Stephen Stockhausen of PTAdventures.com and I sat down for a quick 15 minute chat about life during the COVID-19 crisis. We covered a lot of ground and talked home care, out patient, travel PT, and telehealth.
I’m not one of those people who writes, stops, crumples up a ball of paper, and starts over. Usually, I sit down at the computer, write whatever comes to mind and move on with a few edits later. This time, I just can’t get this blog going. I’ve started, stopped, started-over, and re-started over. There’s so many obstacles to writing this blog. The biggest barrier is that while many of us are finding ourselves with additional free time, we are so all-consumed with this virus that we can’t seem to get anything done – like writing this blog. Another huge barrier has been the speed things are moving at, every time I think I have a handle on what’s happening in healthcare and with the virus, it changes. Finally, I think I’ve been trying to fit too many ideas in one blog that truly contradict with each other.
Contradictions, that seems to be the hallmark of this crisis. While some facilities are laying off all their staff from lack of work, others are overloaded and woefully understaffed. One minute I’m convinced we’re all doomed to big, big trouble, the next I know we’ll be fine, then I swing back the other way. Should my last few remaining patients be scared of what I could spread to them, or should I be scared of what they will spread to me? I worry and I’ve had to quickly learn to manage that.
All those contradictions are why this has now become at least 2 separate blogs, maybe more if this isolation drags on. In this first one, I’d like to lay out the challenges that many travelers are facing in this crisis and some of the resources that are out there to help those challenges. In the sequel to this blog, I’d like to take a more positive note and look at some of the opportunities for change this crisis will bring. But I can’t write that piece without first writing this one that expresses the true graveness of this situation.
We’ll see if I get through writing this. Things will undoubtedly change before I can push that “publish” button. So please grant me some grace in knowing that what I write today may be outdated or completely inappropriate by tomorrow.
This thing is moving very fast. A few weeks ago, I was finishing up a paternity leave in Hawaii. The impetus for the trip was the wedding of an old travel PT friend. At that time in the beginning of March, the COVID-19 concern had started to build, but wasn’t doing much to affect every day life. The wedding went off without a hitch, was awesome, and was full of international guests and current/former Travel PTs and OTs from all over the country. I haven’t heard of a single illness from that wedding. Phew.
The next Monday, still in Hawaii, I had a meeting with some colleagues to decide whether to hold or cancel a PT event. While most of us agreed on a wait-and-see method, one colleague was not happy with the decision and had somehow anticipated or learned of the seriousness of this virus. Only 24 hours later, I would share his opinion that we absolutely had to call off the event (of course now, this is commonsense). In that one day, things had started to fall apart back in Colorado, and I had realized the gravity of what was happening.
All of a sudden, the Govenor was closing down everything in the state. Our county and town had also taken aggressive actions to stop large groups of people from congregating – first no more than 50, then 25, then 10, now 5. From a place of relative comfort in Hawaii where very little was happening COVID-wise, these seemed like drastic measures. Was our Governor OK? Or some kind of germaphobic lunatic?
Because of the craziness in Colorado, we decided to stay a few extra days in Hawaii. There were about 3 extra good beach days in Hawaii before the gravity of COVID-19 hit – then it became time for us to get out. Our flights all started getting cancelled, there were protests to shut down the local airport, quarantines for all arrivals were put in effect. As much as I love Hawaii, I didn’t want to get stuck there. Following many hours on the phone and internet with United and Hawaiian Air, we eventually ended up on a red-eye direct to Denver with a newborn and toddler. We safely made it home in time for me to return to work the next day.
I share this story to say that COVID has an interesting effect of people thinking they’re OK until they aren’t. That original colleague who wanted to cancel our event KNEW already, then the Colorado Governor KNEW, I didn’t know until a full week later. If you’re still out there thinking we don’t need to be social distancing yet, your time is coming. You too will KNOW soon. Please be safe.
Running parallel to my timeline in Hawaii, watching Colorado respond from afar, an interesting story was playing out back home in Aspen. A group of Australians had visited and brought COVID with them – even a month later, we only have 30-something confirmed cases in our county, 10 of them are those dang Aussies. Two of these patient-zero-Australians decided to quarantine-in-place at their 5-star slopeside hotel on Aspen Mountain, with the knowledge and agreement of the hotel staff. BUT, they did something no one could have anticipated – those awful, awful people snuck out and went skiing with the general public, putting everyone at risk.
It’s my understanding that their indiscretions is what closed down our city, county, and ultimately the state very early in this pandemic. Those arrogant jerks may just have saved us. Time will tell.
At work, I continue to be gainfully employed – at least as I write this, but nothing is certain. We have trimmed down to “essential” patients only, basically anyone who will be permanently disable if they don’t see a Physical Therapist right now, mostly post-ops. I have about 1-2 patients each day and am managing to stay impressively busy with projects. Administration indicates that they are keeping everyone they possibly can working in whatever capacity they can so that if a “surge” comes, our workforce is immediately ready. Hopefully that surge never comes. I have heard our anticipated peak is April 17th. So, the moment of truth draws near.
