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The Life of a New Grad Physical Therapist

The Adventure Continues…

Month

February 2016

The Last Two Weeks

I’ve been getting more and more comfortable with where I’m at.  The therapist that didn’t exactly seem all that inviting has really opened up and we talk quite a bit.  We even went to this skills lab thing where we were partners to practice techniques on.  I think the potential is there to be friends.  The other therapist who started a week before me is allllll over the place.  To be honest, I wouldn’t be surprised if she got fired in the next few months.  She’s always trying to do a million things at once while treating her patients…and by that, I mean she’s trying to do a million things that are completely unrelated to PT while she’s treating her patients.  For example, she’ll be telling me about something that happened over the weekend, while looking up how to get a license at the DMV, and completely ignoring the fact that one of her patients is waiting for their HEP or for her to take them through the next exercise.  Our clinic director has gotten on her a number of times which has led to the therapist ranting about how she doesn’t know why the clinic director keeps getting on her case….while the clinic director is still in the building!  So I just do my best to change the subject, which is awkward!

The clinic director, for the most part, leaves me alone.  I’ll get updated on things I haven’t learned yet but I haven’t been told anything negative about how I’m performing.  We are super over-staffed right now so that has given me the chance to get the hang of things without feeling super overwhelmed.

There have been a couple things I’m not quite fond of.  For example, our clinic just switched over to charging patient’s for therabands and that bums me out.  What was once free is now $16!! It blows my mind.  So I’ve been working really hard to find ways to modify patient’s exercises so that they can still get what they need without having to fork over money.  That being said, I’m practicing at a clinic where the average patient probably makes at least double what I make…so a $16 theraband probably isn’t the end of the world to them.  Anyway, it still bothers me.

Another thing I don’t like right now is having to see a crap ton of Medicare.  It’s not the Medicare patients I don’t like…it’s just Medicare.  Documentation for Medicare makes you want to rip your hair out.  And if you have Medicare patients overlapping on the schedule, it becomes super annoying trying to figure out how you can get 3 units of therapy out of the session.  So that has been really frustrating and the people up in the front scheduling haven’t been scheduling in a way that would make it easier for the therapists.

Let’s see…I had discharged my very first patient after only 4 visits! One of my patients switched onto another therapist’s schedule which really stressed me out that I wasn’t doing  a good enough job BUT one of her patient’s switched onto my schedule….so whatever.  Oh! I’m also learning Farsi.  I have a patient who speaks Farsi (her English isn’t the best) so I’ve been having her teach me things each time she comes in so that I can communicate with her better and so that if another Farsi speaking patient comes in, I can communicate with them! So far I can….count to 10 (working on 11-20), say right and left, say ankles, knees, hips and back, say hello, goodbye, good job, say ___ more times, say ____ seconds or ____ times and put a lot of it together to say ____ times with the right/left leg or ____ second with the right/left leg.  What’s really great about it is that I’m getting to learn something from a patient while they are learning something from me!  And the patient really appreciates the effort I’m making!

Anyway, that’s the news for now! 🙂

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Who the Heck Am I?!

Wow, 2 posts in one week for me.  I’m impressed 🙂

As I wrote in my previous post, this week started off a little rough.  It did get better, though.  I had moved over to sit with the other therapists so I felt more included.  I was seeing patients for their second or third visits (and some of them had gotten A LOT better!). It went pretty well.

The problem I’m currently having right now is figuring out who I am as a physical therapist.  What do I believe in?  What do I stand for? What is my preferred way of practicing? I’m still figuring that all out and it’s a little scary.

I had had 3 clinical rotations in outpatient ortho before going to per diem at a clinic and then taking the full-time position where I’m at now.  All of these experiences have been super helpful, but they are also confusing the heck out of me.  Some therapists did STM…others were very much opposed to it.  None of the therapists on my rotations used ice and stim but my per diem position did and now they are telling me I should do that with my patients where I’m currently at.  One clinic had 1 patient every 45 minutes with no overlapping (it was the best!!!).  Everywhere else has been 1 patient every 30 with overlapping (and my per diem was switching to 1 every 20 min!!…glad I got out!). I get why  it comes down to that but I absolutely hate that set-up, especially since I know what it’s like to have complete 1 on 1 time with patients.  I can’t help but feel completely stressed out about making sure everyone is happy and feeling cared for.  And I don’t feel like I can really make sure they are doing things appropriately.  But there’s nothing I can do about that.  Ultimately, the goal is to find a clinic where patients are seen 1 on 1 without overlapping but, for now, I need to get experience under my belt.

