Hello friends!! Long time, no blog post. It’s been a little over a year since I’ve published a blog post. I have been quite busy in the past months. Most of my time has been spent acclimating to my NEW job as a physical therapist. After graduating from PT school and passing the board exam last August, I landed my first real “big girl” job at an outpatient orthopedic clinic in my hometown. As of this month, I have been working for six months, which is surreal to think about. Without further ado, here’s what I have learned so far…
Your FIRST job doesn’t have to be your dream job.
I had high expectations for myself in terms of where I wanted to work – the Texas Medical Center (TMC). I thought that the multiple connections I had with people who work there would be sufficient to get a job there, but the timing wasn’t right. I couldn’t wait any longer, I needed the health insurance. It also didn’t help that I kept seeing other new grad PT friends sharing their news of getting their dream job, the job that I wanted. In my first few weeks of working, I had to remind myself that the first job is all about gaining experience for the next one. Not everyone is lucky in landing their dream job as their first job.
I really grew into loving my current job. It’s close to home both literally and figuratively. It’s only ten minutes away from home, and it holds a special place in my heart because my mom was a former patient at the clinic. My co-workers are great, and everyone gets along with each other. I have more flexibility in my schedule, and I don’t have to work weekends. At my dream job, I wouldn’t have these conveniences. Do I still want to work at the TMC? Possibly. Dreams don’t have to come true right away.
I don’t know what’s the next chaPTer for my career.
Speaking of dream jobs and ideal careers, I feel like I’m supposed to establish my speciality, get CEUs to treat certain kinds of patients, and/or obtain certifications for skilled interventions (e.g. dry needling, manual therapy, IASTM, etc.). There are many options presented at work, especially since I work in outpatient orthopedics, and I get overwhelmed by all my options. At the same time, I ask myself, well what’s the point in learning all of this supplemental material if I probably not going to apply those skills and knowledge at my next job in a different setting? Recently, I was reassured by one of my professors with whom I crossed paths. Following their advice, I have decided to take it day by day and just focus on gaining experience.
While I’m uncertain about specialities and certifications, I am certain that I want to be a mentor to pre-physical therapy students and/or a clinical instructor. There are a handful of students who are observing us at the clinic, and I thoroughly enjoy talking, providing resources/advice, and explaining my treatment methods to them. Even though I was not the perfect pre-PT student and student physical therapist, I think that makes me a better mentor because people can learn from my mistakes and experiences. This is why I started #fortheDPT – to help others on their journey while sharing mine.
You can’t win them all.
I’m quite the optimistic person, and most new grad physical therapists are hopeful thinking that they can heal all of their patients. However, no matter much pain science education and quality care you provide, there are patients who won’t meet the goals. Perhaps there were insurance and/or financial limitations. It’s possible the patient wasn’t always consistent with their home exercises or attending their sessions. Sometimes, the ageing human body has adapted to changes exercises alone cannot fix. It feels discouraging, frustrating, and disappointing from both the therapist’s and patient’s perspectives. In the end, at least you can say you tried your best.
Protocols are a blessing and a curse.
In PT school, the message of evidence-based practice was heavily preached, but what happens when the evidence is inconclusive, not reliable, or limited? What is a new grad PT to do with such limited experience? Thanks to Google and other rehabilitation experts, there are protocols for every diagnosis. It’s a blessing because it removes the guesswork on what exercises you can and cannot do with the patient. Protocols are also better than the generalized exercise sheet or YouTube video a patient can simply discover on their own in that there is typically a timeline associated with certain exercises.
For a while, I relied on these protocols. I would print multiple versions and compare them. Then, I realized one protocol would conflict with another. These protocols are merely based on experience and opinions. If they are scientifically sound, it’s not always visibly mentioned. Plus, if treating a post-operative rotator cuff repair was as simple as following a free protocol off the internet, why did I spend three years and thousands of dollars in grad school? If the protocol can be used for tons of patients, the concept of the individualized patient care experience ceases to exist.
So what do I do with rehabilitation protocols? With everything else you see online, remember that protocols serve as a guideline. As a therapist, I have the choice to say no to doing certain exercises and progress the patient as indicated – and that’s what makes the patient’s plan of care individualized.
It’s okay to not know what you’re doing.
Some may think it’s imposter syndrome, but I think I’m just straight up incompetent because I really just don’t know. I just graduated, should one really expect me to know everything? I knew enough to pass a licensing exam, but I still can’t draw the brachial plexus from memory. Physical therapy school only hit the tip of the iceberg with certain concepts. For instance, I had to evaluate a patient with transverse myelitis. In full transparency, I looked up what that was and interventions for it fifteen minutes prior to bringing in the patient. I admitted to the patient that I had zero experience in treating patients with that particular diagnosis. (Fortunately, the patient was understanding about it and was transferred to another facility.)
Not knowing what you’re doing doesn’t just stem from incompetence. There are other times when I’m unconsciously competent. I think fellow physical therapist, Yusra Iftikhar, said it best in one of her Instagram posts,
“…even if a patient got better, I was always convinced I had no idea what I was doing with a person with shoulder pain. Anyone who got better did so as a fluke…”
I can recall instances when I whip out a treatment mode out of thin air, and it’s the one-hit-wonder that puts the patient one step closer to discharge. It’s in those moments that I surprise myself and thank God for helping me to recall that sliver of knowledge. I may not have the perfect explanation as to what is caused the patient’s pain and how they became better. Certain lifestyle habits and musculoskeletal adaptations can be mere correlations and not causations. In the grand scheme of things, what matters is that we know when the patient is/isn’t making progress. Being honest with your patient and yourself when you don’t know it all is the characteristic of a real professional. Oddly enough, not knowing everything is the kickstarter to ultimately knowing everything.
After six months of working as a licensed physical therapist, I have learned so many things and grown so much as a healthcare professional. Writing this post inspired me to share more about my life as a new graduate physical therapist. Who knows where I will be in the next six months, a year, and even five years? I may have plans and dreams, but GOD’s plan and purpose are always better.