Adaptation, Reflection, and More Adaptation: Recent Graduates Use 3D Printer to Make PPE
We all know that whenever a physical therapist is presented with the question of what to do in a patient care scenario, the answer is "it depends."
It depends on the patient's ability, available resources, and personal desire. These things aren't always clear at the outset of a session, so we go in with plans A through F, and then use patient feedback, clinical reasoning, and outcome measures to identify the plan that best enables our patient to progress toward his or her goal. We also know that the first thing you try almost never works. So the process of navigating "it depends" is as much about adaptation as about preparation.
For me, adaptation was harder-fought than preparation. I could study until I'd ace didactic tests, but I struggled, especially at first when practical exams didn't go the way I expected. In my final clinical experience at Stroger Cook County Hospital, the adaptation piece of my physical therapist practice finally got strong. Stroger was tough, and I loved it because every day when I woke up to go to work I told myself that the experiences I was about to have would make me a better PT by the end of the day.
Every day going home I reflected on why that statement came true, and the answer was always adaptation. Many of my patients did not speak English. I improved in my conversations through interpreters and learned clinical Spanish. I learned how to perform gait training safely with impulsive patients who were recovering from drug addiction, which exercises to prescribe for a patient who had heterotopic ossification in his pelvis from multiple gunshot wounds, and I helped family members learn to bump a patient with ALS upstairs in a wheelchair safely, so he could go home to spend his final days with his family.
On one particular day, I was chart reviewing an incarcerated patient prior to a co-treat with an OT so that we could time his session with both his medication and the officers' shift change. In that moment was when I got called into a room and told my clinical experience was over due to COVID-19. Just like that.
I was stunned and scared like everyone else in the class of 2020 when clinicals ended abruptly. I spent about a day scrolling Facebook and the news. One friend posted a picture of her colleague, an emergency room doctor, who had put a plastic container over his head to intubate a patient because he had no face shield. That image had a profound effect on me.
Three weeks ago on March 27, my husband Eric Landahl and his colleague Jay Margalus from DePaul University, gained permission to run DePaul's 3D printers at home to join a nascent worldwide effort to quickly manufacture personal protective equipment, or PPE, items that throughout this pandemic have been in short supply.
We converted our house into a factory and simultaneously founded the Illinois PPE Network, a large distributed network making 3D printed face shields and cloth masks. To date, the network has made over 25,000 face shields, with more than 2,000 made in our home. Although we work individually and practice strict social distancing, Illinois PPE Network is big and full of caring people, including Lindsay Ardiff, PT, DPT, one of my classmates in the Northwestern physical therapy class of 2020.
We have sent face shields to emergency rooms, hospital floors, rehab clinics, nursing homes, fire departments, shelters, and other locations where personnel work with COVID-19 patients, both in Chicago and beyond. We work closely with #GetMePPE Chicago, an association of medical students that gathers face shields and other PPE items and distributes them where they are needed. Many of the medical students were in clinicals that got cut short just like me.
I have never worked harder in my life than I am now. My days are spent fielding requests from desperate clinicians, repairing 3D printers that have broken down from being run 24/7 for weeks on end, and sanitizing and packaging face shields for delivery. Adaptation, reflection, and more adaptation are the hallmarks of this effort, skills that I learned in physical therapy school at Northwestern and in my rotation at Stroger. 3D printers lend themselves very well to that process because designs can easily be created, altered, and individualized. We tested several designs before settling on one based on feedback from local emergency room physicians.
Neither our product nor our process is elegant and seamless. The face shield is made of a piece of 3D printed plastic, a clear 10 millimeter report cover, and a bike inner tube. It is sanitized in a 4-gallon bucket of 10% bleach solution in my bathroom. This is not the forefront of medicine. The work we do is impactful because it addresses a problem in health care that is so serious that it's risking and taking lives.
PPE is lifesaving technology that is simple but inaccessible at the moment, and this is exactly the problem that chronically faces medically underserved populations. This experience has left me motivated to devote my future physical therapy career to the medically underserved.
