Clinical Experience Spring 2019

The clinical site I had the opportunity to work at was VCU North Hospital with the Traumatic Brain Injury unit. This site was an inpatient neuro rehab facility and my wonderful CI was Carter Read. Going into the experience my objectives were:

1. By the end of week one, the student will complete an initial evaluation with min assistance from the CI.

2. By the end of week one, the student will write time based functional goals for a patient with min assistance from the CI.

3. By the end of week two, the student will show initiative in learning new skills and observing different conditions independently.

4. By the end of week two, the student will perform a stand pivot transfer with less than 50% cueing from the CI.

I was very nervous to start the clinical. Neuroanatomy was by far my hardest course this semester and I wasn’t confident in my neuro knowledge to answer any questions my CI could maybe throw my way. Additionally I was nervous, yet very excited, to be dealing with actual patients who truly have the diagnoses that we have been studying. Having said all this, I was confident that I would bring a positive mindset and a good work ethic to the experience so I would learn as much as I could in the short time period.

I felt like the experience was a tremendous learning opportunity. I would say I successfully completed 2 of my goals and made good progress with the other 2. I surpassed my goal with the stand pivot transfers. I not only independently performed several stand pivot transfers but I also successfully performed several max assist squat pivot transfers on a very tall patient. This was a much more advanced transfer than the ones I had been routinely practicing in class. It was a challenge my CI encouraged me to take on and one that I was really proud to have completed. I was able to take the lead on 2 initial evaluations; however, I required probably mod assist due to the complex nature of the TBI patient’s conditions. Additionally, I did less goal setting than I initially planned for and instead did more of the treatment planning. I was able to take the lead with planning one of the patient’s daily treatment and guide that patient through it. This was a great chance to think creatively to come up with the best way to meet that patient’s individualized goals.

The TBI unit was amazing and provided both challenges and chances to grow as a therapist. A challenge that I didn’t fully prepare for going into the experience was the lack of attention/low arousal of many of these patients due to their TBI. This made leading the patients through their rehab very difficult. However this also forced me to be creative in finding the best way to deliver information to get the desired response out of the patient. The best part about the experience was seeing the improvement with the patients. One patient in particular who had just been admitted when I first arrived, went from not being able to sit without max assist at the beginning, to taking a few walking steps by my last day. It gave me goosebumps to see this patient stand knowing the hard work and patience it took to get to that point. It was a very rewarding population to work with.

One of the APTA’s core values is Excellence, and my CI consistently impressed me with the excellent care she delivered each day. She was so compassionate and went above and beyond to really provide the best therapy for the patients. She truly wanted them to get better and was willing to work very hard in order to achieve that. When many of the patients were tired and not enthusiastic about therapy, she did not just succumb to the situation but really pushed the patient to work and to get the most out of themselves. Additionally she was not afraid to challenge the patients. One of the patients was hemiplegic and was going to require max assist to support and guide them through taking a couple of steps. But that did not stop her from going for it anyway. She had to physically exert herself so much in order to assist the patient, but she knew the importance those few steps would be to the patient’s progress so she was willing to do whatever she needed. She inspired me so that when I am a practicing physical therapist, I want to go that extra mile to provide the best care for my patients regardless of the difficulties that will go into it.

I can’t say enough great things about this experience. I look forward to the next clinical being longer so I can improve my initial evaluation, goal setting, and therapy planning skills.

Writer’s Choice- Professional Path

As I finish up my first year of the VCU DPT program, I find this to be a great time to reflect on the growth I have undergone and the development that is yet to come.

 

When I first entered the program, I had a surface level idea of what the profession of physical therapy entailed. My only in depth experiences came from my time as a patient in sports physical therapy. I didn’t know the profession encompassed everything from cardiopulmonary to neurologic to ICU. Now after completing my first year of courses, labs, and a few clinic immersions, I have a greater understanding of all the possibilities physical therapy has to offer.

 

My path for the future has not changed. I still envision myself practicing in an outpatient orthopedics clinic that specializes in athletes, preferably in the states of California or Colorado. However I am now open to the idea of potentially practicing in an entirely new setting. I enjoyed the Parkinson’s lab way more than I expected. I found the impact I as a physical therapist could have on patients like the ones we worked with, could be life changing and impactful to a degree beyond that of an outpatient orthopedics clinic. I greatly look forward to my first full time clinical rotation this summer in which I will be introduced to inpatient neuro, specifically TBI patients. I look forward to growing as a physical therapist and experiencing a new form of physical therapy I have not had experience with. Who knows, maybe this will change my path. For now I am enjoying the process and open to the changes along the way.

