As I prepped for my clinical yesterday I decided to text my dad letting him know I was about to go work in the ICU for the day…his response, “why would a PT need to be in the ICU?” Well…well….well let me tell you a little about what a PT needs to be doing in the ICU.
Even though the popular belief is that physical therapy is mainly for people who hurt themselves during sports, have a joint replaced, or are in a nursing home, believe it or not physical therapists also treat things such as women’s health, concussion management, and do work place ergonomic screenings. The fact of the matter is that movement is medicine and physical therapists are the doctors That may sound kind of jaded, however it is true. After completing our undergraduate degrees, we (typically) spend 2 years in a classroom learning about everything from how the muscles work to make each joint move through the importance of movement across the spectrum of care. After the 2 years in a classroom, throw on another full year of clinical experience where you can choose to hone your craft in outpatient sports medicine or venture around to see what trips your trigger like I did.
My approach to clinical rotations was to see as much as I could. During my rotations I got to see surgeries, work with OT’s and speech pathologists, shadow dozens of physical therapists, and now I moved into the world of acute care physical therapy at the highest level—physical therapy in the ICU.
While the hospital I am at is not a trauma 1 center, the first patient I saw had 3 chest tubes, a nasogastric tube (NG tube), an arterial line, oxygen, and a J tube. Needless to say switching from outpatient ortho to this was a quick adjustment. The main point of physical therapy in the ICU is to safely move the patients who may be a little intimidating for nursing staff to move for the first time. While the nurses are highly trained in things that we aren’t, such as medications and managing what’s going into/coming out of the various tubes, sometimes we can assist them on how to safely transfer the complex patients.
We then moved on to a patient who was in critical condition after a massive GI bleed that led to him receiving 22 units of blood since the beginning of this week. For those of you who are unaware what that really means, a healthy adult typically has 8-12 units of blood in them at one time…so this gentleman required 2x the average amount of blood a person has in them, in 3 days. He was recently extubated so we were allowed to pick him up on our schedule (hospital specific protocol, some hospitals allow people who are intubated to be seen by PT). While our session mainly consisted of bed exercises, the plan is to get him standing edge of bed tomorrow once some of the medications wear off.
Finally, the therapist I was working with asked if I wanted to try and lead an evaluation since I seemed comfortable working with the more complex patients. I thought to myself for a second, realizing I am about to be entry level and out on my own, and figured now is as good a time as any. We did the chart review and to my surprise I would be evaluating a guy who had a stroke 2 days ago. Luckily for me the stroke was not a major one and this gentleman was rather high functioning so the evaluation went smoothly.
Overall, my one day exposure to the ICU was an amazing one and I hope down the line I get to work in that setting because the fast paced nature mixed with the complexity of the patient’s is very intriguing and something you don’t have to deal with in outpatient.
With all of the benefits of early mobilization for patients in critical condition, someone has to take the lead from their first encounter. Physical therapists are now being recognized as the movement experts in hospitals and a specialty service. While some still view us as exercise instructors, the doctoral level education is pushing us out of gyms and into hospitals where our knowledge can also be utilized. Early mobilization of patients has been shown to reduce hospital stays, which in turn reduces hospital costs, which down the line saves you as the consumer money.
I know some people think physical therapists are here to rub your neck and stretch your muscles, but that just is not the case anymore. This profession that I love already is quickly changing and I am so excited that in about a month I will be able to approach it as a professional instead of as a student.
Hopefully this blog was a little more insightful on what physical therapists do than the last few have been. I appreciate anyone taking the time to read what I am putting out here! All of the information I put out is to try and inspire at lease one person, either to see a physical therapist or to make their day a little better!
Happy Friday my friends—until next week!
I am a new graduate DPT and am interested in personal growth and becoming a connector within my profession.