4 answers
De'Ashaj
Student
Rock Hill, South Carolina
1
Question
Asked
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future physical therapist assistant?
How do you break the bad news to patients and what are the struggles getting into this field?
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4 answers
Lauren Swansinger
Physical Therapist Assistant
13
Answers
Wyandotte, Michigan
Updated
Lauren’s Answer
Most of the bad news is already told to the patients by the physician that sent them to your clinic or by the PT; you just reinforce the news and plan of care. You need to be straightforward and confident in your responses and if you are not sure, defer to PT. It's okay to defer to the PT about anything you do not feel confident in responding to.
Truthfully the bad news you give patients is not life and death. It's lifestyle changes and advice on how to manage and live with their current condition.
My biggest struggle was the intense schooling. I applied for the program, which took two years to get into, took my prerequisites during those two years. Once I was in the program it was full time on top of my full-time job. They warn you not to have a job while going to school and I can see why but, gotta do what ya gotta do.
After the schooling you may find it hard to find a job, depending on when you are looking (the market does fluctuate). But in general, a lot of places take new grads because they are "cheaper" which makes it easier to find a job. Finding a specialty job though, (peds/neuro/oncology) can be harder, because, there are less of them and people who get into them often stay in them.
There will be stress in school, there will be stress in the workplaces, getting used to the pace of the workplace, how to manage time (patient care, notes, work discussions about pts, progress notes) can be difficulty. You will get frustrated with insurances, your coworkers and patients. If you find the right job, make sure you like your coworkers.
Truthfully the bad news you give patients is not life and death. It's lifestyle changes and advice on how to manage and live with their current condition.
My biggest struggle was the intense schooling. I applied for the program, which took two years to get into, took my prerequisites during those two years. Once I was in the program it was full time on top of my full-time job. They warn you not to have a job while going to school and I can see why but, gotta do what ya gotta do.
After the schooling you may find it hard to find a job, depending on when you are looking (the market does fluctuate). But in general, a lot of places take new grads because they are "cheaper" which makes it easier to find a job. Finding a specialty job though, (peds/neuro/oncology) can be harder, because, there are less of them and people who get into them often stay in them.
There will be stress in school, there will be stress in the workplaces, getting used to the pace of the workplace, how to manage time (patient care, notes, work discussions about pts, progress notes) can be difficulty. You will get frustrated with insurances, your coworkers and patients. If you find the right job, make sure you like your coworkers.
Beth Burgess PT, MS, GCS
Physical Therapist
56
Answers
Dallas, Texas
Updated
Beth’s Answer
Hi De’Ashaj, Lauren’s answer was great, I agree completely. In healthcare, we all have our roles. It is not the role of the PT or the PTA to break big bad news like “ your injury is permanent” However, people need to hear bad news multiple times in different ways for it to sink in. We stay objective with research evidence “this usually heals in 8 weeks, it has been a year now, we need to work with what we have”. I never dismiss faith or prayer because miracles do happen and new meds and procedures are always developing. Encourage patient education and help them understand the the “bad news” isn’t bad, just different.
As to my biggest struggle, I would agree with Lauren that getting into the program is tough. You are competing with top students who all have good grades and test scores. You need to show other interests in therapy outside school - volunteer at a nursing home, play sports, help with special Olympics, etc.
All of healthcare is fast paced, short staffed, overworked and underpaid. But you will be with a wonderful caring group of coworkers who really care about you and their patients.
Good Luck for the future!
Keep your grades up!
Shadow a therapist in different settings.
Visit APTA.org for more professional information
As to my biggest struggle, I would agree with Lauren that getting into the program is tough. You are competing with top students who all have good grades and test scores. You need to show other interests in therapy outside school - volunteer at a nursing home, play sports, help with special Olympics, etc.
All of healthcare is fast paced, short staffed, overworked and underpaid. But you will be with a wonderful caring group of coworkers who really care about you and their patients.
Good Luck for the future!
Beth recommends the following next steps:
Yikila Enestine Sevidzem Nkefon
Medical laboratory technician
3
Answers
Yaounde, Centre, Cameroon
Updated
Yikila Enestine’s Answer
Breaking the bad news to patients is not always an easy task to do.