Personal Values

In my first year in the VCU DPT program, we compared 21 given values to determine our top three. This activity was harder than I first expected. I thought I had a pretty strong notion of what was most important to me. However I soon found that there are many things in life I hold closely and it was a challenge to differentiate between the things I cherish. All in all, I believe the activity did reveal my three most important values: health, pleasure, and achievement.

Health is my top value because I believe without health, one cannot attain any of the other 21 values listed. Conversely, when we are in good health, other aspects of our life seamlessly start to fall into place. As a competitive runner I have experienced both sides of this equation and have proven it to be true. When I was injured and had to undergo surgery, I found my emotional well being, relationships with others, and motivation deteriorated alongside the decay of my physical health. But when I am in peak fitness, I find I can think with more clarity, treat others with greater empathy, and pursue new areas of life. Knowing the importance of health, I have prioritized it by eating healthy, sleeping plentifully, and moving abundantly. I look forward to a future in physical therapy where I can restore people’s health and therefore improve their quality of life.

Pleasure is also something very valuable to me. I am not a “what doesn’t kill you makes you stronger” supporter. I believe “what makes you happy makes you stronger”. I do not believe the goal in life is to sacrifice and endure in order to reach the top, rather I believe life is meant to be lived and enjoyed to the fullest and the top will be reached organically. I can spread this value to patient’s by connecting their therapy to what brings them pleasure. If playing with their grandchildren fills them with happiness, I can remind them of that joy when they are doing their exercises. This way they feel energized and have a healthy motivation.

Finally my third value is achievement. I find great satisfaction in setting meaningful goals and establishing a path to that goal. Having direction and purpose brings me more fulfillment than the end result. In running, my favorite part of the season is the beginning because that is when the potential is greatest. I get to dream up my goals and map out my plan of action. By the time the final race comes around, I find solace in knowing I have done everything I could to prepare for that moment and the race will take care of itself. This value is important to instill in my patients because many times the end result is out of our control but we must take action in the process. Helping my patient’s come to the realization that achievement is not black and white but rather a continuum will open the doors to them having a more successful outcome.

Health, pleasure, and achievement have guided my decisions in life and will continue to do so in the future. I look forward to my future in physical therapy where I can implement these values in order to help others.

Intro

My name is Emily Mulhern and I am currently a student in the DPT program at VCU. I received my BS in Kinesiology from the University of Virginia, graduating a full academic year early. Additionally I competed at UVA in Division I cross country/track, where I received All-USTFCCCA honors and All-ACC honors. I am continuing my NCAA eligibility and competing for VCU while enrolled in the DPT program. My academic and athletic background has laid my foundation for becoming a successful physical therapist.

My clinical and personal experiences have shown me the value of inclusion, compassion, and empowerment in physical therapy. As an intern at the Fried Center for Advancement of Potential, I witnessed the intellectually disabled community defy societal limitations and prove their physical capabilities. I saw a man with down syndrome perform perfect push ups and a women with cerebral palsy and spondylothesis correct her curve through strengthening and stretching alone. At the UVA hospital, I got to work firsthand with hospitalized victims of the protest violence in Charlottesville, and I saw the importance of providing a safe space that transcends social barriers and guarantees equal treatment in a world that may not always do the same. Additionally, I have had a lifelong window into the lifestyle and intellectual culture of competitive distance running, and have gained an invaluable personal education in physical therapy. Supporting friends and teammates, I have seen it all: from eating disorders that disintegrate the body to overtraining syndromes that derail careers.  As a Division-I runner, I have also been through it all myself: fibularis tendonitis, plantar fasciitis, tibial stress fractures, metatarsal stress fractures, and (most recently) Jones fracture surgery. I understand the physical and mental aspects of injuries, what it takes to overcome these obstacles, and how to inspire others to overcome as well.

I look forward to the experiences and life long lessons that I will continue to build through my time at VCU. I hope to bring my unique perspective to the physical therapy world.

 

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