Reflections on the First Year of PT School

 

There are many things that come to mind as I reflect back on my first year of PT school. Some things that come to mind are: study hard but take breaks; always ask questions because someone else might be wondering the same thing you are; and never feel inadequate because we are all learning and no one knows everything. These lessons and acceptance of these lessons have come in waves but stand out to me as things I am happy to have learned.

Through the spring semester, we were faced with a new challenge that forced us to take the remainder of our classes at home, online, and in isolation. This was a tricky time in navigating the correct course of action, but overall, we all were able to finish the semester online with the help of our professors. During this time of slowing down, I was able to reflect more on this first year of grad school and I am very grateful for that time. I had realized how caught up I was with the mentality of “what more can I do to be better” and the everyday whirlwind of classes. Rather than being inspired and excited, I was guilty of the comparison game that we all fall trap to, feeling like I needed to be doing what others were doing to reach my goals. I needed that forced reset.

During this forced slow down, a big lesson that I hope to carry through my life is to surround myself with people and have things every day that require me to step out of my “stress bubble” and remember the other parts of life that make it more enjoyable. I absolutely love my program and have enjoyed the classes, professors, and fellow peers, but I was reminded of all the things that I can enjoy during the day that did not include looking at a screen, memorizing lists, and drawing out flowcharts and diagrams. What was interesting was when I allowed myself to fully enjoy having a separation from school work and having things I enjoyed every day unrelated to physical therapy, I was a more productive student and got more out of lectures and labs online. Rather than feeling like I had to keep re-reading notes without end, I read fun books, went on walks, called friends and was more intentional with my conversations with others because I wasn’t constantly talking about school.

My ultimate career goal is to be the best physical therapist I can be for my patients and this time has definitely solidified that goal, but this time also has helped me realize what I can be doing to actively be reaching for my goal rather than being blinded by the goals of others. It also has helped me realize that I need a separation between work and life and I should honor when I feel that need rather than burning out because I didn’t listen. I was reminded of the things I have taken for granted and put off to the side, and I hope to incorporate them into my everyday life to be a more balanced student and ultimately, a balanced physical therapist.

Virtual Reality

“Without Hope,” 1945 by Frida Kahlo

We were asked as a class assignment to choose a piece of art that demonstrated physical pain and explore how that piece of art could help us understand the pain experienced by our patients. I chose to interpret Frida Kahlo’s painting “Without Hope.”

Frida Kahlo sustained many surgeries and had a difficult medical history. She contracted polio at age 6, it is thought that she also had spina bifida, she sustained a horrible accident which left her in a full-body cast, contracted gangrene which required the amputation of her right leg from the knee down, and is thought to have contracted bronchopneumonia in the days leading to her death. She drew upon her medical hardships as well as personal tragedies as inspirations for her art. This specific painting “Without Hope” depicts her being fed pureed high-fat food by her doctor while on bedrest. At this time in her life, she no longer had an appetite for food due to many surgeries, necessitating her doctor’s decision for her health.

This painting stood out to me because this is a patient or loved one we all have seen or heard about. While shadowing in the hospital this year especially, we learned about feeding tubes and about patients who required alternative means of nourishment because they could not physically eat on their own. This painting certainly depicts pain in the emotional sense because she is not able to move and has lost hope. I am a firm believer that emotional pain (or spiritual and intellectual pain) can translate into physical pain. Frida Kahlo was also experiencing physical pain as this was a time when she had many surgeries and had lost a great deal of independence. She feels helpless and hopeless.

While reflecting on this painting, it struck me that as healthcare professionals, we will become jaded and desensitized to the human experience of pain, both emotional and physical. This occurred to me because upon seeing this painting I thought, “Well she needed food and the doctor knew that was best.” I needed to stop myself because that took the patient’s experience out of the act being done. This could be healthy for us because if we felt such strong emotion for every patient case, we would “burnout” and not be able to perform our jobs as well. This also can be detrimental because we see the bigger picture for why we’re doing something (i.e. feeding someone through a feeding tube that feels like force-feeding, as Kahlo described) and forget the human aspect of pain and may overlook someone’s struggles because we see that bigger picture. Although this picture has some medical relevance to us, it is from the perspective of the patient, which we should always consider when working with them.

