October 09, 2012

 

“They took me down in the basement and spanked me!” one 50-something patient declared in the morning. Alas, I did not call 911 – it was the medication talking.

I’ve been a physical therapist for 16 years. Currently I work at a hospital rehabilitating patients after they complete surgery. Medication can play tricks with patient’s minds and I occasionally hear tales of the most interesting “dreams” as these patient’s come out from under the strongest drugs.

My work is considered in-patient therapy. (Other therapists specialize in treating out-patients, nursing home or acute rehab center residents or children/pediatrics.) About 40% of my patients have had knee or hip replacement, other common surgeries include back or shoulder.

Typically I spend 75% of my workday on my feet with patients, while the remaining 25% is taken up with paperwork. I LOVE my job! I love getting to know and helping people. I see about six patients twice a day. When I first meet them, they’re usually at their worst. They’ve just come out of a major surgery, they’re in pain and quite short on sleep. The nurses let them know a physical therapist will be coming and they’re often apprehensive.  I come in with encouragement, telling them “You can do it!” Some joke calling me a Physical Terrorist! But when they leave three days later, it’s SO gratifying – because they CAN do it! They’ve surprised themselves and are so improved and thankful! My career is very rewarding.

When I arrive at the hospital for work, I head to my first patient’s room. I greet him, review his chart, check his vitals and evaluate. If no PT (Physical Therapist) has seen him, yet, then I do a complete post-surgery evaluation to see if he’s in good condition to start therapy. I talk with the nurses as they are in charge of every patient’s pain medication, which is critical to the patient’s ability to complete their rehabilitation exercises. Then we begin. 

With my knee or hip patients, we head for the gym. My goal is to teach them how to use that leg again. They are hooked to an IV and catheter and they walk to the gym with the aid of a walker. One of the first things I do is fit them into a recumbent bike. After about 15 minutes on it, we’ll head to the mat and proceed with other appropriate exercises. We’re working to get their mobility back, overcoming pain and swelling. We teach proper precautions, especially with hip replacement, as they’re at risk for dislocation. Throughout therapy I must keep checking blood pressure and other vitals. A spine patient is taught first in the room – things like how to get out of bed, stand up, sit down, how to use a brace, etc. – then we walk in the halls for their next therapy stage.

I have many patients who look at me as I enter the room and ask “you and who else?” They assume that because of my petite frame I won’t be able to even help them out of bed, much less assist them in physical activity. But we are trained in how to get people to help themself. Only with those of great size might I need a partner in a couple areas.

Occasionally we encounter a patient reluctant to get up. We encourage the best we can. We chat for a bit to see if it’s a matter of attitude or if we need to consult the nurse about their medication. Everyone reacts differently to surgery, pain and meds. A certain amount of pain is to be expected, but we have to keep it a level where they are able to do the therapy. Too much pain blocker and they are rendered immobile, too little and the pain can be overwhelming. We aim for the tolerable range, so they can push through the pain. We always tell them the benefits – we hate to see them in pain, but know it’s best in the long run.

The benefits to getting our patients moving early are great! If one wouldn’t begin to exercise, they could lose proper motion. Scar tissue won’t lay down as you want it to. They are at risk for blood clots, pneumonia and a much longer total recovery. A common belief among PTs is that young men are the biggest whiners! We find older people to be the toughest.

The work keeps my interest and the hours go by fast. As I stated, I love helping people, but the job is not without its moments. Vomiting is not uncommon. People pass out. Moving stimulates everything – eating, bowels … accidents happen and sometimes we need to call the nurses to help us clean a patient. But, the floor I work on has such an amazing team and we help the nurses in turn, as well. And, as I mentioned at the start, medication can cause the most unusual hallucinations. ☺

. . . . .

My undergrad is in Athletic Training but it really can be anything. My Masters in Physical Therapy took three years. We learn every nerve in the body. Now many require a 3-4 year doctorate. School is followed by an internship – this is where you really learn to read a patient. This career is currently in demand and the pay is good. There are a variety of working environments, from nursing home to home health, and in-patient and out-patient at a hospital. I would say beyond what you’ll be trained in, you need to have a love for people, a lot of patience and an abundance of energy. I highly recommend it!

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