.

Outcome Measures
by Lisa Mueller

I am (again) starting to work out more regularly. I'm not sure if it was the long and miserable winter, but I hadn't felt like exercising for a while. Now that the sun is out and the days seem longer, I'm making a commitment to exercising four days a week. I tend to go to extremes, either living a completely lethargic and sedentary life or exercising to the point of not being able to move. I was inspired by a Twitter trend to focus on 30 minutes of exercise and I'm hoping that will force me to moderate between the extremes to a successful regime.

Anyway, I was a little sore after one of my first lifting workouts this season and noticed a few aches in my upper back. Huh. My mind then started to think from the perspective of a patient. How bad was the ache? Maybe a 1 on a 10-point pain scale. Very tolerable. Then I thought about outcome measures -- so I went online to complete the Oswestry questionnaire and was surprised my results indicated a higher level of disability than I would have guessed. Either way, after my light jog the following day, my backaches were completely gone.

I like using outcome measures with my patients -- the information in the questionnaires facilitates good conversation to understand their perspective and goals. Luckily, our electronic documentation system allows for calculation and tracking of outcome measures within the patient's record as well, so it's easy to compare results over time. I have a chart at my desk for reference of the statistical significance for change. In speaking with other therapists, it seems like our profession does very well at using outcome measures with individual patients, but we lack a general knowledge of data and results, diagnosis-specific or otherwise.

One question I have for you about outcome measures is this -- how do you compare the outcome measure results of your patients to other therapists? How do you benchmark against external data? If you have a patient following a lumbar fusion, how does that person's Oswestry results compare to the national average? Do you think it's useful to know an individual patient's outcome measure results and improvements without knowing the standards of the industry?

You Might Also Like...

Modified Constraint-Induced Therapy

Incorporating PRACTICE principles to improve movement in stroke survivors.

How Can We Improve?
by Lisa Mueller

When I think about making improvements within physical therapy, my mind automatically transitions to evidence-based practice and focusing on outcome measurements. When thinking about department goals and making improvements, I consider factors impacting those two areas such as improving access to research sources or compliance when using outcome measures. Since the role of physical therapists lies primarily in helping patients improve, I often forget about other components that could significantly help a department of physical therapists.

At one of my clinical rotations when I was in school to become a physical therapist, I worked at an outpatient facility that provided whirlpool treatments to patients needing wound care. I remember one patient scraping his leg on the side of the whirlpool, which resulted in some bleeding and my instructor needing to file a report describing the situation. The report was extremely difficult to fill out; it was handwritten with lots of boxes to add information and took me and my instructor nearly 30 minutes to complete. A few weeks later, we received an email from the department manager that the report had been made into a digital version (PDF) that could be completed on a computer and printed for circulation.

I remember working in a therapy department that would have a few students rotate through each year. We always set aside a few small projects for the students to assist with, such as researching new equipment or literature supporting treatment techniques. One summer we ended up working with two more students than we originally planned for, and as a result we were able to make much more progress toward our department goals. Our students helped us organize some areas of our equipment closets.

In both situations, I witnessed how seemingly little changes easily improved the day-to-day tasks of the physical therapists. Reports were easier to complete and equipment easier to find. Improving the small things can really add up to staff being happy about their jobs, and I hope to keep these things in mind throughout the year -- celebrating the "small wins."

What do you think? What small things have made your job easier?

You Might Also Like...

The Inspired Treehouse

Pediatric therapists team up to share treatment ideas with parents and teachers.

Sharing Information
by Lisa Mueller

When I was a student in my clinical rotations for physical therapy, I spent a lot of time researching various topics. It would start with a diagnosis I was unfamiliar with, which would lead to some research articles where I would learn about different tests and measures and treatment concepts. It was exciting to learn all these new things and implement them immediately into practice, and I would often share these "discoveries" with my clinical instructor.

