I knew that this program would be different but I never knew how challenging it would especially to my preconceived comfort zone and my previous. The things I do now I would never have imagined I could survive 6 months ago.
A bit of background, I was sick a lot when I was little, I actually missed so much school and had such problems adjusting and interacting with others that the school implied I was delayed and my parents were forced to enroll me in a religious school with a smaller ratio. I always had problems interacting with others and I realize that it is just my personality. I am the quiet person that wants to hide at the back. The problem with the school system that I now realize is that it is very passive and not interactive. In most classes we sit, listen the teacher, write notes and then go home. The problem for me was that my english speaking skills never properly developed. I did talk to friends a lot in HS but still not as much as I should have.
University changed me quite a bit. In 1st year I became very severely sick with bronchitis and it months of recovery. I realize now that the bronchitis was aggravated by the fact that I had a unbalanced diet and had severe stress. But after my illness I developed a phobia to anything to do with people. I became a germaphobe and did not even want to talk to people because I was afraid they would have a cold, would get me sick and I would not get better. I would cover my mouth with a scarf whenever I was anywhere near people so that I would not inhale the germs. Needless to say I did not develop a lot of friendships during my undergrad because I was so focused on getting good grades and not getting sick.
So during undergrad, my english communication skills deteriorated since I was not talking to anyone and at home I do not speak english.
My world turned upside down this year. I was forced to talk to other student, ride the transit system daily and at this placement I was forced to interact and communicate with patients, staff, instructors and other students! Going into this program I thought my biggest problems would be my reduced anatomy knowledge or not knowing exercises, but I realized that even though I have some deficits there, my biggest problem are my poor speaking skills.
Every time I open my mouth to speak I feel like I have to use all my available energy to make sure something coherent comes out. I often have trouble finding the words or phrases that my brain so desperately wants to say. When I do speak, I often make grammatical mistakes, and have to quickly correct myself. I am sometimes so nervous that I start to stutter. It is very frustrating, and most people do not understand how much effort it actually takes me to speak. In familiar situations and topics like school I can manage, especially if I have a script in my head. Novel situations become a lot more difficult.
How do I explain to an instructor that I don't know what to say after I said Hi? That it takes me a few seconds to process sarcasm or a joke? That I don't talk because talking to new patients makes me so nervous I start stuttering and my heart palpitations get worse?
If I could hide my deficits before I could no longer hide them in this placement. The weird thing was that my partner who is asian has a lot of the same problems that I do although not to the same degree, and it was comforting to know that it's a lot more common than I thought.
The question now becomes how do I deal with it? I quess in any setting a clinician does develop a script of what to say to a patient and how to interact, it does eventually become easier, but the problem is that takes time and patience, and a lot of instructors don't understand that and find it's easier to provide 'constructive criticism' such as 'poor communication skils' or 'flat affect' when in reality I already know those things and do not need them hammered in.
The instructors also do not realize the progress that I did make, such as not getting sick, coming on time, not falling asleep, not wanting to run the other way anytime anyone coughed, being able to support patients which I was afraid to touch before, being able to express the problems I do have and finally not being so nervous when surrounded be people (social phobia). Most of these things, most people take for granted, but it took me a long time to accomplish these things and yes I do have a lot still to work on, but as with physio, it is a process and Rome wasn't built in a day.
Hope everyone has a good weekend!
Friday, February 25, 2011
Tuesday, February 22, 2011
Things I learned from my placement
This placement has taught me a lot (not everything clinical) but I am still dissapointed since it could have a much better experience. What have I learned?
1) Keep your mouth shut and agree with everything your instructor tells you even if you think and know they are wrong it is irrelevent, since they are the ones that will be passing you. I weigh my words carefully and think about it for 30s before I say anything since I know that saying the wrong thing will get me into trouble. The least amount I speak the better, since when I get nervous I start to use grammatically incorrect language.
2) They system is not fair. The sooner I accept this the better, although for some reason I always have a hard time accepting this and keep thinking I can change things when in reality I can't. A lot of services are private and it takes a lot of effort and time which most don't to get reimbursed, therefore the rich get better care than the poor.
3) Some Instructors are judgemental. Yes there are those instructors that have a chip on their shoulder and actually criticize you on your hair, and clothes (which is conservative), and posture. Yes they are crazy, yes you do have to humour them and smile and make sure they understand that you are sorry for whatever the h*** they think you are doing wrong and that you will try your best to change and be more conforming to their ridiculous ideas.
4) Placement is not school. It is worse. There is a lot more pimping and if you ask a question their answer is to look it up, which would be fine if there was a computer available to look it up on...I quess I should get a smartphone or a tablet although with their ridiculous rules, I might be banned from using them.
5) Everybody lies. Patient will lie although mostly unintentionally and its your responsibility to probe and find the answer.