I am proud to be a physical therapist. We are professionals who can hack together solutions to help individual patients surmount barriers to activity, address health disparities by making best practice physical therapy available even when the best resources aren't, and even help provide a solution to a global health crisis full of unknowns. My final clinical rotation at Stroger and the bizarre weeks that followed have left me confident that as a new physical therapist I can do all of these things and more.
Sarah Rice, PT, DPT, is a recent graduate of Northwestern University. You can connect with Sarah through the Illinois PPE Network website.
Podcast: Professional Advocacy in the Midst of the COVID-19 Pandemic
Listening Time — 33:21
While COVID-19 has many of us staying home and practicing social distance, there has been a lot of activity on Capitol Hill to address the pandemic. Some of which will pertain directly to you and your profession.
Justin Elliott, APTA's Vice President of Government Affairs, joins us on this special episode of the Pulse podcast to discuss what's happening in Congress, what's to come, and what APTA is doing to advocate on behalf of the profession.
Here's our conversation with Justin.
To get the latest information from APTA pertaining to COVID-19 visit www.apta.org/Coronavirus. And to get information about APTA’s advocacy, policy priorities, and how you can advocate for your profession visit www.apta.org/APTAAdvocacy.
APTA Podcasts like this one are available on Apple Podcasts, Google Play, and Spotify, or by visiting APTA.org/Podcasts.
You Can Be a Military PT
8 minute read
I remember it being my last week in physical therapy school when it became quite clear that student loans were now in sight. I distinctly recall a lecture where the professor made it a point to show our salary when we got out of school and the amount of debt we were going to be in. Sad to say, it was extremely lopsided, and not in a good way. They said with a proud, but nerve stricken smile, "We hope you like your job since you will be in a lot of debt." At that moment, I looked for ways to combat this seismic weight that just got put on my shoulders, as I didn't want to be enslaved to debt for the rest of my life.
This is where the military came in. Now, don't stop reading thinking, "I don't have a desire to be in the military." Well, I had this same thought. If you would have asked me before physical therapy school, I would have told you that I would be working with athletes as would 90% of future physical therapist students. So, I challenge you to buckle up and endure a few paragraphs of why I think you should consider being a physical therapist in the military. Reading this may change your entire career path, or you may have a better understanding of what it means to be a military PT, which I would be happy with either.
I am going to expound on four reasons being a military PT could be a possible career path for you, and they include the following: debt repayment, privilege enhancement, no insurance, and growth opportunities. Here, I'll disclose that I am in the Air Force, so I will be speaking on Air Force-specific experiences and processes.
Let's start with money. Yes, I know it sounds superficial, but this was one of my hook, line, and sinker appeals. Any time you go to a job interview, this is always the elephant in the room. It's like you want to know, but you don't want the person who is interviewing you to think that you are in it for the dollars. Well, let me take that awkwardness out by starting with this first.
The military has programs for PTs where if you sign up for active duty and possible reserve for a set number of years, they will in turn help pay back your student loans. How much? It all depends on your commitment level and how many PTs the Air Force will need that year. The health care recruiter in your local area will have that information. Don't be fooled by them though. There is a big tax — up to 30% — that comes along with it. Your recruiter may "accidentally" fail to tell you this. Either way, it is much more than you would normally be able to pay back in one lump sum.
Now let's talk about compensation, also known as your salary. In the military, your compensation is based on your rank and time in service. The great thing about the Air Force is that every year or two you get a pay raise. Every time you move up to the next rank, which can take two to eight years depending on the rank, you bump up in pay. You could search for your pay right now if you wanted to, based on rank and time in service and find the exact amount that you would make. There are no bad surprises with salary in the military. There are good ones, though, such as getting various allowances for housing and food. There is much more of an opportunity to make a better salary with the progressive payment system the military offers. This doesn't even touch the surface of other benefits, such as free health care and getting paid to move, which is beyond the scope of this blog.
Another great benefit is the increase in professional privileges. This may not seem important to you now with either never practicing or having less than a year under your belt, but believe me this is extremely important. It also may seem daunting, but remember, so was going to physical therapy school and look where you are now.
