How to Professionally Resign from a Position

So, I feel like this is a topic that may seem like it is common sense knowledge, but I recently had a less-than-stellar situation at work. So, I thought perhaps I should write about it in hopes that someone would read it and maybe think twice before acting (a fool).

You land your dream job and everything seems like it couldn't be more perfect. But, what happens when you realize that what you thought would be a good fit really isn't? Sometimes life isn't perfect and you need to re-evaluate and do what is best for yourself. And I'm talking about what is best for yourself in both a professional and personal manner.

One thing that I think is so important is that you never want to burn any bridges or lose any connections. Especially in certain geographical areas where the physical therapy community is small. A lot of times people know people who know people who know people who... you get the picture. If you need to resign from a position it is of utmost importance to do so graciously, and with your reputation still intact.

So, what is the "professional" way to resign?

1. First, talk with your supervisor

• Nothing stings more than a complete blind side. If you are struggling in your position, talk to your supervisor or mentor (if you have one). Sometimes your supervisor may not even be aware there is a problem and if it is one that can be rectified the first step is letting them know.

2. Provide your own suggestions on ways to improve your employment situation

• If you are overwhelmed, stressed about scheduling, don't like a certain policy, etc. come prepared with some suggestions on how to fix the situation. Nothing stinks more than having someone say, "This sucks" with no ideas on how they would like to fix the situation. 

3. Carefully consider the pros/cons

• Once you've discussed your issues and you've come up with some potential "fixes" decide if this is going to truly work for you. I am a big proponent of keeping a pros/cons list to help yourself see outside of the emotions.

4. Once you've made your decision, create a resignation letter

• There are plenty of resources available online to help you create a professional resignation letter. 

5. Give at least 2-4 weeks notice.

• I know most companies have a policy, so you should follow it. Under no circumstance should you ever disappear and leave your caseload with no therapist to treat. Four weeks gives your employer (and yourself) time to assess the situation, find a replacement and get your caseload in order to take over.

6. Discuss your decision (calmly) with your supervisor

• Take the time to discuss your decision with your supervisor in person. Although the professional relationship is not going to work out, they still gave you a position and you owe them the respect to discuss your decision. Again, don't burn bridges- you never know where you may go and who may know someone you worked with before!

7. Move on and keep your lips sealed!

• You've done it! You made it through your resignation notice and now you are free. Be proud that you did what was right for you. But, please keep your lips sealed when it comes to your prior employer. No matter how awful the situation was, you never want to badmouth a former employer. It just plain looks bad on you. It will never reflect poorly on the company. 

Happy One Year Anniversary (to me)!

Today marks a special day in my physical therapy career... I have been my company for one full year! I cannot even believe that I have been a practicing physical therapist for ONE YEAR! I often think back on my time in school and praise the Lord above I am no longer in classes. Right now, if I were in school, I would be in neuro class.

I feel like I have learned a lot in one year and that I have a lot more to learn as I grow as a physical therapist. Working for my company has been great and stressful all at the same time. But, I'm looking forward to what the future will bring.

Here are ten things I've learned in the past year:

1. When you get a straight forward patient case, be thankful; they do NOT come often.

2. No matter how much you try to get "buy in" there are just some patients that aren't going to buy what you are selling, and that doesn't make you a bad physical therapist

3. You will get people better that you thought you could never get better; and vice versa... You will not get people better that you thought you could get better.

4. You'll find that the most rewarding part of your job is when you can laugh with a patient.

5. Your coworkers will drive you insane from time to time; it's not always sunshine and happiness.

6. You will learn to love the patients that are difficult to love.

7. When you think that you cannot do one more thing, you'll do ten more and impress yourself with your own multi-tasking skills.

8. You may want to quit, and that's OK, everyone has job related stresses.

9. You will learn that it is finally OK to take care of yourself and have hobbies, instead of reading your notes all night.

10. You will learn that yes, after all the questions and doubts, you did make the right choice!

Guess what?

We are engaged! 