Now I ask the class… In what ways have you seen healthcare practitioners having to address a patient’s pain, but also having to do their job and do what was best for the patient? For example, I remember watching a PT work with a patient who was post-op hip replacement. The patient was literally hollering and shouting every time the PT helped her move or asked her to stand (for her assessment!). I asked the PT afterwards how she deals with that and she answered that she knows that it’s best in the long-term for her patients and that it’s not actually doing anything damaging to them, but she always does check in with her patients and gives them breaks to let the pain subside. She also would express how much she cares about the patients and that she just has to do her job because she wants them to get better, and she expressed this to the patients.

 

https://www.fridakahlo.org/without-hope.jsp

https://www.frida-kahlo-foundation.org/biography.html

 

 

Personal Values

In a professional development class during my first year of PT school, we completed an assignment which had me rank a list of 21 values to help us narrow down which three were the most important to me. The following is my reflection on the assignment.

I actually found this assignment very insightful, especially when I discovered what my top three values were. I honestly was not too surprised by my rankings, but found myself wondering in what context I should be thinking about these values. For example, when ranking the values, should I be considering the importance when I’m at school or at work or should I think about them in the context of being with friends and family. For example, values such as religious faith may be of more importance to me when I am with my family. I attempted to take a more global perspective rather than just putting myself in one of those contexts. My top three were love, wisdom, and a tie for honesty and altruism.

Reflecting on these values, I have noticed how often I am guided by them in decision-making. Especially after taking the Meyers Briggs Personality Test, I am more aware of the fact that I let feelings rather than judgment guide my decisions. This is apparent in my values. Rather than focusing on wealth, physical appearance, or power, I definitely focus more on how my actions will make others feel. I have noticed these values come out when interacting with others who have a more objective way of looking at things. I’m usually the one to interject by saying, “Well how do you think that decision will make others feel?” or “Would that be the best decision for everyone?” That being said, I also need to listen to the other perspective, such as thinking about what the best decision in regardless of feelings involved.

Some situations that challenge my values are when objective decisions need to be made. These are difficult to me because I get stuck in the mindset of “But how will this make others feel? Will they still feel cared for and loved?” This is frustrating because it prevents me from making objective decisions. When I am confronted with those situations, I have to turn that part of my mind off and discuss the decision out loud with someone who is more objective than I am. I do not completely ignore my values, however, because they help me implement the decision in a way that makes me feel better about that decision. For example, when someone suggests an idea and I have to decide which idea will work, I do not want someone to think they had a bad idea because I refuse it. I have to go about my decision-making process in this way to prevent myself from feeling guilty for saying no to someone’s idea. I also have to explain myself to the person so that they know why I made the decision the way that I did.

If I were ever confronted with a patient who had different values than mine, I feel like the first step would be to acknowledge that. As a future healthcare professional, I have to be aware that patients and I may not click necessarily, but I will still have to do my best to treat them fairly and to the same degree as I do other patients regardless. I shadowed a physical therapist once in which this situation did occur. The conversation was about a specific religion and the patient was making jokes about the religion and wanted to continue the conversation. The PT would acknowledge what he said and maybe respond with “Some people might say… (in an attempt to explain that part of the religion),” then try to change the subject to something less controversial. The PT explained to me that rather than questioning the patient, he would acknowledge what the patient said, then try to change the subject. I admitted I hadn’t realized during the conversation how the therapist actually felt.

After reflecting on values and their importance, it is very interesting how much we as individuals differ in respect to which ones we care the most about and how important they are in our interactions and decision-making. I think it is important to acknowledge these differences when interacting with others because it may help you gain another perspective. It also may help you understand where someone is coming from to prevent yourself or others from being offended or taking things personally. For example, if someone values recognition or autonomy and you do not realize that, they may become defensive because you have not addressed that value they find important. This exercise was beneficial in raising my awareness about my own values that I find the most important while acknowledging that others will have different values than me.

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