One of the privileges include what you can order for your patients. When you have a patient in front of you, it is such an amazing feeling when you can order something needed for their plan of care instead of having to call a doctor's office and talking to their staff. I can order imaging like X-rays, MRIs, and CT scans, as long as it is associated with the Veteran's Affairs. I can order labs for patients who I think have symptoms related to low vitamin D levels, for example. And more importantly, I also can put in referrals for patients who I think require a multidisciplinary approach such as pain management, neurology, or any other services. All of these can be a great asset if used appropriately by the clinician.
An additional privilege associated with being a PT in the Air Force is being able to prescribe medication. This helps immensely for patients who have high levels of pain and you need to get them moving. Let me be clear, this doesn't mean that you are acting as a pharmacist. The medications prescribed are directly related to musculoskeletal issues such as for pain, inflammation, and muscle spasms.
Besides prescribing and ordering imaging, your clinical skills can be heightened to a whole new level. The Air Force values a continual growing of skills and even allowing PTs to have manual skills beyond what many of our non-military peers could do. One example is by allowing all military PTs to perform dry needling. PTs are allowed to become certified in battle field acupuncture and become competent in steroid joint injections. Once you become an Air Force PT, they won't give you the tools and expect you to know how to use them. You have to be properly trained in each of these skills if you would like to use them. The Air Force offers ways to improve your clinical skills through residencies and fellowships, and you get paid to do it. Let me say that again. You get paid your full salary to do a residency and fellowship. Now they can be competitive, but it's almost unheard of to get paid to do these opportunities.
Moving on, and again you may not feel this one, but don't worry, you will. In the military, insurance is not an issue. You don't have to remember what each insurance will reimburse you for and have color-coded charts that may or may not remind you of key details. With private insurance, you may get reimbursed 30%-40% if you're lucky. So what does that mean? This means that you have to see more patients to get what you are worth. This equates to more volume of patients, which leads to less time with each patient. Remember that dream you had to make a difference for a patient with one-on-one time each visit. The military lets you have that.
As a PT what is the progression? Well, you could be a better PT. Good, I like where your head is at. You could progress to be a clinic director? Yeah, sounds fun, a little more pay for a lot more hours. And then, well, that may be it. That's not the way it is for an Air Force PT. Sure, if you just want to see patients, then for the most part you can head in that direction. However, there are multiple career paths that the Air Force can guide you into such as research, leadership, or embedded into units. You can sign up for jobs outside of our career field to get a better scope of the military life. You are the limiting factor of what you can imagine you could do with a career in the Air Force. If you are bored as an Air Force PT, that's likely your own doing. There is constant change and exciting new opportunities just waiting to be explored by you. Other benefits include the environment being family-friendly, a constant challenge, and the emphasis on leadership development.
There are some cons to all these pros. You would be wearing the uniform, which is symbolic for not only the rich history that you are helping to maintain, but also the fact that you are on duty 24/7. There are possible deployments and times that you may have to be away from family. You are owned by the government, and you don't have too many opportunities to say no.
Besides all of the pros and cons — and maybe more importantly — you would be serving in a capacity that is bigger than yourself. You may not be teaching patients who have had amputations how to walk again, as most people envision with military physical therapy. However, you may be getting patients better who need to get back to their job of being a missileer or security forces and in control of monitoring our nuclear weapons.
In this article, I made a challenge to you to consider working in the military as a PT. I have spoken only of my experience with the Air Force, but I invite you to explore serving in all of the branches of the military. Despite working in the civilian sector for almost two years, I am biased toward being a PT in the Air Force, and I know serving is a personal decision you'll have to make with you and your family in mind. If you have any questions, please don't hesitate to reach out to me. Major Walter out.
Here is a picture of me wearing my blues at my promotion ceremony as I pinned on the new rank of Major. Beside me is my beautiful wife, and the one who is cuter than I’ll ever be is my son who was about 8 months old in this picture.
Major Eric Walter, PT, DPT, is a physical therapist in the United States Air Force. You can connect with him at firstname.lastname@example.org.
Podcast: ED PT
Listening Time — 49:14
John Seip, PT, DPT, is a physical therapist in Minnesota. But he’s not just any physical therapist, he’s an ED PT, or an emergency department physical therapist.