I’m also struggling with what types of exercises I like for my patients.  In this day and age, we have access to sooo much information. It’s great but it’s overwhelming.  There are so many therapists posting their opinions on exercises and techniques that it’s really had to figure out which is the best.  Obviously, if there’s research to support it, it makes that decision making process easier, but sometimes there isn’t any research.  So what do you do?! How do you figure out the best course of action for your patients?  I’m not going to lie, there have been quite a few days where I’ve felt like hiding the content from all the PT Facebook pages and just saying “screw it…I’m just going to do things my way”.  In a way, that’s actually probably what is best but then I freak out about missing something that my patients could really benefit from.

So I’m obviously floundering around at the moment.  I know I’m eventually going to find my way and I know I’m going to come out of this a great therapist.  I care too much about my patients to give them anything less than what they deserve.  I just have to figure out myself out along the way.

 

 

Overwhelmed

I’ve completed my first full week as a licensed PT.  Well, sort of.  I had to do some online training for our EMR so I got to stay home on Tuesday and spend 7 hours on a conference call doing that…but still…I’m pretty sure I got paid for it.

The week did not start off all that well.  I had to finish a few evals over the weekend because it was the end of the month and they had to submit the billing or whatever.  So I was crazy stressed out about that since I didn’t really know how to use the EMR that well.  Plus, it was my birthday and I was really hoping to not have to think about work.  I had a Medicare patient coming in on Monday who I hadn’t done any tests to assess anything related to balance because I was told he was coming in for his shoulders.  He told me he was most concerned about his balance but we were waiting for the referral to get faxed over and the front office had told me it was his shoulders.  His English was very minimal too and I don’t know Chinese.  I had gotten the referral before I left on Friday saying that he was coming for both shoulders AND gait instability.  Great.  So I was all stressed out that I was going to get into trouble about that.  I had a few more evals on Monday too, so I knew that I was just going to be overwhelmed with more paperwork.  Basically, I just felt awful.

So it is Sunday night and I’m standing in the kitchen sobbing.  Like end of the world sobbing.  My boyfriend is totally at a loss for words because he can’t imagine what could be all that bad.  Despite him telling me that it is all going to work out, I just can’t seem to pull it together.  I just wanted to hide under my blankets and wake up the next morning a kid again.  Why is adulting this hard?!

This isn’t new for me.  I tend to build things up to be WAAAAY bigger than they actually are.  You’d think knowing this about myself would prevent this from happening but it doesn’t.  I had always wondered why I had had panic attacks before PT school but I’m starting to see why.  That was a HUGE step and so the amount of building it up was increased a bazillion-fold.  Starting a new job….I’d say that’s a pretty big life event, too!

So here I was crying.  I was sort of relieved that I was because I spent Wednesday-Friday of the week before driving to work feeling like I was on the verge of tears but holding them in so I didn’t look like a mess by the time I got in.  I’d then come home and be so tired I felt no urge to cry.  I was thankful to finally be letting it all out.

I woke up Monday morning still feeling like crap but I sucked it up and pushed forward.  I got to work and, sure enough, nothing was as bad as it had seemed.  Basically everything I had been stressing out about ended up not being a big deal.  And, after talking to one of my co-workers, I found out that I’m not the only one to have felt like this.  Apparently she had cried every day for a week or so when she first started.  She had even admitted to searching for a new job during the first 3 weeks of her employment.  But she said she feels a lot better now and that she really enjoys working where we are at.

Anyway, the whole point in writing all of this is for my fellow stresser-outers out there.  YOU ARE NOT THE ONLY ONES!  It’s okay to feel overwhelmed but you’ll get the hang of it.  And trust me (someone who constantly doubts that it’ll all work out)…IT WILL BE OKAY.  Keep your chin up and move forward.  You can do this.

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