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.