In this episode, John shares how he landed this spot in his local hospital, shares insight on what working in this setting is like, gives advice and tips to students and new grads considering pursing the ED as a career path, and he even talks about the current COVID-19 pandemic and what he’s seeing in his hospital.
Here’s our conversation with John.
To learn more about physical therapist practice in the ED visit www.apta.org/EmergencyDepartment.
APTA Podcasts like this one are available on Apple Podcasts, Google Play, and Spotify, or by visiting APTA.org/Podcasts.
Every Student Will Experience Worry, Stress, and Anxiety
5 minute read
A.T. Still University posted "The Difference Between Worry, Stress, and Anxiety," a Feb. 26, 2020, New York Times article by Emma Pattee, and I decided to read it because as a third-year student, I am feeling all three with trying to finish rotations, study for boards, and get to the finish line. I honestly thought that these were similar feelings, but how you respond to them are quite different.
Every physical therapist and physical therapist assistant student will experience worry, stress, and anxiety at some point during their school or clinical work and will express it in their own way. I get it, not everyone is a feelings person. I'm not.
You might be thinking, okay, why are you writing this then? Well, I read this article back in March when everything became sort of a nightmare, I'd say. I finished my second clinical rotation. Boards were supposed to be in April, but who knows now. I was to graduate in three months, still am, but in a completely different way than I expected. I am hearing that some new virus has made an appearance in the world population. These feelings do occur. Let me describe briefly the difference and how I made it through physical therapy school dealing with worry, stress, and anxiety.
Have you taken a test and thought, I definitely failed, and thought about it all day and for days after? But then you passed and life was back to normal. Yes, that's worrying. When we worry, we think about negative outcomes and it can become obsessive. It's a way for our brain to handle problems. When you think back to questions that you could have changed, you are trying to problem solve. What I do is write my worries and thoughts down. Once they are written down, the thought is placed somewhere else and you can move on to your next worry. We are physical therapy students. We don't just have one worry.
Let me guess. You have walked into class and told the student next to you: "I am so stressed!" Yeah, me too. Stress is how you respond to an event. In school, this probably occurs leading up to midterms and finals with having multiples tests, practicals, or assignments in one week. Once everything is done, you feel that stress has been lifted. Try to make sure that the stress does not turn chronic where you are constantly go, go, go, and your stress does not resolve. If this occurs, it is important to find time for yourself, relax, and hang out with friends and family. Do something that is not physical therapy. For first and second years who do sit in the classroom all day, I highly recommend getting vertical in some way, whether it is walking, running, hiking, or playing a sport. For third years standing all day in the clinic, still take time to get out of the physical therapy world. Do something that changes your environment, as it may decrease the stress to experience a new setting.
Anxiety is like the middle part of the sandwich. It is a combination of worry and stress. Anxiety is a way for your mind and body to try to solve a problem, but the problem does not exist. At this moment, we have the coronavirus that has been affecting all of society in the United States and around the world. Yes, I know this is a real problem, a huge problem, actually. How this has affected me as a third year: Boards are postponed and graduation is canceled. Will I still be taking boards? Yes. Am I still graduating? Yes. The situation alters the perception of my end goal, but has the goal changed? No. I also cannot predict the job outlook in one to two months, which means still no threat. The situation has increased my anxiety, altered my perception of ending my physical therapist education, but my goal to finish school has not changed.
The real question is how do you deal with anxiety? As worry occurs with your mind and stress is a feeling with your body, remember anxiety is a combination of both mind and body. In our current situation with COVID-19, it is important to take control of what you can and understand that there are situations that you cannot control. Currently, I am doing what I need to do to finish physical therapy school and I cannot control that boards, clinical, and graduation may be affected in the process. Get in the mindset that not everything goes as planned, and get comfortable with it. I learned throughout school to become adaptive to what happens in the clinic. This happens with life too. Be proactive now in order to get to where you want and need to be in the future.
