Physical Therapists in the Hospital World

PT Profile: PTs in the Hospital World 

Are you looking for variety in your daily work? Do you have the confidence to handle surprises, the ability to communicate well, and the flexibility to work with patients of all ages? The varying opportunities of a hospital setting may be for you. For the past 9 years, Michael Brickens, PT, has worked as a physical therapist (PT) in the Level 1 Emergency Medicine Trauma Center at Methodist Hospital in Indianapolis, Indiana. Although APTA identified emergency and urgent care as an emerging practice a few years ago, only a few emergency departments include a PT as part of their fulltime staffing. The Methodist emergency department is a large center with 78 beds that includes a "fast track" or urgent-care setting and a 23-hour observation area. Brickens is often called upon to consult on critical-care patients. He may be involved in fracture splinting, various musculoskeletal sprains/strains, vestibular dysfunctions, and wound care.

Brickens is especially proud of the collaborative setting and the emergency department's ability to treat the full patient. Physicians seek him for a physical therapy consult because of his differential diagnostic skills. It's a consultation, not an order, he stresses. This teamwork allows the physician to focus on the immediate injury such as a head bleed or fracture, and the PT focuses on the rehabilitation and the safety, evaluation, and screening of the patients to ensure they can be successful when they return to their home environment. It's a true team effort.

Brickens learned about emergency room physical therapy when he attended sessions at one of APTA's Combined Sections Meeting (CSM) presented by colleagues from an Arizona emergency room. His range of skills and background, which includes previous work at Methodist Hospital, as a travel PT, and a two-year stint for a local registry company that treated workers at their worksite, were great training for emergency room physical therapy work. This variety, in addition to experience working in nontraditional settings without access to typical equipment, prepared him for the emergency room setting where, once again, he treats patients in an atypical setting within a short time.

When Brickens returned to Indiana from CSM, he learned that Pauline Flesch, PT, director of rehabilitation for Clarian Health Partners, which includes Methodist Hospital, was placing PTs in the emergency department, and he joined the team. Brickens feels it's important to have a PT in the emergency department. He says the keys to success are confidence and a well-rounded knowledge base. Working in the fast-paced environment has taught him to think more autonomously and understand the complexities of the health care system. If your facility doesn't have a PT in the emergency department, he advises that you be proactive and make it happen.

Across the state line in Ohio, Jeff Taylor-Haas, PT, MPT, OCS, CSCS, is a physical therapist at the Cincinnati Children's Hospital Medical Center in Cincinnati. He works in two locations, the main hospital and its sports biodynamic center as the sports/orthopedic outpatient physical therapist. He, too, treats a wide variety of patients, ranging from 5-year-olds with Legg-Calves Perthes disease teenagers with ACL reconstructions to older employees with chronic pain disorders.

Taylor-Haas is especially proud of the Children's Hospital core pillars of quality care, which include research, education, community outreach, and leadership. Before moving to the hospital, he researched its reputation and learned it was "the place to go" if a child is sick or injured. Prior to moving to Children's Hospital, he worked at AthletiCo, a private outpatient orthopedic facility, where he developed his skills treating orthopedic and sports medicine patients, specializing in treating endurance athletes. After AthletiCo, he spent a year at Good Samaritan Hospital as an outpatient orthopedic physical therapist.

On a typical day, he has evaluations in the morning and afternoon because the hospital's patients are primarily in school during the day. Afternoons are usually taken up by seeing follow-up patients. Taylor-Haas spends time on research and educational projects and is currently working on a case report from the hospital's Runner's Clinic. Taylor-Haas is proud of the Runner's Clinic and the community outreach the team does by providing complimentary running screening at local running-shoe stores. The clinic is devoted to evaluating, treating, and preventing running injuries in adolescent and adult runners. He enjoys being a part of the team to safely and effectively return an injured runner to competition.

Taylor-Haas says the keys to success in the hospital setting include the ability to be an effective communicator, motivation to learn new approaches to patient care, and flexibility to work with patients from all age groups and development stages of life. He also feels it's important that evidence-based care is the standard of care and finds that at Children's Hospital. In both instances, these PTs found their work in hospitals to be valuable because of the strong commitment to the patient, community outreach, and education. Both are proud of the teamwork atmosphere among physicians, PTs, and the patients. In addition, both have gained a further appreciation for the challenges in the health care system.

Perspectives for New Professionals of the American Physical Therapy Association, Supplement to Physical Therapy, January 2010, pages 27-28 

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