6) Work does not make you happy. This is probably the hardest to accept since I've always had this fantasy that therapy does wonders for people and people are overjoyed with the help. Now in one way this is true, and physio does help many people BUT it does not solve all the problems in their lives and this is the problem. Even though people may regain their physical functioning after a medical emergency or traumatic event there are other issues that can not be helped such as memory problems, having to rely on disability due to the impossibility of going back to work, having to downgrade your lifestyle, changing relationships with your friends and family. Work is still work. Most days are hard since no matter how emotionally distant you are, you cannot mask the fact that the person will not be able to achieve what he achieved before the accident. The work is difficult physically as well as emotionally and it becomes difficult to prevent your own injuries when helping others. I need to find other hobbies
7) Changing reality of the job market. Unless I am very lucky I will most likely not work in the public sector. Therefore what I see will not be the reality of my future work-place. I will not have the oppportunity to see 1 patient per hour and only see 5 patients per day. I will most likely work in a ortho setting and see 20 patients a day. I will not have the amount of time they do to provide good education and build good rapport.
1) Keep your mouth shut and agree with everything your instructor tells you even if you think and know they are wrong it is irrelevent, since they are the ones that will be passing you. I weigh my words carefully and think about it for 30s before I say anything since I know that saying the wrong thing will get me into trouble. The least amount I speak the better, since when I get nervous I start to use grammatically incorrect language.
2) They system is not fair. The sooner I accept this the better, although for some reason I always have a hard time accepting this and keep thinking I can change things when in reality I can't. A lot of services are private and it takes a lot of effort and time which most don't to get reimbursed, therefore the rich get better care than the poor.
3) Some Instructors are judgemental. Yes there are those instructors that have a chip on their shoulder and actually criticize you on your hair, and clothes (which is conservative), and posture. Yes they are crazy, yes you do have to humour them and smile and make sure they understand that you are sorry for whatever the h*** they think you are doing wrong and that you will try your best to change and be more conforming to their ridiculous ideas.
4) Placement is not school. It is worse. There is a lot more pimping and if you ask a question their answer is to look it up, which would be fine if there was a computer available to look it up on...I quess I should get a smartphone or a tablet although with their ridiculous rules, I might be banned from using them.
5) Everybody lies. Patient will lie although mostly unintentionally and its your responsibility to probe and find the answer.
6) Work does not make you happy. This is probably the hardest to accept since I've always had this fantasy that therapy does wonders for people and people are overjoyed with the help. Now in one way this is true, and physio does help many people BUT it does not solve all the problems in their lives and this is the problem. Even though people may regain their physical functioning after a medical emergency or traumatic event there are other issues that can not be helped such as memory problems, having to rely on disability due to the impossibility of going back to work, having to downgrade your lifestyle, changing relationships with your friends and family. Work is still work. Most days are hard since no matter how emotionally distant you are, you cannot mask the fact that the person will not be able to achieve what he achieved before the accident. The work is difficult physically as well as emotionally and it becomes difficult to prevent your own injuries when helping others. I need to find other hobbies
7) Changing reality of the job market. Unless I am very lucky I will most likely not work in the public sector. Therefore what I see will not be the reality of my future work-place. I will not have the oppportunity to see 1 patient per hour and only see 5 patients per day. I will most likely work in a ortho setting and see 20 patients a day. I will not have the amount of time they do to provide good education and build good rapport.
Monday, February 14, 2011
Growth and acceptance
Part of my placement involves participating in group therapy and in a roundabout way the group therapy helps me deal with my own issues. I never thought about it before but I realized the last few years have been quite difficult. I have dealt with depression, anxiety, phobia's,stress and anger. It probably doesn't help that I'm a type A and am very unhappy when I don't get what I want and that's the problem.
The fact that in life nothing turns out the way you plan it and you don't necessarily get what you want is a very tough thing to accept. Even after 6 months into the program, I ask myself if I made the right choice, or if there was a better choice...and if someone mentions about how someone got into med school I bite my tongue and pretend I didn't hear them.
The group therapy has taught me that I do not deal well with stress and it accumulates to the point that I do lose my mind. I also do not deal with my anger issues and that compounds the stress. Of course in addition to those add in sleep deprivation and and the inability to fall asleep as well as unhappiness and you get the perfect recipe for a breakdown. Some of the things they try to explain if the importance of breathing and counting to reduce stress and anger. They also talk about setting limits and not trying to do too much since the added responsibilities just compound the stress. In addition they mentioned a key phrase: 'everybody has good and bad days' and I realized that being happy all the time is unrealistic and having the perfect job is also unrealistic, all that I can do is try to see the glass as being half full instead of half empty as I currently do.
My other problem is that I keep thinking that something else will make me happy. First, I thought this program can make me happy but that didn't happen, then I thought that placement is where I will finally feel that I am making that difference in people's lives and that will make me happy, but as you can tell that hasn't happened either. I think I realized that a job will not make me happy, money will not make me happy either although most people do think it helps. What I realized is as much as it scares me, if I truly want to be happy I have to go out and interact with others, and that is my next biggest challenge to tackle.