If these are feelings that you have been struggling with for a long time or throughout physical therapy school, I highly suggest finding at least one person to whom you can express what you are going through. If you have more than one person who you can think of, you are already ahead of the game. You have a great support system and those people are treasures.
I hope that everyone stays safe and well through these times. All these events can raise worry, stress, and anxiety. Everyone has different ways of dealing with these feelings, and there is not just one way. Find what fits you.
Here are other self-care ideas: eating well, hydration, routines to calm your brain/mind, meditation, yoga, understand what you are consuming on social media/news, sleep, and reach out to people.
Finally, here are three things that you can do right now to alleviate any feelings of worry, stress, and anxiety:
- Write your thoughts down.
- Get up and move — exercise, walk, hike, time for yourself.
- Be proactive and organize for the future.
Juliette Dassinger, SPT, is a third-year student at A.T. Still University. You can connect with Juliette on Twitter at @jdassinger2020.
APTA Updates for Students: Spring 2020
The American Physical Therapy Association is a national professional organization representing more than 100,000 members. APTA seeks to improve the health and quality of life of individuals in society by advancing physical therapist practice, education, and research, and by increasing the awareness and understanding of physical therapy's role in the nation's health care system.
APTA headquarters is located in Alexandria, Virginia, with more than 165 employees serving APTA members.
APTA Student Assembly Board of Directors would like to give PT and PTA students consistent updates on all the great work being done by APTA staff! Starting in April, we'll highlight projects and initiatives that staff are working on, behind the scenes, at conferences, online, and out in our communities.
Student Recruitment - Youth Outreach
From Ryan Bannister, director of student recruitment and Mya Shackleford, program manager for student pipeline initiatives.
Since 2018, APTA has looked toward raising awareness of the physical therapy profession throughout grades K-12 and collegiate educational pipeline. In 2019, APTA staff and volunteers participated in 25 local, regional, and national student recruitment events. They expanded our partnership with HOSA-Future Health Professionals to include sponsorship of their national events, placing APTA in front of more than 240,000 student members nationwide. They also hosted the first virtual residency and fellowship education recruitment fair for students. Currently, APTA staff is working on new methods and resources to help volunteers go out in their individual communities to spread the word about the physical therapy profession. They will need the help of the Student Assembly. Want to stay up-to-date? Create a profile on APTA Engage and select Student Recruitment as an area of interest.
American Board of Physical Therapy Residency and Fellowship Education
From Kendra Harrington, PT, DPT, MS, director, residency/fellowship accreditation.
The American Board of Physical Therapy Residency and Fellowship Education celebrated its 20th anniversary on June 14, 2019, of granting the first program accreditation. ABPTRFE accredits clinical and nonclinical residency and fellowship programs in 22 different areas of practice, with 330 programs having obtained ABPTRFE accreditation. Currently, there are over 7,000 graduates of accredited residency and fellowship education programs. In 2019, ABPTRFE launched a new Candidacy Workshop and Accreditation Workshop through APTA Learning Center. In 2020, ABPTRFE is scheduled to conduct more than 105 program on-site visits with over 130 programs seeking initial or renewal of accreditation currently, and plans to develop a certification process for faculty mentors.
Physical Therapy Outcomes Registry
From Karen Chesbrough, MPH, director, APTA outcomes registry.
The Physical Therapy Outcomes Registry now contains more than 1 million patient visit files (representing approximately 130,000 individual patients). Physical therapists using the Registry data are making clinical changes that are impacting their patient outcomes. The Registry has identified improvements in patient outcomes when practices and PTs track and examine their clinical data, identify areas for improvement, and then reevaluate the data the following quarter.
Have questions? Reach out to the people listed above or feel free to contact anyone on APTA's Student Assembly Board of Directors.
How Do I Get Involved?
4 minute read
One of the very first things that I did after starting physical therapy school was join the American Physical Therapy Association.
I had been following APTA on social media for years as a pre-physical therapy student and was excited to finally have the opportunity to become a member. I spent more time than I care to admit exploring all of the members-only resources, and I could not wait to receive my membership certificate and my first copy of PT in Motion magazine in the mail. However, the excitement faded, and I realized that although I was proud to be a member, I had no idea how I really planned to use my membership as a student.