Looking back on that experience from my perspective now as a rehab supervisor, I wish the student Lisa would have shared more of that knowledge with a wider audience. I wish I would have offered my research findings to other therapists in the department. I'm always impressed with the wealth of collective knowledge our rehab department holds -- with so many therapists each with different experiences and specialties, we have a lot of information when united as a group. So, how do we make sharing information and knowledge easier?

When looking at making departments more efficient, or when implementing the "lean" concepts to healthcare, underutilized knowledge and talent is one of the eight wastes frequently needing attention. Wow! What an awesome thing to contemplate. Using everyone's skills and talents to the fullest capacity is on the same thought chain as working efficiently. That's awesome! This also reminds me of a book I read in physical therapy school and have written about before -- Now, Discover Your Strengths. Recognizing strengths and talents is the first step in being able to utilize them to the fullest potential.

How does your department or facility work to share information and capitalize on each therapist's strengths? Is your work biased toward independent caseloads, and therefore less interaction between therapists? Or, do your therapists connect regularly to share ideas and specific patient cases? With the growth of technology and options like email and web discussion boards, what's the best way to stay connected with each other?

You Might Also Like...

Three Critical Questions

Before expanding into a new location, grow your practice from the inside.

Ends Justify the Means
by Lisa Mueller
I took three courses of philosophy during my undergraduate years and never really got into it. I'm not even completely sure I understood the phrase, "the end justifies the means," until I was a little older. Experiences added up and I learned how to focus on the end result to get through the process, and like an "aha" moment, I finally got it.

I'm in the age of family planning. It seems like every week another acquaintance is sending photos of baby bumps and due dates. I remember working with a patient right after graduation who told me, "Don't worry, there's still time for you," when she learned I didn't have kids, and that was five years ago! I had dinner with friends a few months ago who told me that after years of trying, they wouldn't be able to have kids. My friends had other options, such as adoption, but the bottom line was if she wanted to carry her own children, she would (at the direction of her OB) need to try IVF treatment. And there it was -- the ends justifying the means.

I've seen this happen in physical therapy practice occasionally. I educate my patients on their treatment options, collaborate on a plan of care ("the means") and establish together the goals ("the ends"). Some patients decide that the ends justify the means, and others don't. For example, a patient wanting to walk again may decide the hard work of pain with weight bearing, the challenge of balance training, and the difficulty in learning eccentric control is worth the end goal of ambulation. Another patient may see the same process and determine he cannot tolerate the means to achieve the end.

Our role as physical therapists is simple -- help support, educate and guide our patients during the healing process to get to the end. We have the education and experience to see our patients' goals before they're able to visualize their own success, and our jobs require us to remind, reinforce and facilitate our patients as they work through the difficult processes of changing the way their bodies function.

What do you think? Do you have patients who struggle through the process of change, only to be pleasantly surprised by the outcome? Do you have to educate your patients on why the ends justify the means?

Related Content

From Hospital to Home

Physical therapy is a key component in facilitating smooth transitions for patients.

How Many Hats Do You Wear?
by Lisa Mueller

One of my student clinical rotations was at a smaller physical therapy outpatient clinic with just three staff members who managed all aspects of the operations. They all worked seamlessly together and the patients had a lot of fun during their appointments, partially because their therapists were very knowledgeable about every aspect of the business. As I think about that facility now, I have even more respect for those therapists than I appreciated when I worked alongside them.

When I interact with patients, my brain is focused on every component of practicing physical therapy. I consider differential diagnosis, muscle fiber length-tension relationships, observing my patient's response to changes in position and palpation... all of the factors that go into successful treatment. It's not easy for me to switch from that kind of thinking, to say, billing cycles or scheduling equipment calibration. The group I worked with in school kept track of all the billing, scheduling, staffing, ordering of supplies, as well as paying the building rent, electrical bills and insurance coverage. This is what a lot of private practice physical therapists take on, and I am impressed.

Many times we are asked to wear additional hats at our jobs. There are other components of physical therapy practice that extend beyond patient care and need to be completed, whether the setting is private practice or a large organization. Each of these parts are equally important in setting the framework to provide excellent patient care. We aren't able to treat patients without a building to practice in, equipment to use, and systems to collect payments, for example. I imagine the variety of responsibilities may be overwhelming for some physical therapists and stimulating for others.