After almost 8 years of dating, he finally popped the question last night. And, of course, 

I SAID YES! 

Setting Career Goals Early

Something that I feel very passionate about, is not becoming complacent in life. I feel this way with both my personal and professional life, which is why I think it's so important to set career goals early and re-evaluate those goals frequently. I try to keep thinking about goals in terms of 6 months, 1 year and 5 years. By doing this, it helps keep me motivated to work hard in the present and by checking in on my goals I keep myself in check for moving forward in the future.

Before I graduated, one of our professors gave us an assignment that I think every PT school should make their students do and it was called a "Professional Development Plan". It forced every single one of my classmates to think about what they wanted to accomplish, professionally, in the next 3-7 years. I feel like when you're in PT school, the end goal is graduation. The end goal is to get that DPT. The end goal is to survive. Right? Well, I found myself, after graduating and passing the boards, having a short moment of, "Now what?" For the past 4-5 years I had been so focused on setting goals of going back to school to take pre-reqs, getting accepted, getting through school, passing the boards, and landing a job that I hadn't spent much time thinking BEYOND that point. 

So, I was actually really glad that one of my professors forced me to think about life beyond that first job, and then to record down some goals in WRITTEN FORMAT, to hold myself accountable. And, now that I'm roughly 6-7 months into my first position and things are starting to normalize, I feel that I've been thinking a lot more about "the future" and what my next steps should be to get there. 

For this reason, I wanted to post the thought process that my professor enstiled in me, and the thought process that I currently use when I'm thinking about the future and what moves to make next. 

Here is a somewhat simple five step process to make your own professional development plan that is actually more than just saying, "Someday I'd like to..." (Underneath each step, I am going to share with you, one of my personal goals as an example.)

Step 1: Choose a goal that is something you'd like to do and choose a TIMEFRAME to achieve this goal

• Become a successful clinical instructor at my place of employment (Summer 2016)

Step 2: Consider what your reasoning is for this and what the potential benefits could be

• Important to the continuation of this profession
• Valuable learning experience for the student and myself
• Background and interest in education

 Step 3: What strategies are you going to utilize to get to this goal... specifically?

•  When interviewing, discuss opportunities for becoming a clinical instructor, the guidelines that the company employs and how to meet those guidelines
• Observe colleagues that are clinical instructors to gain knowledge
• Continuously practice in a professional and ethical manner
• Complete the APTA Clinical Instructor Education and Credentialing Course

 Step 4: What resources and support are necessary for you to meet this goal?

•   Lecture from Principles of Practice V (my course at school) regarding becoming a clinical instructor
• Information available on the APTA website
• Continuing education courses from APTA on clinical instruction
• Using colleagues that are currently clinical instructors as a resource

 Step 5: What challenges or problems may occur that would impede reaching the goal?

•  Ensuring that I find a place of employment that will support me in this goal and help me achieve my goal in a timely manner
• Being able to manage time effectively with the additional requirements that will be required with taking on a student
• Receiving appropriate preparation and resources from place of employment and academic institution

By placing this much thought into a goal, it turns that goal into a plan rather than a wish. And when you have a plan, and you have a guideline and you have thought about what you may encounter en-route to your goal, then, in my opinion, you are more likely to succeed and reach that goal. 

Wow, a lot has changed!

I just looked back through my blog to around this time last year (and then the year before) and, wow. I have come a LONG way! I can't believe that it's 2014 and I'm a licensed PT working on my 5th month of rightful employment. ;) I remember when I first decided to go back to school for physical therapy and how daunting and impossible everything seemed... and even reading my blog from July 2013 and July 2012, I realized how far I've come... This time last year I was in my last semester of classes in PT school. I was working on writing my systematic review for graduation and learning about some more specialty-type areas of PT (including aquatic therapy and burn care.) The year before that, I was just about to start my very first clinical experience. Holy moley... I remember being so worried about my first clinical experience, and it has turned out to be an invaluable experience that, to this day, I still cherish. (And still use information from that clinical... well, the nuggets that stuck with me!)