During a meeting with my academic advisor shortly after joining, I mentioned that I was interested in health care policy and public health issues, and he invited me to the Oregon Physical Therapy Association's Government Affairs Committee meeting. I was very hesitant to take him up on the offer. After all, what did I really know about government affairs? I knew it would be out of my comfort zone, and I decided to take some time to think about it before committing. However, a month later I finally said yes and took that first step toward becoming involved. Although I still don't know very much about government affairs, taking that first step opened doors for me to meet some inspiring people, learn about physical therapy advocacy, and begin my own journey of professional involvement.
I have learned much more than I thought possible during my first year of physical therapy school, but perhaps the biggest lesson has been to just say yes to opportunities. I spent much of my first semester of school wanting to be more involved, but having no idea how to go about it. While I know that I have only scratched the surface of what it means to be involved in APTA, I do have some advice for students who may be in that same boat.
Join APTA. I feel so much more connected to the physical therapy community by being a member of APTA and having the opportunity to be engaged with what is happening in the profession outside of the classroom, which has made me that much more excited to keep studying to become a physical therapist. I recently learned about #PTfam at an APTA Value Talk, and I think that it perfectly describes how it feels to be an APTA member, especially as a student.
Tell people that you're interested. I learned that many of my professors are involved with APTA at the state or national levels. They want to help students get involved, but they have to know that you are interested! If you don't know who to ask, start with your advisor or a favorite professor and simply tell them that you want to be more involved. I have no doubt that they will know who to connect you with to help you pursue your passions. You also can reach out to a member of the APTA Student Assembly Board of Directors or the core ambassador in your state. They exist to help students get involved.
Say yes! I did not know what I was getting into at that first committee meeting, but attending was the first step. I have had the opportunity to meet some awesome people who are doing great things for the profession, and I've learned a lot about what physical therapy advocacy looks like in Oregon and nationally. Once I said yes to that first opportunity, I started to say yes to many more, including being selected to be on Oregon's Student Leadership Committee and serving as next year's core ambassador.
Be a resource for others. I think that it is really important for students who are involved with APTA to reach out to others who want to be involved as well. After all, those students are the very ones who encouraged me to get involved. We are the future of the profession, and the more people we can encourage and bring with us, the better!
The first year of physical therapy school is difficult. Everything is new and challenging, and it took me a long time to feel like I was truly good enough to be in my program and in this profession. However, when I began getting involved with the Oregon Physical Therapy Association, I started to feel much more at home in the world of physical therapy. For anyone thinking about getting more involved, my advice is to go for it! Don't worry that you don't know enough or aren't far enough along in your program, because involvement can be for everyone. I've learned that there are so many involvement opportunities at the program, state, and national levels, so if you're interested, there is a place for you. I am looking forward to growing in my professional involvement and putting my APTA membership to good use in the years to come.
Want to get involved? Check out the student involvement guide and sign-up for APTA's volunteer portal, APTA Engage.
Sydney Neumann, SPT, is a student at Pacific University and serves as the core ambassador for Oregon. You can connect with Sydney on Twitter at @neumann_sydney.
New Federal Student Loan Changes Over COVID-19
2 minute read
With lectures and labs being suspended and online learning becoming the norm, physical therapy students have had to adjust to a new normal. But there is some potentially good news when it comes to students who have federal student loans.
First, on March 20, the Department of Education announced that it would provide financial relief to current students and graduates with student loan debt during the national emergency. The office of Federal Student Aid announced the following changes:
- All federal student loan interest rates will automatically be set to 0% for at least 60 days.
- Borrowers who are delinquent on payments for more than 31 days will be automatically placed in administrative forbearance (or suspension of payments without penalty) for at least 60 days.
- All borrowers can request administrative forbearance by contacting their loan service provider.
These changes are restricted to federal loans and federal loan borrowers only. How long will this last? The Department of Education has stated that it will provide this relief for at least 60 days and will extend the relief, depending on the severity of the COVID-19 national emergency.
