The other night I received an email from Penny Thomas, the person running howtobecomeaphysicaltherapist.org saying we have been included in their latest blog post “20 Stunning Physical Therapy Infographics.” Pretty cool stuff if you ask me!

Now that I have endless amounts of free time I checked out Penny’s site and it seems to be coming along nicely. On the main page is a directory of sorts with the most helpful links (in my opinion) being found on the left hand side. If you find yourself with some extra time I think you should paruse on over to howtobecomeaphysicaltherapist.org.

Ok enough of the blabber, below is the link to the 40 youtube videos. This comes from a post I found on Penny’s blog. Enjoy!

Click here - 40 informative youtube videos on physical therapy techniques

Here’s a youtube video that I think does a pretty good job of explaining a thorough chest inspection. The narrator explains just about everything and even dumbs it down for those who don’t speak medical.

I have been following The PT Project for sometime now since there is nothing good on tv tonight I figured now would be a good time to write about them. I mean I’m sooooooooo busy normally.

What makes the PT Project cool and unique is that the majority of their content comes from volunteers, which brings a nice mix to articles they publish.

They cover a variety of topics ranging from things related to clinical practice, practice management, stuff for students, stuff for patients, continuing education, videos, and so much more!

Below is a little excerpt from their about page:

The Physical Therapy (PT) Project is a unique initiative dedicated to the development and advancement of physical therapy professionals within the United States, as well as throughout the world.

The PT Project was developed to strengthen and improve the entire physical therapy industry by creating a resource where quality information, case studies and medical research is shared among those professionals within the industry that are dedicated to providing the best quality care for patients. This is about physical therapists teaching other physical therapists so that everyone, including the public, benefits from the expanded knowledge and information.

I read something on their facebook awhile back that I feels like should be repeated.

[The PT Project] Needs help with the running of the website. We always need good content, editors, and help rounding up content and formatting the monthly newsletter. Email jon@theptproject.com – if you could help. We don’t sell ads on the site to preserve integrity – that means there’s no money to keep it going – and we rely on volunteers.

I think it’s safe to say we have a decent amount of visitors each month, so hopefully this little shout out helps a bit! If not I will buy them a cupcake. A cupcake you ask? Yes, that’s right! Why you then ask? Because they are so delicious and I am tightwad.

Their facebook page has a ton of useful stuff as well and can be found here

I definitely think The PT Project is a site that should be bookmarked!  So do it! Peer pressure!!!!

I believe every single PT student should do their first clinical rotation in an acute care setting. Here’s why: You see most everything a physical therapist does all in one setting:

• Orthopedics- if you work in a major hospital chances are you will work with a s/p joint replacement of some sort. Hips, knees, shoulders…you name it. It’s all there.
• Cardiopulmonary- CABG, Cath, AV valves, Respirators OH MY! You better know your sternal precautions.
• Geriatrics- Not everyone in the hospital is old, but the majority certainly are.
• Neuro- CVA, spinal cord stroke, GBS, SCI… It’s all here folks.
• Multidisciplinary learning- you are surrounded by Nurses, OT’s, Speech Pathologists, Respiratory Therapists, Dieticians, MD’s, any many other disciplines. Wonder what they all do? I’m sure your CI would love to let you spend half a day shadowing one of them.

I believe it is the perfect place to start on your first clinical because it will provide you with a nice foundation for the rest of school. You will learn patient care skills, bedside manor, and you will be able to understand where your patients are coming from. Unfortunately, this acute rotation is my last. It has been a nice summary of everything I have learned, but if I could do it all again I would most definitely choose acute care first. So, if you are wondering where you should go, find a hospital that will take you and make the most of it. I promise you will not regret it!

I have another solid find while on my last clinical. A whole bunch of handouts to give out as patient education. Exciting stuff I know! Most of the forms can be found on handcare.org. It is a pretty comprehensive site and I am sure most OT’s know all about this site, but for the PT’s and PTA’s out there this might be something new. Granted when you think about the hand most people will automatically think oh that’s an OT thing, but there are hand therapists out there that are PT’s so you never know!

There are around 40 different handouts and they are all written so a lay person can understand exactly whats going on and it even has pictures, so enjoy!

Click here to check em out

During my SNF rotation, I encountered a lot (see previous posts authored by me) of interesting situations. One in particular though was very intriguing  for me: Fear of falling. One patient in particular had such an intense fear of falling that she would go into full body tremors when attempting to go from sit–>stand. It interested me enough that I did some research and actually came up with some interesting little tidbits. Subsequently, I turned these tidbits into an inservice which can be downloaded here:  Fear of Falling Inservice (462)  Enjoy!

As I enter the very end stretch of my latest clinical rotation at a school district, I thought I would write a little ditty on my thoughts and findings.

Let me just start by saying, if my life didn’t revolve around money this is the perfect job for me. For some people money isn’t everything, but for someone who is looking at 120k+ debt I am pretty much looking to whore myself out to the highest bidder… ok maybe not the highest bidder, but I would like to make more than peanuts especially considering I will have a doctorate!

So you are probably sitting there saying to yourself, “Don, why is this the perfect job for you???” Well I am so glad you asked! Let me explain.

**Disclaimer** This is just my experiences, everyone will have different experiences. So don’t take what I say to be the final word.

Like:  The schedule

My typical day started around 8am. I saw my first kid around 9:30am and I was out the door no later than 3pm. I have off every major holiday as well as winter break, spring break, and any other break you can think of. I get the summers off!!

