Its hard to believe that we have almost finished our thrird week on our first of three 10-week rotations at various hospitals, clinics, skilled nursing facilities, homes, and rehab facilities. During this first internship we are finally getting in past our ankles. By the end of this ten week stint we should have around a 50% case load of patients. At OHSU in Portland, OR I am working in the trauma unit which is my first ever acute care experience. And what an experience it has been!!! The diversity in patients is incredible! the age range so far has been from 15 to 99 years old with diagnoses ranging from spinal cord injuries, gunshot wounds, traumatic brain injuries, cervical fractures, multiple system trauma from car/motorcycle/bicycle accidents, and many more. One of the most difficult aspects to working in this unit has been the absence of any predictive value of how the patient will perform at evaluation. I have had patients that have fallen from 25 ft discharge home on the same day, and then treat someone that trips on a curb and is requiring constant vital monitoring and services from speech, OT, and PT. You can never know how a particular injury will present but this difficulty is also why i am really enjoying my time in the trauma unit. It is forcing me to apply clinical reasoning and utilize my knowledge from all of my classes from the first two years. It is truly a place where all of the body’s systems are frequently involved in treatment and need to be addressed and considered in order to deliver optimal care. I have struggled a little bit with the coordination of care because these patients often have many co-morbidities that require treatment from nearly all professions. Daily events include organizing with nursing to have the patient medicated but alert enough for therapy, co-treating with OT, and Speech, organizing around the patients surgery/dialysis/family visits/x-rays/blood draws/medical consults/bowel care/case management/etc…. And the list goes on and on. It requires a diligence and integrity in ones work, chart review, and documentation to be a successful practitioner and i feel like i am starting to get the hang of it. Still so much to learn still which makes me so happy to have chosen this field of health care.
Stay calm and PT on!!! =)