Twenty Pieces of Advice to a Young PT

In the spirit of keeping my fingers limber while I toss ideas around in my mind, wait for them to settle, and collect the courage to write about larger, tougher, even less popular issues than I usually write about. This, from 2010:

Twenty Pieces of Advice to a Young PT

1. Give your Clinical Instructor (CI) time to get to know you. You know you can do the job, but they have just met you and need to observe you for awhile before they know they can trust you to do your thing. You have to earn their trust with your behavior and your skill, and that takes time.
2. CI's differ, just like people, because amazingly enough, CI's ARE people. Some will want to micromanage you, some will give you a longer rein right away. Don't make assumptions about someone's likes and dislikes, ask them what they prefer.
3. Keep a running list of things you need to look up or review. It will help the next day and in the long run. Develop your special interests and then don't be timid, offer your knowledge and opinions in a humble yet confident way.
4. You are the student and that's okay. Some people will completely ignore you, some will assume you know absolutely nothing because your tag says student, and some will have as much confidence in you as you have in yourself. In the end you are just passing through. Learn as much as you can, give the best care you know how, and let the rest go.
5. You will not click with everyone, CIs, coworkers or patients, and that's okay. With some CI's and patients you will get along like a house afire and genuinely make friends and "chosen family". With others a strictly business relationship is all that is required. They are your boss, treat them as such, and then go home.
6. Go to different states, different cities, and different hospitals if you can. You will meet people with a wider experience, varied perspectives and get to be a temporary local in great places. Every place is what you make it. If you aren't loving it, maybe you need to put a little more love into it.
7. When your first, second and third choice for clinic falls through, be excited! This only means that the experience you are truly meant to have is coming your way. Three out of four of my original choices were changed to something else, and I ended up loving what I got instead of getting what I thought I wanted.
8. Be assertive and brave and open to all new experiences. The ones you never considered can turn out to be the best ones. Go up on the high wire, the view is great!
9. Laugh at yourself regularly. Here's a little known secret: CI's don't actually expect you to be perfect. They expect you to be competent and get better with practice. That's a big difference. Perfect will make you crazy. Practice will make you better.
10. Never underestimate the value of repetition. Perhaps you, like me, sometimes get bored by repetition. No matter. There is value in it and you will come to respect the ability of the brain and the body to remember a piece of information or a skill with repeated exposure and practice. Soon things will be second nature, and then you can add a little style.
11. "To thine own self be true." Know yourself. Know if you are an introvert or an extravert, know the signs when you need a little rest or silence, and know that it's okay to ask for what you need. If you sometimes need silence to concentrate, learn to express that professionally and with good humor, because you don't want to get to that frazzled point and then snap someone's head off before you know you've done it. If you have a quirky sense of humor, express that appropriately. If you like to use your body in your work you will discover that. People differ in what makes them happy, pay attention to what makes you happy in your practice, where you get bored, where you need "more cowbell."
12. Find your tribe. PT's are a pretty varied group. What part of PT gives you that "all systems GO!" feeling? Warning: it may not be what you expect. This is why it is vitally important that you try everything you possibly can, including working with different age groups, different approaches and different hospital and corporate environments.
13. Be organized. I'm not talking about freakish organization here, I'm talking about keeping a basic calendar and a few labeled manila folders. Print your syllabus, mark your dates, allow for the inevitable SNAFU. Really. Don't make yourself, your CI or your professors crazy over such a simple thing. Get and keep your "poop in a group" with regard to papers.
14. Learn all you can about your organization. Know the mission, the goals, the basic structure of the organization and demonstrate your knowledge early. Ask your CI if you can spend an afternoon in specialty clinics, with other PT's who have specialty knowledge, etc. This will help you broaden your experience.
15. Develop a gentle hand with people, literally and figuratively. Your patients aren't feeling well, they have pain, or they would not be coming to you. Start gently with them, you can always add more pressure, force, energy, intensity. Think of it as coaxing a kitten. Watch their face, watch their eyes, pay attention to what you feel beneath your hands. Ask, ask, ask. Ask them for feedback. More? Less? Here? There? Better? Worse?
16. Know your anatomy. You've heard it everyday for three years. It really is your best friend in the end. PT's are maestros of the body and in order to play well you have to know your instrument, inside and out, upside down and sideways.
17. "People are crazy." And that's okay. A wise friend offered me that bit of advice a long time ago, and now I offer it to you. It explains a lot of situations, and I say it lovingly. We are all crazy in our own way. Your patients, their families, your co-workers and innocent passersby on the street are "whole body preps" - they come with a past, a present and future, they sometimes come with mental challenges of various sorts, mental illness diagnosed or undiagnosed, fears, frustrations, needs, wants, memories, hurts, foibles and ticklish places. Treat them gently, they have placed their trust in you. Treat yourself gently, stay focused, know your boundaries, and do your best work in the midst of the craziness around you.
18. In the end people are responsible for themselves. I would love to tell you all your patients will be grateful, that they will always adhere to their program, they will follow your advice to quite smoking and eat smaller portions, but alas, some will and some will not. You will continue to do your job by considering the whole person and counseling and treating them holistically. However, you cannot "make" them do these things. You can explain in ways they can understand, you can break tasks down so they are less daunting, you can instruct, encourage, demonstrate and modify. People must meet you half way and do their part. Explain that good PT treatment and good outcomes is a partnership.
19. Laugh if you can, cry if you must. You will be with people in some incredibly intimate moments, and the more appropriate humor you can demonstrate the more comfortable everyone will be. Dealing with "Brother Ass" can be incredibly funny, and it's okay to laugh WITH your patient. You will also work with patients and families who are facing a very hard time in their lives, some may even be dying, and relatively soon. Unless you are made of stone you may shed a few tears, too. Remain composed, be discreet, keep your focus on the patient, and have a big boo-hoo later in private if you need to, there is no shame in it.
20. Throw your hands in the air and enjoy the ride. Individual days may be long, but the experience itself will go by fast. Don't forget to enjoy yourself, and be thankful for the opportunity.