As I said in my first introductory blog, I stated that I’m not the perfect, role model PT student. If there is something to take away from my PT experience, it’s to learn from my mistakes. A few nights ago, my PT little [not to get this confused with my sorority littles] texted me requesting tips for her first rotation. Of course, I responded to her, but I thought I could expound on the topic through a blog post!
But first, you need context. Our program curriculum consists of three rotations: one 10-week term during our second year and two 12-week terms at the end of our third year. My first rotation was at a major hospital in the middle of the medical center. My clinical instructor (CI) worked in general acute care. The primary objective of the first rotation is becoming competent in performing patient evaluations and functional training skills.
1) Note to self: Take notes.
You’re going to do chart reviews of multiple patients. You’re going to be conducting patient evaluations. You’re going to do various interventions with your patients. Rinse + Repeat. There’s a chance you will not be able to document until after you have seen 3 to 5 patients [because hospitals are sticklers for efficiency + productivity], so how are you going to remember the measurements and treatments for all of your patients? Write things down.
I used a small notebook that fit in my scrubs’ pockets. My CI wrote on the back of physician’s referral orders. Another PT I followed folded a blank sheet of paper into 8 boxes – one for each patient. My notes were scattered all over the notebook page, but I managed to remember what happened when I looked at them and document successfully. There are PTs who have the ability and mental capacity to remember what they did with each patient AND document it all at the end of the day. [Kudos to them and their hippocampus.] As a student, it just looks better if you took notes. It shows that you’re taking an active part in your learning experience.
2) It’s okay if you don’t know it all.
In reality, you’re not supposed to know it all. I admit, during chart reviews, I googled patient diagnoses I didn’t recall learning in class. My CI would quiz me on things I learned in the first semester that I didn’t remember. If you don’t know it, learn it, and now you’ll remember it!
Not only does this lesson apply to concepts, but this also applies to your hands-on skills. If you’re still uncomfortable with performing patient transfers independently or guarding, ask your CI you can practice with them being the patient. It shows that you are able to admit your flaws and take initiative to better yourself. In my case, my CI felt that my transfers skills needed improvement, so we took 20-30 minutes at the end of treating our patients to practice. In the end, I got a free gait belt that I still use to this day.
I know what you’re thinking, it may seem like I’m stupid [or a better word “incompetent” – proof: I’m not stupid.] There’s just things you can only learn through experience, and that’s usually how I learn best. There are only a few opportunities to practice and be assessed on skills in the lab, but that’s why there’s clinical education – so you can learn in the REAL WORLD.
3) Your CI isn’t your only instructor
During my 10-week experience, my CI had scheduled days off and vacation time. HOW DARE SHE? I’m only kidding – everybody needs a break! Her time off was my opportunity to follow other PTs. As much as I love my CI, I enjoyed working with her colleagues in other areas of the hospital like the intensive care units to learn different techniques and manage my way through all the lines + tubes. The first day I followed another PT was the same day I treated a patient on my own [under supervision, of course]. If it wasn’t for her co-worker giving me the opportunity to be independent in treating a patient, I don’t know when I would have taken the initiative to do such. Additionally, when I wasn’t with my CI, I had the chance to co-treat with OTs (Occupational Therapists). Through co-treatments, I observed what makes OT different from PT. We had a discussion about how their program works and what they did/didn’t learn. [Who doesn’t love interprofessional learning opportunities?!]
4) Use your TIME wisely
If you know me, I am not a morning person, but I woke up at 5 o’clock every morning so I can have time for chart review and have an early start. My CI and I worked together in prioritizing which patients need to be evaluated and treated first. After spending time socializing with others and eating lunch, I took the rest of my lunch hour on documentation/more chart review. My CI also let me work on documentation while she saw patients. Some days, my CI and I would finish with work early, so we could go home early or take some of the co-workers’ load and treat their patients. While waiting for my ride to go home, I wa studying for online classes [or taking power naps].
5) POOP happens
I’m trying to keep this blog clean and wholesome. You can use alternative language if you choose, but you get the idea.
I don’t mean this figuratively. When you go into your acute care rotation, be prepared to encounter bodily fluids, or they could end up on you. Part of why I became interested in PT is because you don’t have to deal with bodily fluids in comparison to other healthcare professions [AKA nurses; This perception was purely based on my first exposure to PT, which was at an outpatient setting.]. However, I experienced many “firsts” during my first rotation:
- first time holding a vomit bag (and left clean free)
- first time cleaning patients after urination and bowel movements
- first time getting poop on my favorite pants (It was literally only a dot, but I still had to wear temorary scrub pants for the rest of the day.)
Well, I guess you could take this lesson figuratively. I was doing swell during Weeks 4-6 of my rotation. If I’m going to be honest with you, I didn’t end my rotation on a high note. I hit a plateau. During the last two weeks of my rotation, I kept missing red flags in chart reviews even after going over them with my CI. One day, I ended up leaving the hospital crying because I didn’t know how else I could improve or correct my mistakes.
When bad things happen, good things will come. Eventually I learned from my mistakes and moved on. You just have to wash the scrub pants and start clean and fresh.
Fin
I hope you found this to be practical. [I’m not one for abstract advice.] It’s hard to believe my first rotation was ONE YEAR ago. While it’s somewhat a blur, I did learn many things, and it really affirmed my calling to physical therapy. I really enjoyed my acute rotation experience. [I’ve even considered working there.] I’m looking forward to my last two rotations. Where I’ll be placed is still a mystery, but I’m getting ready for what’s to come.