5 WAYS BEING A SKILLED NURSING PT HAS MADE ME A BETTER PERSON

I first drafted this blogpost on June 4, 2020. With this being the last week of work of my first full time PT job, it’s time to reflect


1 | Patient
I definitely feel like I am more patient since working with predominantly the geriatric population. I used to get irritated very quickly trying to help my parents trouble shoot tech issues and now that I do it all the time at work with patients, it doesn’t make my blood boil nearly as much

2 | Protective
When the COVID19 pandemic hit and all nursing homes went into lockdown, restricting visits from loved ones (for good reason), those who work in nursing homes, effectively became stand in family for all of our residents, a task I didn’t take lightly. I’m not exaggerating when I say it tore me apart to know my residents weren’t getting to be with their loved ones, in some cases, even prior to death. I know as healthcare workers it’s not recommended to get attached to your patients, but how could I not? We were the only family they had? Especially as the therapy team, we became such a source of joy and happiness for our residents who were isolated from peers and loved ones

3 | Flexible
There’s really no choice but to be flexible working in the nursing home setting. Thought you only had a 6 hour day so you decided to sleep in an extra hour? Ha, jokes on you! You have 3 surprise evaluations and a 9 hour day. I feel like at this stage in my life e.g. no kids, I am able to manage the variability in work hours day to day, but I can’t see doing this long term once kids arrive. At that point, I’ll be seeking out a job that covers only 1 facility, or maybe 2 small facilities at most to manage the schedule a family with two working parents demands

4 | Intuitive
In the past 2.5 years, I’ve come across a wide variety of patient personalities, from the most highly motivated, to self-limiting, to the most apathetic. While no two patients are the same, I definitely have gotten better at “reading people” aka being able to call people out on their bullshit, both figuratively and literally

5 | Unflappable
No, I did not pull that word from my personal vocabulary. I Googled, word for calm in high stress situations and out popped unflappable, see also composure. I have had a handful of moments in my short career where I have felt fearful and scared for my safety as a result of the actions or exchanges with a patient, most commonly a psych patient. Hell, one of my sites just had a patient elope after breaking 3 windows on the top floor of our building! While there are times I’m apprehensive to approach certain patients or to give undesired instruction, I find that I am more confident in my position of power and authority

Until next time, Meryn


WHAT I’VE LEARNED IN MY FIRST 6 MONTHS, THEN 2 YEARS AS A PHYSICAL THERAPIST

Happy National Physical Therapy Month!

Long before I had the idea of starting this blog, I was working on a thoughtful and well-formatted running list of what I had learned in my first 6 months as a new grad physical therapist. I’ve made some minor tweaks, but the essence of that original writing rings true and can be found below.

I’ve also since added to the list, now that I officially have 2 years of experience under my belt in skilled nursing – oh how the time flies.


What I’ve learned in the first 6 months of being a new grad skilled nursing physical therapist:

1 | This work is not 9-5. I’ve literally had days as short as 2 hours and as long as 10+ hours.

2 | No one outside your immediate department knows your job title, your credentials, or your level of education.

3 | It almost doesn’t matter how good of an evaluator you are as long as the evaluation gets done so that the assistants can start treating the next day, if not later that day.

4 | Companies don’t want to pay a DPT to treat their patients when it is more cost effective to have therapists “do what therapists do best” (i.e. complete evaluations, progress reports, recertifications, and discharges) and have the PTAs treat.

5 | It is rare to find a job where you supervise only one building.

6 | My clinical skills aren’t progressing here and I’m afraid they never will.

7 | There are times when I feel that I am the only clinician who takes the time to truly listen to their patients. When others are quick to dismiss patient’s for being lazy or unmotivated, I’ve tried to uncover a cause for their behavior.

8 | Patients need the permission and safe space to own and feel their emotions. Some people’s entire lives are flipped upside down when they get admitted to our facility. It’s likely they’ve had a decline in their health and medical status, and at times have been uprooted from their routines and even their homes.

9 | Most patients aren’t MORE motivated with constant reminders about their lack of progress, ongoing refusals, and lack of participation. In my experience, this can lead to decline in motivation.

10 | Compassion and a true desire to connect with your patients will go farther than “bad cop intimidation.” Engaging patient’s in meaningful discussion about their hobbies and interests can lend to problem solving and finding motivating factors and ways to successfully hold your patient’s accountable.

11 | Burn out is real and weekends should be treated as sacred time and space to recharge physically, mentally, and emotionally.

12 | Everything you’ve never done before is only scary the first time – at least that’s what I tell myself to ease my fears.

13 | And in the same vain, you only do something for the first time once. Each time you do that task again, you take the knowledge, successes, and failures with you from the first time to make each subsequent interaction better and better i.e. calling family members to discuss patients, discussing patient’s with physicians, calling insurance companies.

14 | Patients rude comments and stabbing words hurt, but they are not a reflection on you as a person, rather the patient’s outward expression of sadness, grief, frustration, etc. – try not to take it personally.

15 | Patients need help recognizing the small wins to keep motivation and morale high.

16 | Salary negotiation is scary (I wonder if it always will be).

17 | The patients you think or appear in the best health are some of the next to die. The patients you think are destined for the grave hold on longer than expected.

And finally, what I believe to be the most important thing I’ve learned in the first 6 months of work as a new grad PT:

18 | You won’t fix everyone. You’ll want to, you’ll feel like a failure when your best intentions don’t work out. Truth is, some people don’t want to be fixed. I remember a clinical instructor telling me this and thinking that was crazy, what do you mean people don’t want to be fixed? But now I know.


What I’ve learned in the first 2 years of being a new grad skilled nursing physical therapist:

1 | You tell yourself you won’t get attached. But you do. And you cry when you see their empty bed and their name removed from the nameplate outside their door. And you’ll think about them when you pass their room or their birthday comes and goes.

2 | Salary negotiation is exhilarating and makes me feel like a strong, determined woman.

3 | Sometimes you have to lie to patients. But not in crazy horrible ways. “Yeah, I’ll look for that book for you” or “I’ll be sure to follow up with maintenance about your tv remote being broken.” Hell no, I say these things and get out, if I happen to run into someone whose job is to handle these issues, I’ll mention it but I don’t go out of my way for non-therapy or health related issues.

4 | I’m not a stern enough clinician. I’m quick to take a patient’s refusal at face value and do a bad job of forcing a patient to participate, especially in an evaluation. I’m not here to force you to do something you don’t want to do. Should I be more direct with people? Probably, but I’m also not about being the bad guy from day one. I educate and provide rationale but if you want to lay in bed all day, that’s your god damn right.

5 | Patients can’t pronounce my name, but that didn’t take 2 years to figure out. So yes, I’ll respond to Mary, Marianne, Marilyn, Meredith, Meryl, Merlin, and Marnie.

Until tomorrow, Meryn