I'd love to say time flies when  you're having fun, but I don't really consider PT school "fun". Yes, there were many laughs and good memories, but it was a lot of work and there were a LOT of times I considered quitting. Now that I'm working, I'm so glad I stuck with it... Everything fell into place so well for me and now I'm getting ready to embark on a bigger adventure with my current company. I'm actually going to be able to to continue to be passionate about cardiopulmonary causes and work towards getting patients the preventative care they need. I would have never believed myself (or anyone) if they had told me that I was going to get to work with such a special patient population, and still work on my orthopedic skills at the same time. I've been really blessed with a first job that is diverse and with a coworker that is a fabulous mentor (although is challenging to work with at times).

It seems like years ago (and let's be honest... it really was... it's been 7 years since I graduated with my education degree) that I was embarking upon a teaching career, or rather trying to, never knowing where I would be 7 years later... Life is funny.

It's days like these when I can sit back and reflect a little and realize that I did it... Classroom to Clinic. I did it, even though there were people who probably doubted me, there were people who didn't understand why I "gave up teaching". I had a supportive family and boyfriend that got me through it. And I'm a doctor now! :)

Just plugging along...

So, here I am still plugging along. Another weekend passed, and gearing up for a shortened work week this week! (I looooove holidays!) I'm looking forward to making a move in my current company, as I had an opportunity present itself to me not long after I posted on this blog last. It was sort of a serendipitous type of thing... I was feeling a overwhelmed, over worked and a little hopeless. And then opportunity came, saving me. Ha.

Eh, the funny thing about life is sometimes when you think you can't push any further and that no one has noticed you've been busting your tail, every once in awhile someone has been paying attention and then good things happen.

I'm looking forward to the move within my current company to give me a bit of freedom (although I've only been there since February, since I was a student there, I had a slight head start on the happenings) and more motivation to continue pursuing my interests with the cardiopulmonary aspect of physical therapy.

And, when a good opportunity comes to further your career, you've got to take it... So, I am. I'm going to be moving to a different office location to help form an agreement with my current company and  a company that is going to be opening some breathing disorder centers. It's a great time to jump head first into being the PT that's interested in cardiopulmonary in our company because no one fills that area, and who knows where it will lead. Maybe nowhere, but maybe somewhere. All I know is that I needed something to come along before I got so burnt out that I made a rash decision, and it came all on its own.

Two. Thumbs. Up.

I hate being vague on here, but I don't like giving too much information that is personal. But, I am very excited for this opportunity and I love my cardiopulmonary patients! :)

The New Grad Blues

Ok, so... Here it goes... I have the new grad blues. I think this is normal... Or at least, I keep meeting with my former advisor from PT school (what a great opportunity that she can continue to be my mentor!) and she makes me feel this way. I had all these aspirations and "life will be so much better when..." moments, so to be honest I feel a little let down. Things aren't really panning out the way I had foreseen in my dreams.

Without sounding like a big baby, just take this with a grain of salt. The reason (well not the only one...) that I chose the job I did was because I had a clinical rotation there and it wasn't overly busy. The environment was slower than most OP clinics and of course, the pulmonary and cardiac rehab was a huge pull for me... However, since I started we have been blowing the doors off the clinic with so many new referrals. In fact, in April I saw the most patients a PT has seen *ever* in one month at the clinic. This is great for experience, great for keeping the day moving fast, but awful for my personal health. I am literally being run into the ground, sometimes needing to stay until 9pm at night to finish everything that I need to do... It's like I'm starting to get burnt out and I have literally just begun.

I know that OP clinics are busy, I get it. (Like I said, not trying to be a baby... although, this is my blog so I can say what I want!) But, I wouldn't be in OP if it wasn't for this particular company and their cardiopulmonary aspect. I'm starting to worry that perhaps this isn't the setting for me. I know that if I were to leave my current position (as in some day, like when I'm ready to move forward with my career) I wouldn't really want to take my base knowledge of orthopedics and head to another OP clinic. It's just not me. There are plenty of people who love ortho and that is fantastic. And I am loving the well-rounded experience I am getting right now, but it's not something I'm going to specialize in later on in my career. Additionally, I am a bit worried about my base knowledge I'm gaining in cardiopulmonary. This is something I have great interest in but I am trying to be realistic about my options for moving forward in this specialized area. I'm not so sure that there are that many opportunities for someone who wants to focus purely on cardiopulmonary.