The best way to do so is to start by explaining the patient's condition bit by bit, showing him love and moral support. You reassure the patient that he has the medical team by and be nice to the patient. While doing so, you bring the patient to understand what his situation is and you make
him understand that even if he doesn't have much time left to live, he can still live the time left joyfully. And most of all he feels loved and cared for. That really makes a patient to feel better.
The best way to do so is to start by explaining the patient's condition bit by bit, showing him love and moral support. You reassure the patient that he has the medical team by and be nice to the patient. While doing so, you bring the patient to understand what his situation is and you make
him understand that even if he doesn't have much time left to live, he can still live the time left joyfully. And most of all he feels loved and cared for. That really makes a patient to feel better.
Lauren T
Physical Therapist Assistant
24
Answers
Joliet, Illinois
Updated
Lauren’s Answer
How do you break the bad news to patients:
I like Beth and Lauren's answers as well. What they've already said is very realistic in the PT industry. While the really bad news may come from the doctor that sent a patient to PT in the first place, there are some smaller obstacles you'll face in a PT setting because you're the one that's front and center and seeing that patient multiple times a week, not the doctor, so the patient may confide in you more than them with what may feel like their failures or lack of progress in PT.
For me, this type of example has come up many times: You may see this when you have a knee replacement patient that is not gaining range of motion (ROM) of their knee flexion (bending the knee). If the doctor/PT and the post-operative protocol (list of guidelines from the doctor of what to do at certain weeks after surgery) had wanted 120 degrees of knee flexion by week 4 after surgery and they're only at 110, the patient may consider this bad news because they're not where they're supposed to be. This is where a PT/PTA may need to bring up some of their gains that got them to that point. Maybe 110 degrees is the best they've had so far, and they've slowly but surely gained motion and are going in the right direction. They're just not there yet. This is your chance as the therapist to encourage your patient, or motivate them to work on their home exercises to see more benefit.
Or maybe the patient already had 120 degrees and now they're down to 110 degrees that day. This can happen if the patient had an increase in activity which could have caused more swelling/edema which gets in the way of their knee flexion, or maybe you normally see them in the afternoon when they've had a chance to do their exercises once at home and they're more loosened up, but on this occasion you saw them in the morning and their joint is stiffer. So you'll need to understand their circumstance to be able to explain why their ROM may have decreased - and these are the types of things you'll learn and experience with more time in the clinical setting as a student or new therapist. And this type of example can be applied to many different types of patients, like an ankle/hip/shoulder/elbow, etc.
As a PT/PTA, it's not our job to tell a patient, "you're going to need surgery." We are not surgeons and this is not our decision, fortunately. You get a patient with their diagnosis and as a therapist you exhaust your resources and do everything you can within the realm of PT, and if it's still not enough, then that patient might not benefit from PT. They may ultimately need surgery to fix their problem. But again, all we do is document the interventions that were used and how the patient responded (or didn't) and provide this information to the doctor so that the doctor will have all the information they need to break this news to the patient.
What are the struggles getting into this field?:
PT, and even PTA school, is competitive. People want to do our jobs because it's rewarding and fun, and also hard work, but worth it. So it may take time to get accepted into a program. My PTA program took 22 students a year. There were about 100 applicants. I had already completed my general education requirements, course requirements for the program, had letters of recommendations, and completed more observation hours than were required. Unfortunately, it may take multiple attempts. Until then, I would recommend getting an entry-level job as a Rehab Tech or PT aide. They're the ones cleaning treatment tables, grabbing ice and hot packs for patients, or helping patients with exercises or equipment. You'll get real world experience and a front row view of what the daily operations of a PT clinic are like. You'll get to interact with patients, see different exercises being used, expose yourself to different diagnoses. It's a great place to start and may get you ahead of some applicants if they've only done observation hours, but you've had a job doing it. And once you're in a program, it's not all going to be completely new because you will have seen some of these things while you were working or already use the equipment you'll learn about in more detail.