The fact that in life nothing turns out the way you plan it and you don't necessarily get what you want is a very tough thing to accept. Even after 6 months into the program, I ask myself if I made the right choice, or if there was a better choice...and if someone mentions about how someone got into med school I bite my tongue and pretend I didn't hear them.
The group therapy has taught me that I do not deal well with stress and it accumulates to the point that I do lose my mind. I also do not deal with my anger issues and that compounds the stress. Of course in addition to those add in sleep deprivation and and the inability to fall asleep as well as unhappiness and you get the perfect recipe for a breakdown. Some of the things they try to explain if the importance of breathing and counting to reduce stress and anger. They also talk about setting limits and not trying to do too much since the added responsibilities just compound the stress. In addition they mentioned a key phrase: 'everybody has good and bad days' and I realized that being happy all the time is unrealistic and having the perfect job is also unrealistic, all that I can do is try to see the glass as being half full instead of half empty as I currently do.
My other problem is that I keep thinking that something else will make me happy. First, I thought this program can make me happy but that didn't happen, then I thought that placement is where I will finally feel that I am making that difference in people's lives and that will make me happy, but as you can tell that hasn't happened either. I think I realized that a job will not make me happy, money will not make me happy either although most people do think it helps. What I realized is as much as it scares me, if I truly want to be happy I have to go out and interact with others, and that is my next biggest challenge to tackle.
Limits of patient's recovery
So I've been in my placement for a week now and have learned quite a bit about different neuro conditions as well as working in a rehab setting. My experiences have been mixed although considering that I usually have totally unrealistic expectations that is to be expected.
I have learned the hard way that being on placement is not the same as being in school and the expectations are definitely higher and much more strict. There are a lot of things that are accepted in school that are unacceptable in some placements and it is usually better to be conservative in everything than to take chances. For example eating in front of patients is frowned upon, dress has to always be conservative, and what you say has to be filtered extensively since you never want to make the pt uncomfortable and in general be professional (easier said than done).
What I find frustrating is that there are limits to what people with different conditions can and can't do, and often recovery does not mean return to previous functioning but it means achieving the max that is possible or attainable during a 3 month rehab and then accepting their new life. I always thought that recovery meant returning to what you were doing before the injury or accident but that is not really applicable to the neuro setting, since the brain and spinal cord do not repair themselves and if someone has a stroke or hemorrhage or aneurysm, there is permanent brain damage that does not recover and even if the physical issues are resolved, the cognitive issues are not and the person may always have memory problems or difficulty with multitasking as well as a host of other problems.
I quess I always thought that everyone could be cured but I realized that the goal of a PT in a neuro setting is to help the pt achieve their own max but it doesn't mean that the pt will be able to walk or even transfer by themselves, the goal is to make the transfers or general mobility easier.
On a professional note, I have finally learned to distance myself from patient's since I realized I if I don't see them as pt I won't be able to help them objectively and will burn out fairly fast. Most days I already feel very overwhelmed by everything and even though I need to study when I come home, the only thing I can do is watch tv since I'm so exhausted.
What I realized is nothing is as it seems and that treating people with complex issues is a lot more difficult and challenging than I thought.
I have learned the hard way that being on placement is not the same as being in school and the expectations are definitely higher and much more strict. There are a lot of things that are accepted in school that are unacceptable in some placements and it is usually better to be conservative in everything than to take chances. For example eating in front of patients is frowned upon, dress has to always be conservative, and what you say has to be filtered extensively since you never want to make the pt uncomfortable and in general be professional (easier said than done).
What I find frustrating is that there are limits to what people with different conditions can and can't do, and often recovery does not mean return to previous functioning but it means achieving the max that is possible or attainable during a 3 month rehab and then accepting their new life. I always thought that recovery meant returning to what you were doing before the injury or accident but that is not really applicable to the neuro setting, since the brain and spinal cord do not repair themselves and if someone has a stroke or hemorrhage or aneurysm, there is permanent brain damage that does not recover and even if the physical issues are resolved, the cognitive issues are not and the person may always have memory problems or difficulty with multitasking as well as a host of other problems.
I quess I always thought that everyone could be cured but I realized that the goal of a PT in a neuro setting is to help the pt achieve their own max but it doesn't mean that the pt will be able to walk or even transfer by themselves, the goal is to make the transfers or general mobility easier.
On a professional note, I have finally learned to distance myself from patient's since I realized I if I don't see them as pt I won't be able to help them objectively and will burn out fairly fast. Most days I already feel very overwhelmed by everything and even though I need to study when I come home, the only thing I can do is watch tv since I'm so exhausted.
What I realized is nothing is as it seems and that treating people with complex issues is a lot more difficult and challenging than I thought.
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