So, this newfound doubt plus the overwhelming stress of literally doing nothing but work/sleep has me feeling blue. In fact, it has me feeling like maybe I shouldn't have gone to PT school at all. I love my patients and I love patient care and I love most things about my job, but the stress is too much. I just feel like I am being pushed so much for being a new grad. I mean, I'm seeing as many (and sometimes more!) patients a day as my mentor/boss who has almost 20 years of experience. It's just daunting. I'm not asking someone to pat me on the back and baby me, but for crying out loud - I. Am. Exhausted.

Pumped about my new work bag!

tic tac tote: verabradley.com

This is such a trivial post... I don't even care. After looking around for the past two months, I finally purchase my work bag. I've been looking incessantly online and in a ton of stores... Not really sure what I was looking for, other than I knew I wanted it to be something large enough to hold a binder and some other items.

Well, I finally decided on this beauty from Vera Bradley. I am not a person that likes spending a lot of money on something, so it was quite the ordeal that I allowed myself to buy this. ;)

But, I think I'm in love.... And I'm about to pack it full of all my things right now. It has a thousand pockets on the inside and it zips shut which is a nice plus. A couple of the other totes I was considering just had a button closure, and the one was actually almost impossible to do in a timely manner when I tried it out at the store.

Anyway, now I'm sad that my binder doesn't match, but what's a girl to do? These are the things that keep me sane while work is keeping me insane.

Trying to find balance...

So, the thing I'm struggling the most with is finding balance between my professional and personal life. It's like, I know that I need (and want!) to separate work from home, but it's so hard. I'm slow with things and not really efficient yet, so sometimes* I have to stay late to finish my paperwork. (*Sometimes is usually ~3 times a week.) And then, I have questions when I have someone with a condition I've never treated before (insert the eval I just did on a lady who I believe has un-diagnosed trochanteric bursitis) which requires me to spend a little bit of time researching on the internet. Then, I am taking over the cardiac program and feel obligated to give my patients the best care I can, which includes looking up education materials. Add all that together and most days I am doing a lot of work related things outside of work.

And, on top of my fatigue issues, all this is making it very hard to make it to the gym on a regular basis. For example, tonight I just came home and by the time I cooked dinner, I was completely wiped out. So, I realize I need more separation than work being work and personal life being sleep... But, I just don't know what to do to make it different. It's very frustrating. I had found an article to read on the APTA about this very topic, but it had nothing good to say... Basically, just that you need to balance things. Well, I know that... I just don't know how when I am at work late, need to look up something about a patient for the next day, and have unrelenting fatigue. (I finally just did some hormone testing, so we will see what the results show and then what my options are for that...)

I've just gotten into bad habits (mainly not going to the gym regularly) since moving away from home and starting school. It's been a hard transition and there's been a lot going on in my personal life. Besides all the stress of school, my mom was very, very ill through 2/3 of it and there's always something going on with our house whether it be renovations, laundry, etc. I just don't have the energy to deal with it all and so I'm ending up suffering. Which, in turn, is making me feel slightly miserable and sort of like crying a lot.

I just keep telling myself that things are going to improve over time. And that it's not always going to feel like this... Or at least, I hope it doesn't or I may drive myself insane. In fact, as I'm writing this, I am incessently yawning and heavily debating on going to bed. I'm just so tired. But, it will get better! It has to!

Yes, you do need to do research after graduating ;)

(But, it's so much more fun!)

So, I got some exciting news that I am going to be taking the lead in revamping our cardiac rehabilitation program at my job. This is great for a few reasons:

1. I *LOVE* cardiac patients, cardiac pathologies, cardiac responses to exercise; I love the heart!

2. Up until this point the cardiac patients have been performing a modified version of the pulmonary program, which isn't "wrong" per say, but it is also not the best we can be doing for these patients

3. I am excited to use my creativity and new knowledge to change the face of this program and then hopefully help market my company and make us a larger player in this field in the area

So, this weekend I found a couple of articles from the American Heart Association on their core components and guidelines, as well as some performance measures for cardiac rehab. I'm hoping to read through those articles later today and then also look back on my school notes and in my textbooks to remind myself of all the important things that should be considered when dealing with a cardiac patient.

I'm so excited to be able to have this opportunity, with a patient population I'm very passionate about... I know I just posted last time about the stress test that I completed, and the reason for that is that I have a congenital heart issue. Thankfully, it doesn't limit my ability to do anything, but it has made me very interested and passionate for the cardiac world. And, I feel I'm in a unique situation where I can maybe relate (a little!) to my patients.

I'm also drooling over the AACPR's textbook on Cardiac Rehab, but it's also $60. I'm going to email my cardiopulmonary professor and my boss to see if we have a copy of this anywhere that I could borrow, before I consider buying it... I don't want to overwhelm myself with information, but I think it could be helpful.

I am also planning on becoming a member of the AACPR because I feel like there is a ton of information on there that would be beneficial. My cardiopulmonary professor and the respiratory therapist are both members (in our area) and it seems like it has been useful for them, so I'm debating on when to join.

So, things are feeling very exciting and also a nerve-wracking, but as I investigate, I'll be sure to post some good cardiac rehab information! :)

My first stress test...

Today I had a stress test done, mostly for my own piece of mind. I'm easy to admit that I'm a bit of a hypochondriac and I've had a little bit of a bumpy time throughout school with some new heart symptoms. Luckily, through trial and error of my own accord (and help from my PCP since my cardiologist would never call back [very annoying and could rant about that separately!]) I eliminated most of my symptoms, but still am left with some anxiety about exercising to my full potential.

So, after my check up at the cardiologist last week (which went well! He tells me my heart looks exactly the same as it did two years ago!) he suggested if I really wanted to have piece of mind they could run an exercise test and that way if I do have symptoms it would be caught on multiple monitors and if there is a problem that only presents with exercise they would catch it.

Well, let me tell you, I am the biggest wuss on the planet. I couldn't make it the whole way through the stress test, but I did hit my almost max HR (with no symptoms, yay!) and I think everything looked great! I had no symptoms and that's the first time I've taken my heart rate past ~164 in two years.

So, I now have a HUGE appreciation for my future cardiac patients who have to go through this stress test. It's not really that fun, and I've had a huge headache since doing the test this morning. (I'm assuming it's from being dehydrated since I did it first thing in the AM and didn't really drink anything before hand... And I also skipped my morning coffee.)

Anyway, this post was sort of pointless... If I was feeling really motivated I could've written all about what the protocol is, but I don't really feel like it right now. And, I'm about to head out for an easy dinner with the boyfriend and a friend!

But, out of all the tests I've taken in the past 2.5 years, I'd say the stress test was the easiest one ;) Sure beats taking a PT exam!

First Day as a "real" PT! :)

Well, as I work on filling in some missing pieces (mainly my 4th clinical experience, graduation, getting a job and studying for the boards), today was a monumental day in my journey from teacher to clinician... Today was my first day as a real-life PT!

Since I did a clinical experience prior to my employment, today felt like I'd never left. I'm not sure if that is a good thing or a bad thing, but it definitely helped ease my anxiety. In fact, there were a few familiar faces today and I guess I can expect a couple more later this week. The clinic is sort of slow right now (compared to when I was there before) which I also take as a blessing that I won't be quite as overwhelmed as I work into getting into a routine.

I was working with some patients today and found myself continually going to my prior-CI to ask for permission. I sort of realized halfway through the day that technically, I can now make decisions based on my own opinions. ;) It's still nice to ask permission for someone else's patient though.

