I’ve spent two weeks in my acute care internship, and so far I am loving it! Here’s a quick recap of the details of the last 10 days:
Where: I am working on the neuro team at the major level one trauma center in Pittsburgh. It is located on the University of Pittsburgh’s campus in Oakland so I am getting used to city living! Because parking in the city is so expensive, the hospital offers student parking passes for $45/month with an employee shuttle from the parking lot to the hospital.
When: My work hours are 7 am-3:30 pm for the most part, with my internship running through the first week of December. Given the time it takes for me to drive into the city, park the car, and ride the shuttle to the hospital, I am waking up around 5:20 am-that is a tad bit earlier than my 9 am rolling out of bed I’d gotten used to for the last month! I try to leave my house by 6:05 to get the car parked by 6:30. Traffic isn’t bad at that hour coming into the city, but leaving is a whole other story. Because I have to take the shuttle through the city to get to my car, and then drive my car back through the city to get home, I’ve been clocking almost an hour and a half commute home every day! Needless to say I am exhausted by the time I get home!
Who: Since my CI is on the neuro team, we see a large variety of patients with neurological diagnoses. The cool thing about this site is that the therapists on each team spend 2 months in a respective unit, and then rotate. My clinical instructor (CI) had been on the unit that primarily sees spinal surgeries for the last two months, and last week we switched units and will see mainly the Neuro ICU and Neuro Trauma population for the next two months. This will be a mixture of various diagnoses such as traumatic brain injury, stroke, motor vehicle accidents, falls, and concussions.
What: Most of my job as an acute care Student Physical Therapist is to evaluate patients and recommend which discharge disposition is appropriate for them. Since these patients typically are at our hospital for only a few days, we are the experts to determine where they should go from here from a mobility standpoint. The three main options are home with home health PT services, a skilled nursing facility (where patients get less than 3 hours of PT/OT/speech per day), or a rehab facility (where patients get 3 hours or more of PT/OT/speech per day). A typical acute care evaluation consists of the basic patient interview and mobility assessment. We need to know the patients’ home set-up (stairs, assistive devices, who is there to help them), if they have support available to help them at home, what their baseline mobility is, and if they have concerns about going home. Once we’ve conducted a brief interview, we must see how the patient can get out of bed, walk down the hall and possibly up/down stairs, and perform transfers to sit in a chair or get back in bed. We also want to see them move with the assistive device that they normally use. For example, if a patient who normally uses no assistive device cannot walk without the use of a walker or hand-held assistance, we know this is not their baseline level of functioning. However, they still could be safe to go home if they have supervision at all times and home health PT could help them recover to baseline from there.
On top of evaluating patients, we also see them over the course of their stay at the hospital to continue to work towards their discharge goal. Treatment typically consists of walking, going up and down stairs, balance training, and other functional activities patients do daily.
Overall, I am really starting to lean towards the inpatient acute trauma setting for post-graduation employment! I am still pediatric obsessed, but I may be finding another passion as well…
As you can probably tell, I have been inundated with information these last two weeks! I’m excited to continue to learn and grow as a clinician, and to share my experiences with you! What aspect of my new rotation would you like to hear more about?
Keep on Dreaming,
Liz
Dreaming dpt 