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In celebration of National Physical Therapy Month (October), we would like to share what it’s like in a day in the life of one of Paragon’s dedicated physical therapists. The daily life of a physical therapist is ever-changing!  Because of the unique patient caseload, no two days are ever truly the same.

Jacqui Strassell is a Paragon physical therapist in Wellspring Health Care Center in Cincinnati, OH. She’s been a physical therapist for 10 years, and has been at Wellspring Health Care Center since graduation with primary focus on geriatrics. Since starting at this facility, she has focused her career in managing dementia cases, neurological conditions, and wound care management. She is a certified wound care specialist and certified in LSVT BIG for Parkinson’s disease.

Question: What kind of clinical setting do you work in?

Jacqui: Wellspring Health Care Center in Cincinnati, OH is a skilled nursing and rehabilitation/long-term-care facility.

Question:  Why did you choose to work in this kind of clinical setting?

Jacqui: When I was in college, like many PTs, I thought I wanted to focus on sports medicine. While finishing up my final year of undergraduate school, I worked with a woman who had suffered a stroke many years prior. I love doing crafts and hated watching soap operas, which is all her caregivers ever did with her, so I would bring crafts over to complete while I sat with her. I noticed she started to do more and more with me, so I started bringing “kids crafts” for her. She was unable to feed herself prior to me spending time with her but I noticed she was starting to touch her face and reach for her food (the little things). I thought it was interesting how spending time doing something fun could impact something so major. When it was nice, we would go on walks with her dog (I would hold the leash and push her wheelchair) and she started reaching for the leash. I realized how much joy we could bring back into some one’s life with just a little work and how much more could be done with more knowledge and more work. I did not get to spend much more time with her but realized how much I could help people suffering from a debilitating diagnosis or from a traumatic event get back to something they enjoyed and gain some independence.

When I completed my first full-time clinical placement at SNF, I was 100% sure I wanted to work with this population, and I have loved it ever since. I love seeing the joy on some one’s face when they “conquer” something difficult that they were convinced they would never do again. Seeing their reactions, make every test in school, and every hard day at work worth every minute.”

Question:  How does your typical day start?

Jacqui: I typically find out the number of hours and evaluation I have the night before. My director does let me know, if my schedule is less than 8 hours, if I have anyone who I may need to come in later to see. If I don’t have anyone who I need to stay later to see or if I have a full 8 hours or more day, I come into work at 7 AM. My schedule changes daily, so when I get in, I check my schedule then any patient doctor’s appointments, dialysis patients scheduled that day, admissions/evaluations and anyone who went out overnight due to medical changes. If I don’t have anyone I need to see before they leave for an appointment, I start my day with reviewing therapy documentation, co-signing notes completed by the PT assistants and initiate any evaluations. I try to do evaluations as early as possible so that the patient can get their rehabilitation started, I can assess transfer and gait status in order to remove restrictions for fall prevention initially set by nursing, and get information submitted to insurance if necessary. I also have patients state that therapy starting so early in the day answers a lot of questions they have concerning meals, visitors, medication times, therapy schedule, therapy goals, prognosis for rehab and discharge planning.

If I have patients leaving for an appointment, I see them as soon as I can. For the remainder of my schedule, I try, to change up times of therapy session if possible to ensure that they will be able to complete tasks at all times of day in case they fluctuate in their ability to participate; i.e. sundowners diagnosis. Primarily for patients I see every day, I vary each treatment sessions from day to day; i.e. transfers, obstacle negotiation, gait training with least restrictive assistive device, balance, and stairs.

On occasion, I would work with patients in the out-patient or home health settings and would incorporate modes of treatment such as group and concurrent treatments. Every day is a new adventure spent creating and executing individual treatment plans designed specifically for each of my patient’s needs.”

Question:  What is the big part of your day as a clinician? 

Jacqui: My day does change daily; however, it is always centered around patient care. Some days are focused on clinical documentation advancing or modifying the patient’s goals, current function, and discharge planning. But no matter what my schedule for the day is focused on, communication with the Interdisciplinary Team (IDT) occurs daily concerning any falls, change in function, pain medication changes or schedule, patient’s progress or lack thereof.

When it comes to supervising PTAs, I find we always work best having open communication —share ideas and discuss different treatment approach/techniques with much complex cases.”

Question:  Has efficiency changed with the switch to electronic documentation?

Jacqui:  “Similar to many other therapists who did not enter the field prior the transition to all individual treatment, back when almost all patients were treated in concurrent or group multiple times a week for parts of their session, the transition to point of service documentation was difficult and frustrating at first. But since progressing to point of services documentation, I find that my documentation, as well as the documentation I co-sign, showed evidence of skilled intervention and need for skilled therapy instead of just indicating what the patient has completed; i.e. types of cuing and cues given  A detailed documentation allows for a better continuity of treatment by PTA  or treatment by another PT.”

Question:  How does your day end?

Jacqui: Every day ends at a different time, but I end my day with something I enjoy, which is patient treatment. I do my very best to do point of service documentation, so I don’t have to end my day with a lot of documentation to complete and prepare for the next day’s schedule.

I have a great therapy director and work with an amazing group of therapists, and we end the day by ensuring that every patient received the services they need.

Question:  What would be your favorite part of a day in the life of a physical therapist?

Jacqui: My favorite part of being a PT is watching my patients walk out of the facility, or able to propel their wheelchair out of the facility, on the day of their facility discharge. I recently had a young lady who was unable to move the right side of her body, unable to roll in bed nor sit on the edge of the bed when she was admitted at the facility, walked out of the facility with a rollator. I am not sure she was able to stop smiling the last couple of weeks she was at Wellspring.  To see my patients, succeed and achieve their goal of returning home is the best part of being a PT.

We would like to thank Jacqui Strassel for her dedication to our residents and for giving her insights in to a day in the life of a physical therapist in a long-term care facility. Having a deeper understanding of the day-to-day effort makes everyone appreciate the significant role a PT plays in the lives of every patients they cared for.  It’s also worth considering that while certain patient care settings provide some structure, flexibility is a must for every PT.  Morning always start with preparation for the day’s patients and days end with treatments, documentation and possibly preparing for the next day’s patients.

 

 

 

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