If you don't have the availability to work as a tech or aide, then shadowing or observing is also helpful. Try out a few different settings like an outpatient orthopedic clinic, nursing home, hospital, pediatric setting, home health. This may be a nice introduction for you to see what type of setting you could see yourself doing in the future, or which ones you really don't. Or open yourself up to other opportunities. I have a friend who was a rehab tech and applied and did not get into PT school. But she knew she liked working with pediatric patients. After a few years of failed attempts to get into PT school, she ended up deciding to go to school and become a nurse. And she now works on the pediatric floor of a hospital as a nurse.
Start getting some experience and start learning all about PT! Observe/shadow a therapist or find an entry-level job as a rehab tech or PT aide.
I like Beth and Lauren's answers as well. What they've already said is very realistic in the PT industry. While the really bad news may come from the doctor that sent a patient to PT in the first place, there are some smaller obstacles you'll face in a PT setting because you're the one that's front and center and seeing that patient multiple times a week, not the doctor, so the patient may confide in you more than them with what may feel like their failures or lack of progress in PT.
For me, this type of example has come up many times: You may see this when you have a knee replacement patient that is not gaining range of motion (ROM) of their knee flexion (bending the knee). If the doctor/PT and the post-operative protocol (list of guidelines from the doctor of what to do at certain weeks after surgery) had wanted 120 degrees of knee flexion by week 4 after surgery and they're only at 110, the patient may consider this bad news because they're not where they're supposed to be. This is where a PT/PTA may need to bring up some of their gains that got them to that point. Maybe 110 degrees is the best they've had so far, and they've slowly but surely gained motion and are going in the right direction. They're just not there yet. This is your chance as the therapist to encourage your patient, or motivate them to work on their home exercises to see more benefit.
Or maybe the patient already had 120 degrees and now they're down to 110 degrees that day. This can happen if the patient had an increase in activity which could have caused more swelling/edema which gets in the way of their knee flexion, or maybe you normally see them in the afternoon when they've had a chance to do their exercises once at home and they're more loosened up, but on this occasion you saw them in the morning and their joint is stiffer. So you'll need to understand their circumstance to be able to explain why their ROM may have decreased - and these are the types of things you'll learn and experience with more time in the clinical setting as a student or new therapist. And this type of example can be applied to many different types of patients, like an ankle/hip/shoulder/elbow, etc.
As a PT/PTA, it's not our job to tell a patient, "you're going to need surgery." We are not surgeons and this is not our decision, fortunately. You get a patient with their diagnosis and as a therapist you exhaust your resources and do everything you can within the realm of PT, and if it's still not enough, then that patient might not benefit from PT. They may ultimately need surgery to fix their problem. But again, all we do is document the interventions that were used and how the patient responded (or didn't) and provide this information to the doctor so that the doctor will have all the information they need to break this news to the patient.
What are the struggles getting into this field?:
PT, and even PTA school, is competitive. People want to do our jobs because it's rewarding and fun, and also hard work, but worth it. So it may take time to get accepted into a program. My PTA program took 22 students a year. There were about 100 applicants. I had already completed my general education requirements, course requirements for the program, had letters of recommendations, and completed more observation hours than were required. Unfortunately, it may take multiple attempts. Until then, I would recommend getting an entry-level job as a Rehab Tech or PT aide. They're the ones cleaning treatment tables, grabbing ice and hot packs for patients, or helping patients with exercises or equipment. You'll get real world experience and a front row view of what the daily operations of a PT clinic are like. You'll get to interact with patients, see different exercises being used, expose yourself to different diagnoses. It's a great place to start and may get you ahead of some applicants if they've only done observation hours, but you've had a job doing it. And once you're in a program, it's not all going to be completely new because you will have seen some of these things while you were working or already use the equipment you'll learn about in more detail.
If you don't have the availability to work as a tech or aide, then shadowing or observing is also helpful. Try out a few different settings like an outpatient orthopedic clinic, nursing home, hospital, pediatric setting, home health. This may be a nice introduction for you to see what type of setting you could see yourself doing in the future, or which ones you really don't. Or open yourself up to other opportunities. I have a friend who was a rehab tech and applied and did not get into PT school. But she knew she liked working with pediatric patients. After a few years of failed attempts to get into PT school, she ended up deciding to go to school and become a nurse. And she now works on the pediatric floor of a hospital as a nurse.
Lauren recommends the following next steps: