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A day in the life of an inpatient physical therapist

Oct 20, 2018, 21:30 PM by Jessica Wyble

dayinthelife1

When Christine Lai thinks back
to her first exposure to the world of physical therapy, her grandfather comes to mind. 

After having several strokes, he needed the help of trained physical rehabilitation professionals to regain his strength and command of his body. As a child, Lai sometimes accompanied her parents to his therapy sessions, where she witnessed firsthand the integral role the physical therapists played in his recovery. 

She remembers being immediately intrigued. 

“He went from not being able to move one side of his body to walking out of the clinic,” says Lai. “I remember it was so strange for me at such a young age to watch it all unfold, but it always stuck with me.”

Fast-forward a couple of decades and Lai, a UTMB inpatient physical therapist, now helps jumpstart the recovery and rehabilitation process for countless patients who come through the doors of UTMB’s Jennie Sealy and John Sealy hospitals every day. 

This day, like most, Lai arrives 30 minutes before her 8 a.m. shift begins to review patient charts and outline her priorities for the day. She has a general routine she likes to follow but stresses that no two days are the same. 

“I like to do a thorough chart review before hitting the floors,” says Lai, who is currently the primary inpatient physical therapist for the Neurology and the Blocker Burn units. “Today I have patients ranging in age from 29 to 80, and they are each recovering from something a bit different—one has an ankle fracture, one is fresh out of hip-replacement surgery and another has an arm fracture, just to name a few.” 

Although each patient’s story and needs are different, Lai focuses on two things with everyone she treats—getting them to move early and often and educating them on why that’s important. 

In her role, Lai sees patients in the acute care stage of their recovery, which is typically the first one to five days following a procedure. During this stage, pain can be at an all-time high and many patients tend to want to stay in bed and rest. Lai works closely with the patients, their caregivers and the other medical professionals on their care team to emphasize that staying in bed is the opposite of what the patient needs to do to get better. 

“If I notice it’s getting close to 11 a.m. and a patient is still in bed, I try to facilitate some sort of movement or positional change because that’s going to promote a faster recovery,” she says. 

She stresses that no movement is too small or too little to aid in recovery and that sometimes just scooting to the edge of the bed and sitting for a bit can be good progress. 

As Lai makes her rounds, she brings along her two essential tools of the trade—a walker and a gait belt—to help get her patients up and moving. It’s quite the load to carry as she rushes back and forth between John Sealy and Jennie Sealy, but Lai has it down to a science—all the while checking her pager each time it buzzes, a frequent occurrence on this day. 

While the basic mechanics of what she’s doing stay the same from patient to patient, Lai carefully adapts her approach to best meet each individual’s specific needs, abilities and personality. 

“I teach them different leverage points and how to maneuver their bodies in a better way,” says Lai. “Regardless of what brought them into the hospital, it’s something new impacting their body that will affect how they do things.” 

Ultimately, her goal is to maximize a patient’s functionality and independence so they don’t have to rely on someone else as much once they’re discharged. 

Beyond the physical part of the job, a lot of what Lai does is educate patients on the benefits of incorporating physical therapy throughout the full recovery process. 

“Here in the acute setting, I don’t get to follow my patients for very long, so I don’t usually get to see them magically walk out of the hospital better than they walked in, although that sometimes happens,” says Lai. “I do, however, have the opportunity to change their outlook and perspective on how they’re taking care of themselves. When I see the lightbulb go off when I’m teaching them something that will carry through, that’s very rewarding to me.” 

Lai works hard to educate and inform not only her patients but also care managers, loved ones, residents, nurses and other medical professionals. All of her explanations and observations are carefully noted in the daily documentation she completes for each patient; often, Lai reiterates her recommendations in person to ensure everyone clearly understands her concerns and is on the same page. 

The Progression of Care Rounds (POCR) that take place in her units each day offer Lai and the other medical professionals the chance to provide each other with the most current information regarding their patients. 

The goal of these daily interdisciplinary meetings, a UTMB initiative that formally launched in 2016, is to improve coordination of care and ensure an appropriate length of stay for each patient to support the best possible outcome. Lai comes ready each day to ensure the mobility and rehabilitation component for each patient is thoroughly considered during these conversations. 

According to Starr Stanich, program manager for UTMB Rehabilitation Services, physical therapists are a key part of the POCR process, which includes discharge planning. 

“From day one, physical therapists are making recommendations to ease the transition to home or to the next level of care,” says Stanich. “They’re a very important part of the decision-making team.” 

From discharge planning and documentation to basic patient education and interdisciplinary teamwork, Lai has realized that there’s much more to being a physical therapist than she originally believed. 

“Physical therapy is not exclusively patient care,” says Lai. “I went into this field thinking it was just going to be the patient and me in a closed-off room with no one watching you help them. But, no, it’s actually the art of teaching and talking to a lot of people.” 

Lai admits she initially came into her role very timid and shy, but the nature of her work has forced her out of her shell. 

Stanich can attest to the change. She has watched Lai hone her skills and grow into a confident physical therapist during the two years she’s been employed with UTMB. 

In addition to working as part of an interdisciplinary team, Lai also meets regularly with the other inpatient physical therapists providing patient care. 

As one of 16 full-time inpatient physical therapists on UTMB’s Galveston Campus, Lai touches base with her colleagues daily just after lunch to share good patient outcomes, brainstorm solutions for difficult cases and more. The brief meeting gives Lai and her team the chance to reset and recharge before the afternoon rounds begin. 

Once her shift is over at 5 p.m., Lai says she can feel all of the squatting, lifting and bending she did throughout the day. 

“I’m usually pretty beat by the end of the day,” says Lai. 

Despite the aches, Lai loves her job. 

“I love my patients,” she says. “I strive to treat them all like they’re my family.”