Building upon this, on Friday, March 27, the president signed the Coronavirus Aid, Relief, and Economic Security Act, or the CARES Act, that provide additional support for students and educational programs. Under the CARES Act, federal student loan borrowers will be able to defer payments, and employers can offer repayment benefits tax free. Payments on federal student loans can be deferred through September 30, with no accrual of interest during that period. Additionally, the stimulus allows employers to contribute up to $5,250 annually toward an employee's student loans without the benefit of being taxed as employee income. The employer provision applies to any employer payments made between now and January 1, 2021.
The U.S. Department of Education's Student Federal Aid office has posted additional information as well as frequently asked questions on Coronavirus and forbearance for students, borrowers, and parents at: https://studentaid.gov/announcements-events/coronavirus.
Addressing student debt burden and loan repayment challenges remains a top priority for APTA. APTA has advocated to Congress to have physical therapists participate in student loan forgiveness programs such as the National Health Service Corps, and APTA's Financial Solutions Center offers valuable tools and information to help members make the best financial decisions possible.
David Scala, Senior Congressional Affairs Specialist, APTA
How Climbing Has Shaped My Perspective as a Physical Therapy Student
"The summit is what drives us, but the climb itself is what matters" – Conrad Anker
In this time more than ever life feels like an uphill climb. Due to the COVID-19 virus, these past couple of weeks have been filled with transitions and unknowns. It feels like we've been climbing and climbing and just can't see the top.
In recent weeks we transitioned to online classes, and many of our daily life activities have been put on pause. Without a doubt, this has been challenging, perhaps one of my hardest climbs, and has made me hold onto the various lessons I learned through climbing.
Growing up as a competitive rock climber, either competing in the competition circuit or being away in the mountains on real rock, climbing has shaped me into the person I am today. And in tough times like these it is important more than ever to hold onto these lessons, the lessons that taught me how to be resilient and strong, and the lessons that remind me, that yes, we will get through this — together.
We will get to the top of this climb, and hopefully I can share with you some of the lessons that I learned through climbing.
Lesson 1: Be flexible to change your plan.
Before stepping onto the wall I take a minute and look at the route. I place my hands in the air, trying to read the route and figuring out how to best approach it.
Climbing is a puzzle, it involves endless problem solving.
When I was a youth competitor, we had to try and complete different climbs within a short, designated amount of time. We had never seen the climb before, and the goal was to get to the top of the climb on your first try. However, many times what you thought would work on the climb ended up going a different way. You sat back, looked at the climb again, and had to make a quick decision on whether to attempt the climb again the same way, or to come up with a brand new approach to get to the top. Or if your time was running out, you had to make the decision to call it and save that energy for the next climb, or to keep trying. Climbing made me think quickly on my feet under pressure, reflect on what went well or did not go well, and made me learn that it is essential to be flexible to change your plan if needed, in order to meet your goal.
This lesson seems way too suitable right now. As physical therapy students, we have been forced to be flexible during this unprecedented time and to learn in different ways than we ever expected. We have to learn to go with the flow, trust the process, and take one day at a time. Furthermore, as future PTs and PTAs we need to realize that what we envision for a patient's treatment session may go as planned, or it may go the complete opposite. We have to think quickly on our feet, reflect on what went well or did not go well in order for our patients to reach their goals. Our profession is all about being flexible to change your plan, and knowing that it is totally okay to make a new plan. Patients come first, and what worked for them one day may not work for them another day. Climbing was essential in teaching me the importance of being flexible.
Lesson 2: There is no right or wrong way to do the climb.
In terms of outdoor climbing, there were more options for me to be creative with how I approached different climbs. With endless hold options and kid-sized fingers at the time, I often picked grabbing the tiniest of holds over jumping to the next hold.
Climbing made me realize that there are a thousand different ways to approach something, and that there isn't necessarily a right or wrong way in completing the route. One method may have worked for one person to get to the top, but someone with a different body height, size, etc., may have found a different approach that worked better for them. Yet the important message was that as long as you completed your goal and got to the top of the climb, it did not matter how you got there.
