ICE Experience #1 in Four Parts

Part one:

The primary discoveries that I experienced during the virtual simulations was the abundance of questions that were available especially in the case history and collaborators. We have learned a quick efficient outline of questions to ask, but it was interesting to learn additional questions that were critical in getting information from the patient and from the other healthcare providers. One of my strengths was the diagnostic portion of the virtual simulations. The diagnostic portion was my highest scoring category across the board, and I found it pretty straight forward. My biggest weakness with the virtual simulations was definitely the collaborators portion. I found that to be challenging in who is appropriate to collaborate with and who was not, as well as what the right questions to ask them were. But moving in to the live simulations were we had to ask the nurse questions was very beneficial in reinforcing that.

The live simulations were incredibly helpful in reinforcing everything we had practiced and learned throughout this first year, while also incorporating challenging real-life situations and sometimes difficult patients. The most challenging portion of the live simulations was remembering the little details such as hand placement, social history questions, and cueing while also managing lines and leads and difficult patients. Overall, I found the experience to be a great learning opportunity. I think working in teams went exceedingly well as we were able to collaborate the treatment and tackle the more difficult tasks.

Looking forward to week two I am feeling more confident than before the live simulations. Over the next week I would really like to focus on my transfers and mobilization. During the live simulations I worked on bed mobilization and interview skills, so I would really like to expand that into hands-on guarding and line/lead management during sit to stand transfers and gait training while in the hospital.


Part two:

Heading into week 2, the clinical aspect of this course, I was more nervous than I was for the live simulations. These were real patients with real injuries and that was a lot more nerve-wracking. But once I was actually in the hospital working with these patients, I became a lot more comfortable. I was on the burn unit which consisted of ICU level burn patients and general burn patients of all ages. Only having one previous lecture on burns, made me concerned that I would not be able to accomplish the goals I had previously set, but after the first day I had already accomplished all of them. I decided to advance my goals so that I was doing patient care independently with my CI mostly observing. Even the most critical burn ICU patients, I became comfortable with near the end of the week. I felt that over the course of the week I was able to take everything I had learned in the past year of coursework, and incorporate it into treating patients with some of the most critical conditions.

The greatest challenge I faced during this week, was deciding just how much to push these patients. Burns can be some of the most painful injuries, not to mention the psychological impact of such a trauma. Understanding how much to push each patient to maximize helping them, while also keeping the therapist-patient rapport and trust , was the most difficult challenge. Throughout the week I began to establish that rapport with each patient, and I was better able to understand exactly how to motivate and push them enough to keep that trust.

The most surprising aspect of this experience was the psychological aspect of treating these patients. Especially in the ICU section of the burn unit, these patients have gone from mostly independent to a significant loss of function. Something as traumatic as that can really have an impact on these patients psychologically. The difference in affect of these patients was drastic. There were several that were eager to get up and moving every time we went in, and then there were patients that would refuse us the second we walked into the door. Not only was there a difference between separate patients, but there was also a difference between the same patient from day to day. There were good days and bad days for these patients and understanding that definitely made me a better future physical therapist.


Part three:

Out of all of the APTA core values, collaboration was by far the one I saw most common throughout my clinical. During all five days of my clinical, we treated multiple patients everyday alongside the OT or COTA. Having that many co-treatment sessions was a great learning opportunity in how the roles of a PT and OT are similar but also separate. But not only did we commonly work with the OTs, we also worked directly with the RNs and social workers on every patients case. Discussing each patients case with the RN before treatment, and following up with social work afterwards was just part of the routine of every single patient. Even outside of the healthcare professionals, there was constant collaboration between us as the therapists and the patients as well. Some of these patients had been on the burn unit for months, and knew what worked for them better than we did. Having the constant communication and collaboration during a treatment session with the patient, made them feel more confident, more willing to participate, and ultimately more comfortable. Throughout every aspect of this clinical experience, collaboration was a constant recurrence and a critical part of successful patient care.


Part four:

This experience was an incredibly helpful, challenging, and exciting week. Going from being completely overwhelmed to almost completely independent within only 5 days, was more than I had expected beforehand. This week truly made me remember why I wanted to be a physical therapist in the first place. Seeing the patients who were going through some of the worst times of their life, and being able to help them during that time is what made this experience one of the very best I could have hoped for. In the future, I hope to continue gaining confidence and patient care skills that will make me able to better care for those people who need it the most.

By Jacqueline Tremain

Physical therapy has always been an interesting field of study to me, especially after being a Division I athlete and experiencing my fair share of injuries. Ultimately, though, this is not what lead me to my decision to become a physical therapist. When I was 13 years old, I had the opportunity to go into the NICU with my aunt, a Neonatologist, and see some of the most difficult and heart wrenching patients there is to experience. Seeing the work that the doctors, nurses, and everyone else working with these patients did, influenced me to want to work in an environment like that. It wasn't until a few years later that I decided physical therapy was the exact field that I wanted to work in. When I was around 16 years old, two of my dear friends were both diagnosed with cancer within a month of one another. It was a long difficult battle that both eventually lost, but not without conquering well beyond what the doctors originally predicted. In those two years of battling these cancers, I saw the immense difference that their physical therapists made with them. I saw the relationship that the physical therapists had built with them. And I saw just how much the physical therapists improved not only their physiological impairments, but also kept them positive and determined. This truly made me decide that I wanted to make a difference like that. As I progress through my education and future career, I hope to one day make a difference in those populations that need it the most, like the babies in the NICU, the children in the hospital, and the families that are experiencing their most difficult times.

1 comment

  1. Jackie –
    This is an excellent reflection. Working with patients who have suffered burns is one of the most challenging roles we have as PTs and you identified the reasons so well. I completed a clinical experience in a pediatric burn ward and the faces of some of those children and the stories of their situations are as fresh for me today as they were over 30 years ago. I am so proud of you for all that you learned and accomplished in this one important week.

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