So, it was a long day... 10 hours.... Wow. My feet are absolutely killing me, so I'm looking forward to getting used to the feeling of being up and moving all day so that my poor feet don't feel like they walked through a war zone.

I'm also exhausted. It has been about 10 weeks (I would guess) since I last even touched a patient, much less was active all day. I could honestly go to bed now and am literally considering it once I finish this blog post.

I honestly can't believe I just went to work today. I literally went to work and got paid! It's crazy. I remember when I started this journey back in 2009, it seemed like 2014 would be a million years away and now it's here! The interesting thing is, now that I'm done with school I want to try to pick up some hobbies, but I have NO IDEA what I want to do with all my newly earned free time... Definitely getting back to the gym is on the top of my list, and I keep trying to convince my boyfriend we should get a fish tank. Thank goodness the Olympics are on and I can entertain myself with that for the time being! Go USA!

Studying for the NPTE: My Plan

So, I've decided upon a plan to study for the NPTE and figured I would share it here... I am not sure if this plan will work, but it's what I'm going to try to do.

I have 6 weeks until test day and plan to allot my time as follows:

Day 1 - 12: Neuro (my weakest topic) (two days will taken off for baking holiday cookies and Christmas Day!)
Day 13: Practice Exam 1
Day 14 - 20: Cardiopulmonary
Day 21: Practice Exam 2
Day 22 - 28: Start Musculoskeletal
Day 29: Practice Exam 3
Day 30 - 36: Finish Musculoskeletal
Day 37: Practice Exam 4
Day 38 - 41: Review weaknesses and other small topics
Day 42: Exam Day

I'm hoping by starting with my weakest subject that I will spend the most time with it and then ending with musculoskeletal will help have the most things in my memory right before test day.

We shall see what happens!

Time to study for the NPTE

Well, now that graduation day is over, it's time to seriously start planning how I'm going to study for the NPTE. I have the TherapyEd course books and plan on using them as my main means to study. I have a classmate that I am planning on studying with from now until test date; hoping we can keep each other motivated.

My rough draft plan is to start with my weakest subject, which is neuro, then move into cardiopulmonary and finish up with musculoskeletal. Although musculoskeletal is the largest section I hope that studying it closer to the test date will help me remember more.

I feel like I didn't really get to celebrate graduation all that much because this test is looming over me. But, I'm also ready to buckle down and get this very last thing done and over with!

The Day I Got My Doctorate

(below is the speech I proudly gave to my fellow classmates, professors, family and friends on graduation day)

Wow, graduation day. I know for myself and the rest of my classmates, we’ve all had moments when we thought this day would never come. It’s been a long journey. While I was thinking about my experience through PT school, I thought about how each of us has encountered countless highs and lows. Obviously, today is the highest high we’ve had yet, probably being surpassed only by the day when we proudly hold onto our licenses. And we aren’t the only ones who have experienced the ups and downs leading to graduation- I know that our families and friends have been beside us through the good and bad. And, they are all sitting here today, ready to celebrate.
When I was trying to find the right thing to say, I came across these words by Nelson Mandela that perfectly describes the journey of PT School. He said, “It always seems impossible until it’s done.”
Mendela’s statement resonates so well, because everyone in this room knows that PT school is not all roses and rainbows. In fact, it’s more like practicals and playing Jeopardy with Dr. Schreiber. The low points happened to everyone, but occurred at different times - things like waiting until the last minute to do our PBL, working endlessly on the matrix,  our blunders on exams, our mistakes during practical- These were all moments for each of us that made PT school seem impossible.
But, for every low, there was inevitably a high. And, so I’d like to remind us of the good times-- things like: remembering the day we got accepted into PT school, the lifelong friends we’ve all made, the first time we aced an exam, our first clinical and our last clinical—these are all moments that made the journey worth it. These moments were when we stood proud, and we said to ourselves, “We can do this.”
And so, we had different personal journeys through school and each one of us has specific events in the past two and a half years that are etched into our memories as the highs and lows. But even though we’ve all had unique experiences, we made it here together today.
So now, I stand proudly in front of my classmates, my fellow doctors of physical therapy, our wonderful professors, our loving families and friends - and I can say- we did it. It doesn’t seem that impossible after all. Congratulations to the Class of 2013!