Are you asked to assist with maintaining the equipment in your facility? Do you participate in patient billing? Do you work closely with the landlord of your facility, or schedule fire marshal inspections when needed? How do you balance the multiple hats you wear? How do you multitask your multiple responsibilities?

Related Content

Coping With Therapy Caps

What physical therapists need to know -- and do.

What Equipment Do You Need?
by Lisa Mueller

When I was in my outpatient neuro clinical rotation I learned a lot from my instructor about PNF skills as well as standing, kneeling and seated balance training. It was a lot of hands-on work and we didn't use a lot of equipment other than parallel bars and balance pads, and a mat table. The clinic set-up was simple yet effective; patients had what they needed but not a lot of high-tech gadgets I've seen at other facilities.

After graduating from physical therapy school, I became very familiar with budgeting. Every dollar had a place. That same budgeting concept probably applies to every physical therapy clinic. How do owners, supervisors and physical therapists prioritize their equipment needs? My style of treatment and the equipment I need to practice effectively may be very different from my colleague who requests entirely different supplies for her patients. What is the best way to mediate those differences so all patients have what they need during a physical therapy appointment?

There may be ways to offset an immediate equipment need, but it's also difficult to substitute for some supplies when you don't have them. Parallel bars offer a lot of functionality that can't be easily mimicked if they are needed by a patient. The best example I have of needing equipment at the right time was when I assisted patients with gait training in an inpatient setting and my patient was ready to transition from a wheeled walker to a cane. Finding a cane was somewhat difficult because they always seemed to be propped in a corner of a patient room, so I often used my hand as assist although this wasn't the same as the patient handling a cane independently.

This topic of equipment also ties in with the "lean" concept I wrote about two weeks ago. How do we make sure our clinics aren't wasteful with equipment and supplies? How do we remove excess or unnecessary equipment from our clinics? And, how do physical therapists think when budgeting for equipment and supplies? Do we invest in what patients need, in what we can market, or in both?

Related Content

Get Them Standing

Standing in abduction prevents contracture and improves hips in children with neurological conditions.

by Lisa Mueller

Have you read ADVANCE blogger Allison's post this week about her first resignation from a physical therapy job? It sparked a lot of comments (mostly about the PTA role), but it also got me thinking about her comment on "greener pastures."

We all often consider the pros and cons of various employment opportunities, like any other profession outside of physical therapists. I remember two years ago thinking about my commute time, skills I would be able to practice, scheduled hours and my colleagues when I made the switch from inpatient to outpatient. Now as a rehab supervisor, I'm much more conscious of the rehab team's engagement, morale, and overall satisfaction with their jobs. Patients like to be cared for by therapists who like their jobs. We've all had experiences with an unhappy staff member in any setting and know our experience as a customer or patient was impacted.

My mom recently told me, "The grass is greener where you water it" -- a saying I'm sure she heard or read from someone else. Does this ring true to physical therapy jobs? Can physical therapists invest time and energy into making their own job a place they want to be?

When I first started working as a physical therapist, I was so motivated and felt such a surge of independence -- my years of education had finally culminated in an actual profession, including a job which gave me a paycheck! I was so excited to work, I didn't really stop. After about a year-and-a-half I was very burnt out. My energy was gone, I had a hard time concentrating and an even harder time connecting with my patients as I normally did. When it happened, I was surprised and felt badly because I knew my patients deserve better than that. It was a good learning lesson for me -- to recognize the signs of over-working so I could take a step back and pace myself.

What do you think? Are you a happy employee? What do you do each day or week to make sure you stay balanced? If you don't get what you want or need from your job, what steps do you take to get it?

Related Content

Setting Alerts to Simplify Your Job Search

Running the same searches every day is tedious, so why not make those opportunities come to you?



About this Blog

Keep Me Updated

Recent Posts