Like: The variety

Each child/patient is different. I saw a wide range of orthopedic, neurological, and developmental cases in a short span of time. I learned about things I never knew existed. It was a complete revelation to see the other side to schools not a lot of people usually get a chance to see. As students you just show up and learn, but watching and working with the teachers it stunned me how much went into each day. It made me truly appreciate teachers more than I already do.

Like: The interaction with other disciplines

I always find other disciplines fascinating. I think its because I really don’t know what each one truly does. So working in the schools I was able to see speech, OT, and vision do their thing and gain some insight into what they actually do

Dislike: The pay

It’s not a whole lot. However, to be fair you do get 3 months off during the summer and then every break/holiday imaginable. So you could work PRN and make a nice chunk of change to supplement.

Dislike: Limited skill set

Ok let me just say before someone writes all pissed off about this. This was my experience so I am sure there is quite the variety requiring you to use all your knowledge, but for me it wasn’t the case. So I would worry about losing some skills. Keep in mind you do have the flexibility with your schedule that you can work PRN elsewhere to stay sharp.

Dislike: IEP meetings

I know they are a part of the job and I am fine with that. What I dislike is the wasted time. I can understand the need for the teachers and other support staff to be there the whole time, but why does the PT need to sit through all this stuff that has nothing to do with us?? I could be out golfing! Kidding…. Or am I?

At the end of the day I look back and really enjoyed my last clinical. I wish you were paid more, but I loved the schedule and the lifestyle it afforded me. I was done and out the door by 3pm and I didn’t have to take my work home with me. And come on for 7 weeks I played catch, toss across,

Like any other setting this isn’t for everyone, but there are worse places out there.

I am just about to finish up my SNF rotation, and I got to thinking (always dangerous for me) that there are some things I really enjoyed about this experience, and some things I really did not like. So, without further adieu, here they are:

Like #1: I love speaking with the elderly. Some of my patients right now are 90+ years old. I love hearing about their lives and how much the world has changed in their lifetime.

Like#2: Variety. Most patients in the SNF have a variety of conditions. One comes to mind right now who recently fell and broke C2 (ouch), has a colostomy bag, has renal failure (on hemodialysis), has a PEG tube, and has arterial insufficiency causing LE wounds.

Like#3: Working closely with other disciplines. We work hand in hand with Nursing, OT, and ST, all working together to get the patient back to their PLOF.

Now, for the “hates”:

Hate#1: RUG levels. Sometimes (well, most of the time actually) it makes no sense to me why the above mentioned patient in like#2 has to do at least 120 minutes of PT/OT a day…right after a dialysis treatment. C’mon, give the poor guy a day off and let him recover. Its not like he’s 60 anymore. It frustrates me that these minutes “need to be met so that Ultra High RUG can be met within the assessment period.” Sometimes it does not seem like what is best for the patient.

Hate#2 Motivation. I really do not like having to motivate someone to come to the gym for PT treatment. If you were 93 and have been in bed with pneumonia for 3 weeks would you want to come down and exercise for 2 hours? I think not. I might want to get out of bed for a while and do some light activity, but not exercise for 2 hours!

Hate#3 Patients die. People who you have gotten pretty close with over the past 5 weeks will suddenly be admitted to the hospital over the weekend and die of aspiration. Emotionally this is hard for me, and even harder for the families (who you have also gotten to know), and I don’t like it.

So there you have it. Could I, would I work in a SNF? Maybe, but not for very long.

Finally after months of doing who knows what I have finished the shoulder quick reference sheet. I tried to incorporate all the important things of the shoulder joint.

I highlighted the ligaments, muscles that cross the shoulder joint with their corresponding innervations and actions, a few nifty illustrations and on the backside some of the more popular special tests.

As always if you find any mistakes or something blatantly wrong let me know and I’ll fix it ASAP.

Link: Shoulder Quick Reference Guide
Version: 1.0
Downloaded: 1699 times
Description: Two page quick reference guide consisting of:

• muscles that cross the joint along with their corresponding insertion, action, and innervation
• normal ROM values
• important ligaments
• open/closed pack positions
• special tests
• etc etc

As I continue through my clinical rotation in a SNF, I find that blood pressure and other vitals play an important role in how and even if we can treat patients.  This led me to review my notes and see what information I could find that might be beneficial to others as they embark on clinicals in the SNF setting.  So without further ado, here are a few helpful tidbits just for you.

1. If you obtain a patient’s blood pressure that registers over 200 systolic or 105 diastolic, do not begin treatment.
2. If a patient’s blood pressure increases to over 250 systolic or 110 diastolic, treatment should be ceased.
3. Abnormal response to exercise- reduction of more than 10 mmHg or increase of more than 10 mmHg in diastolic value.
4. PT/INR-  PT should be between 10-12 seconds while INR should be around 1.0 (2.0-3.0 on an anticoagulant).  The higher the INR, the more excessive the bleeding.  A low INR is indicative of a minimal bleeding.
5. Normal adult respiratory rate is 12-20.  This will likely be out of normal ranges in patients with respiratory diseases.
6. Sa02 normal values- above 92%.

So there are a few commonly seen and monitored items I have run across on my clinical. For more information, here is a link to an article published in Cardiopulmonary Physical Therapy Journal.  It is a pretty good review of a cardiopulmonary assessment.

Here is the link:  http://findarticles.com/p/articles/mi_qa3953/is_199910/ai_n8869364/?tag=content;col1