How did 8 weeks pass by so quickly?!

  This week has been so busy and has been going very slowly. I am thankful, though because it's my last week and I'm not ready to go! I discharged another patient this week, but all the other ones I started saying goodbye to today. Some of them I am really close to because I started treating them as soon as I started and I will miss not getting to know how they finish up. I had a couple of my male patients tell me how much they appreciated my kindness and how much they will miss me.  The same patient that brought me flowers last week told me I took "care of him best". It was so cute! I am really going to miss everyone. I'm not looking forward to saying goodbye to all my pulmonary patients tomorrow, they have been the ones I have had the most fun with! 

     Today I gave my in-service on CHF. It went pretty well and then we all had lunch together for my "farewell" which was really nice. My CI even bought me a cookie cake! Everyone just keeps hugging me and telling me about how much they don't want me to leave. I really feel like I'm a part of their family now! 

     And, we talked a bit about the possibility of maybe me having a job there when I graduate... It's very unofficial now because they weren't planning on hiring anyone, but it was really exciting to think that I may have a small lead on something already! 

     This has been a really rewarding clinical experience and I have really loved the chance to work with cardiac and pulmonary patients. I will definitely miss it!

Friday the 13th! No wonder things have been "off"

This week has been a little rough with my CI coming back from vacation. I was used to my expectations from her and then got used to the expectations of me by everyone else while she was gone and now she's back and it's been a transition. She's been commenting on everything that I do, or what order I should do particular things. (Like, "Make sure you put patient 1 on the treadmill so you can finish patient 2's manual!") I know she's just trying to be helpful, but I've got it under control! ;) Well... for the most part. 

Well, after two really rough days, today was GREAT! :) :) I was so glad to have a good day. I had a couple of rough ones and was feeling down. One of my pulmonary patient's perked me up right away in the morning. The respiratory therapist will bring donuts in periodically for the patients on Fridays and there were some donuts on the table. My patient looked at the donuts and looked at me and said, "Sister... in the game of life you've got to keep your eye on the donut and not the hole." It made me laugh and made me realize that I was worrying over two "bad" days and really, I've been doing really well overall at this clinical. Then, we got a patient with congestive heart failure and he is high risk for exercise (his cardiologist sent him to us!) so I have been working with him. Basically, we do a functional activity (like stairs) and then I take his pulse and blood pressure. Then we will do another activity, then vitals, and back and forth for the whole session. So, it's a lot of work just to make sure he is doing well. Beyond his congestive heart failure, this patient has a long psychiatric history including paranoid schizophrenic. I was able to sort of teach everyone a few tips on dealing with him based on one of our lecture's from neuro, which was awesome!  Basically, I just make sure I fully explain everything we are going to do and what we are doing and why we are doing it. His therapy session is very structured and I make sure to not whisper around him (we do try to discuss his vitals to the side from time to time). So, if we do have to discuss something, I always come back and tell him what we are talking about, so that he doesn't feel paranoid and feels safe. So far, everything has been fine and he is actually one of my favorite patients (and the source of my in-service)! After he left today, my CI told me she was really impressed with how I was handling him and that I was doing really well with him. That made me feel good! And then, my patient at the end of the day, who is a little hard to warm up, told me she thought I was really empathetic and she can tell how much I care about her and my other patients and that I've been very patient and kind to her and she thinks I will be a great therapist! It made me feel awesome!! Especially after a couple crappy days!! Finally! A good day and I'm feeling great again!

Gettin' the hang of things...