As a student, this lesson made me realize that all PTs and PTAs are different, and what works well for one PT or PTA may not work as well for another. For example, when we learn techniques in musculoskeletal class, I have learned that I may have to change my hands or body position to be a certain way in order to perform the skill. I have also learned that every physical therapy student has a different story — we all come from different backgrounds, all have different specialty interests, and all have different career paths in mind. Yet there is no right or wrong way to go about being a PT or PTA.
In my opinion, it is all about timing and what works best for you at the right time, while thinking what may work best for you in the future. Climbing showed me that although we all have the same goal in mind, there is no right or wrong way to get there. It is all about what works best for you.
Lesson 3: Be okay with failure.
This is a big one, and one of the most important lessons I have learned. What many people don't realize is that climbing is 99% failure and 1% success.
We try, try, and try again to complete a route, yet we may fall countless times until that one try when everything aligns, and we find ourselves at the top. As a kid, this was hard for me to learn and to realize. The more that I fell the weaker I felt. Farther away from success. Not good enough. Not strong enough.
Oh, how much I have learned since that little climber in me. I have learned that it is not that we fall, but it is the journey. It is about not giving up when things get tough, and to not sell yourself short either. Climbing taught me to not be afraid to try harder routes, as long as it inspired me.
As a student, I learned that it is so much better to push myself out of my comfort zone than to get a perfect grade on an exam or an assignment. I really learned that this year. It is not about the grade, but it is about learning from the experience and how that can help you grow in the future. Be okay with vulnerability. Be okay with failure if it means that you will grow into a better student or clinician. Now, I'm not saying that it is okay to not study or that failure in school is okay, but I am saying that it is human nature to have some fumbles along the way, as long as we grow in the process.
Another thing that I learned is that no one will ever be perfect, we can always be better. Sometimes, in order to strive for greatness we have to encounter failure along the way. I don't think that I would have truly realized that without climbing.
Lesson 4: Trust is a gift.
As a climber, you learn that trust is a privilege, and the word "trust" does not hold meaning lightly. Climbing taught me that you have to earn trust in yourself and in others.
In certain disciplines of climbing, your life is literally in the hands of who is belaying you. One of the most beautiful parts of climbing is the relationships that you make with others and this tight-knit community. That said, with trust comes communication, as it is essential to be able to communicate well when you climb with a partner.
Just as in our profession, your future patients will need to earn your trust. For some patients who are eager and have had great previous experiences with physical therapy, it may be easier to gain your trust. However, other patients may be scared or apprehensive that they aren't going to get better. No matter who the patient is and no matter what the circumstance is, they put their trust in your hands, just like a belayer in climbing. Trust is a gift and it takes time to earn it. Don't forget that.
Lesson 5: No matter what, keep climbing.
Last, but certainly not least, no matter what keep climbing.
Now this lesson is not talking about how everyone should climb. This lesson is talking about the importance of always striving for that next goal, whatever that goal might be.
When I completed a climbing route, whether I had worked on that route for years or for only a couple of hours, I would of course be happy and celebrate that victory. However, immediately the next day, I would always ask myself, "Okay, what's next?" As a climber, it is human nature to keep pushing and trying to do the next hardest climb, or pushing your limits mentally and physically. This is true whether on real rock or in competition. At first, it feels like an endless race, as if there is never really a finish line. For some this may sound anxiety-provoking. You reached your goal, so isn't that good enough? Although those points are valid, there is so much satisfaction in striving to make yourself better and pushing yourself out of your comfort zone.
In school this lesson taught me to never settle and to always ask yourself, "What's next?" Yes, you got into physical therapy school, but how can you strive to be better? Perhaps that is applying to a residency, or as simple as reading a new journal article, or spending just a little more time to get better at a skill. Whatever the reason is — no matter big or small — keep climbing. Don't compare yourself with others, but compare yourself to you. What's next to make you better for yourself and for your future patients?
On another note, if things feel like they are getting tough, even one more step or one more move on a climb will get you closer to your goal. Sometimes it just takes baby steps. We are lifelong learners and will learn from each other.
No matter what … keep climbing.
Rachel Meyers, SPT, is a student at Duke University. You can contact Rachel at Rachel.email@example.com or Twitter at @rmeyers95.