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PT and the Greater Good

The New Normal

Published November 1, 2011 4:03 PM by Dean Metz

How many times have we had to explain to patients about their "new normal?" Things like:

● "You can still get out and about, but you'll use a cane to do it safely."

● "You'll use this sliding board to get in and out of your wheelchair."

● "You'll still be able to exercise, but your knee can't really tolerate a marathon anymore."

We have these conversations with our patients but do we really understand the emotional impact of a dramatically different life? We all go through major life changes. Some are horrible, some delightful, but they are still stressful. There are times such as when you realize you have to do your own laundry because you don't live with mom anymore. Or when your baby wakes up a million times a night and you know you will never sleep the pre-baby way again. The first time you sleep alone because your partner is no longer by your side; or the first time you have to share the bathroom with your new spouse, knowing it will never be the way "you want it" again.

I just received my permanent leave to remain in the UK today. It is the equivalent of getting a green card. Now I know that I will be driving on the other side of the road, saying "to-mah-toe," using "whilst" and spelling words like "colour" and "centre" differently for good. It is an odd feeling. I must release the familiar and embrace this new normal if I am going to lead a happy and successful life here.

The next time you need to have the "new normal" conversation with a patient, try to remember a time in your own life when you had to adapt to a whole new normal.


Hello Dean--well-timed post. I had to do just this today with a young lady who has spinal cancer and all she wants to do is get dressed up in her prom gown. We had to use a tilt table just to stand in therapy. Never an easy task.

Congrats on your card. I did get my UK PT license approved but now have to face the hurdle of getting a sponsorship since the Tier 1 Highly Skilled Immigrant Programme no longer exists. I'm in a Catch-22; can't get a letter of sponsorship til I have a job offer and what employer will hire someone from the States who can't start a new job "on Monday." Any suggestions? The married-to-a-national thing isn't working out for me.

Thanks for all your help; very much appreciated!!

Mary Lou

Mary Lou Stilwell, , Physical Therapist Georgia Health Sciences University November 2, 2011 8:40 PM
Augusta GA

I deal with this all the time.  There is no good way to tell someone their normal has changed.  I try to limit my conversations to rehab needs.  Patients still pick up on the undercurrent that things won't be the same.   I'm usually the first therapy to interact with these patients.  The majority seem to have some inkling the future will be different. At least once a week I  make someone cry when I tell them they need rehab.  This conversation doesn't happen until we've tried to get out of bed and ambulate so they've had a chance to see things aren't working the same so they usually have some idea there is a problem.  Many want me to tell them everything will get back to normal and I can't.  I never know what to do when the crying starts.

Good post.  This is something we should think about more.  More often than not, we're the ones who break the news of the new normal to our patients.

Toni Patt November 2, 2011 7:23 PM

Good advice for many circumstances:  remembering when we were in a similar situation.  Putting ourselves in the other person's shoes, especially if we've actually been in their shoes - or at least worn the same type of shoe, maybe just a different size.

It is so easy to forget the challenges of our struggles once we've passed them.  But so empowering to others when we can hold on to the realities of those experiences and share the hope of being on the other side.

Congrats on the UKs equivalent to a green card!

Janey Goude November 2, 2011 1:10 AM

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About this Blog

    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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