 Another week down! It's been a transition to get back into out-patient after acute care. I'm not used to juggling patients, but I'm already starting to get better at handling more than one patient at a time. On Tuesday my CI left for Australia and she will be gone for almost 2 weeks! I'll be a completely different student when she gets back. In the meantime, I get to work with the owner and the other clinician, which will be nice. They both have more experience and so it has been good to get input on things. On Thursday morning the owner was filling in and I ended up seeing almost all the patients in the morning. I'm not sure if he did it on purpose to see if I could handle multi-tasking, or if it was because he isn't familiar with everyone. I think I did pretty well with trying to keep multiple people going at once. But, like I said, it's a transition from being in acute care and seeing one patient at a time. It's been a source of stress for me and I'm beginning to feel like I'm never going to get the hang of it again!

     I also got to spend some time with the respiratory therapist to see how she works her half of the pulmonary rehab. This has been really cool. I have gotten to sit in and help with two evaluations so far. It's really neat to see how they use the 6 minute walk test to determine how to start an exercise prescription for a patient. Although, they do the walk test on the treadmill, which is sort of odd. The clinic also got a new telemetry unit on Thursday afternoon and only myself and the owner were there to learn how to use it, so on Friday when the owner wasn't in the office, I got to teach the respiratory therapist how to use her new system. 

     Another neat thing that's going on while my CI is on vacation is that some professors from my school are filling in!  It was nice to see one of my professors in the clinic. He's really good with patients. I hope that when he is in on Wednesday he will get to see me work with more patients and see how much I've grown as a therapist. (I was with the respiratory therapist for most of the day on Friday, so I didn't get to work much on the "PT side" as I was helping with aerobic exercise and vitals!) And next week two other professors will be coming in as well. This is the first clinic I've been in that has had a relationship with the professors at my school and it's so nice to see my professors with their clinician hats on!

Back in the clinic! ClinEd 3 begins!

Today was my first day of my clinical experience at my new placement, which is an out patient clinic that specializes in pulmonary rehab. It was a long one (10 hours!) Big shift from doing acute back to out patient. The clinic is small, but it seems nice. My CI is young (she graduated from the same school as me 3 years ago!) and is actually a year younger than me in age. That doesn't bother me as long as I can learn from her.  The clinic serves about 50% out patient and 50% pulmonary rehab. I'm really excited about the pulmonary rehab aspect.The respiratory therapists work on aerobic conditioning (they work the patients up to 20 minutes on 3 different machines TWICE a visit [2 hours of aerobic work!!!]) then PT works on strengthening, balance and reiterating what the RT's teach (like breathing techniques, energy conservation, etc.) I had forgotten that Medicare Part B does not allow students to provide treatment to patients, so I was a little bummed because a lot of the patients today (especially the pulmonary patients) were Medicare and so I wasn't allowed to treat them. Although, it was nice because I did get to sort of observe and see how things happen. I am just hoping that there will be a good number of non-Medicare patients in the pulmonary rehab program for me to treat, since it was the reason I wanted to come to this clinic. Besides that, the day was ok. I got a little prepping on the computer documentation (which is, of course, a new program than I've dealt with previously) and some more information on billing. My CI had me write down three goals for this experience... I said that I wanted to become comfortable and competent with cardiopulmonary patients in this setting (since I am competent in the acute setting), to become independent with orthopedic patients (again), to become better at time management and multi-tasking, and to continue to excel with documentation. My CI seems very open and told me that I can ask her any questions or if I get overwhelmed or not challenged enough to let her know.  I think I am her first student, so it should be interesting for both of us as this goes. 

Back to school...

Ugh... Back into the classroom today. Although I am glad that acute care is over, there are certain things I will miss about being in the clinic. Just a few more classes and then I am done with all of my schooling! This semester is supposed to be a whirlwind, it's only 7 weeks long and there's a lot to fit in. I have Dysfunction of Multiple Systems (lovingly referred to as Multi-Systems) and my final Research course (time to write that systematic review!), as well as a professionalism course.

It looks like a ton of busy work, but I was happy to see my friends. I'm looking forward to getting these next few weeks out of the way so that I can go on vacation!

Oh! The best part about today is... I'M A THIRD YEAR STUDENT!

So excited to have that designation... Woohoo! :)