Our hospital held onto our travel PTs as long as they could until they finally had to cut them loose this week. In talking with the travelers, no one seemed to be surprised, they were happy to be kept on as long as they were. They were let go with a couple weeks of pay and free housing for a few weeks. It was nice to see the hospital treating the travelers well despite having to make some tough decisions at their expense. Which finally brings us to the point of this post.
This is an awful, awful time for many workers in this country, Physical Therapists included. I don’t have any hard numbers, but casually, it seems like 50% of PTs have been cut from their jobs. If you are a traveler and have had your contract cut short, you are not alone, there are many out there just like you. From what I hear, there are some jobs out there that still have openings, particularly in home health, acute, and SNFs. So don’t forget to open yourself up to the possibility of a new opportunity – just in case you can find one.
If you have suddenly found yourself without a job, I hope your agency or your employer is treating you well to the best of their ability. This time is putting a strain on everyone, and I think we all need to embrace a piece of the sacrifice, employers included. Some clinics will not re-open, many PTs will not return to the clinics that laid them off, PT practice and our society will be forever changed. We are living through a historic event the likes of which very few people have ever seen in their lifetime and hopefully we will not see again. This period in time will go down with the Spanish Flu of 1918, both World Wars, and 9/11 – it’s going to be rough, but it will pass. And some of those events of the past have been defining for our profession.
When this is all behind us, people’s knees will still hurt, their backs will still hurt, and they will still suffer strokes and heart attacks. Lots of people will need PT when this is all over! I hope for a very quick rebound, particularly in the realm of clinics needing temporary staffing. When people feel safe coming out of their homes, they will need our services. Hopefully that happens sooner rather than later.
In the Meantime… here are some opportunities to ease the pain.
Emergency License Waivers/PT Compact
There are still some employment opportunities out there. Many hospitals are overwhelmed at this time. It makes sense that as many thousands of people recover from the novel Corona Virus, they will require inpatient rehab needs in a SNF, or the will need home health. If you’re looking for work, it is these setting I would be looking in right now.
I’ve heard some people talking about a possible Federal mandate to open licenses across borders. The main challenge to this happening is that professional licensure is a state protected right by The Constitution. We are far more likely to see more state waivers on licensure like we are seeing emerge now.
The link below from FSBPT is tracking the measures states are taking to allow healthcare workers to come into their state to help in this crisis. There is a huge variation of waivers state-to-state, so your best bet is to click on the link below and see where you might qualify for temporary practice.
A couple examples of what is going on out there:
California – allowing people with inactive and expired CA licenses to re-activate within a matter of days.
Delaware – Allowing graduated, but not licensed PT and PTA students to practice under a licensed clinician.
New Hampshire – Specifically allowing out of state licensed professionals to practice telehealth.
There are a lot of people out there advocating for our role in this global emergency. Our profession evolved to resemble what it is today out of Reconstruction Aides during the first World War and from needs presented during the Polio Epidemic. Our success or failure in responding to this crisis will shape our profession in the future. If we want to be an essential service in the future, we better demonstrate the uniqueness and importance of our skills NOW.
There will be no one else mobilizing and strengthening the thousands of patients who recover from COVID-19 with significant lung damage that needs our skills. All the people that are sitting sedentary at home right now are going to need us badly when they try to leave their homes again. There will be major societal repercussions from this time of solitary confinement. Don’t be mistaken, if you don’t see our essential need yet, you will – it’s coming.
APTA has collaborated with others to develop a volunteer pool matching available professionals and students with needs for volunteers. If you are available, please consider signing up at the link below – while it might be a little scary, this is a great opportunity to be a part of the heroic response and gain some new skills along the way.
There is a tremendous amount of information available for free these days. There are existing resources and new ones that have been recently opened up. If you are finding yourself with extra time to occupy, here are just a handful of ways to expand your mind, but I encourage you to search for more. There’s a ton of stuff out there.
The Academy of Orthopaedic Physical Therapy has release a reading list that was previously a part of a paid course. This reading list is a greatest hits of Orthopaedic Physical Therapy literature and long enough to keep you occupied for months: ow.ly/Z4bT50x2xHT. AOPT has also decreased the price on many of it’s archived courses. You won’t receive official CEUs for these courses, but I’ve taken several of them and they are very meaningful learning opportunities produced by the absolute experts in our field. For $10 or $20 you can get some great education: https://www.orthopt.org/content/education/independent-study-courses/browse-archived-courses
Meditate. Headspace is a online service focusing on guided meditations. Now, they are offering their premium service for free to healthcare workers through 2020. This may be the single most valuable resource on this list. Whether you are under-worked or over-worked, some meditation could probably do you some good in this time. Mental health is so important in a time like this.
Many universities offer free courses on a regular basis including Harvard. I’ve always wanted to check out what they have to offer, now might be that chance.
Audio Books – Audible has over 1,000 titles available for free. With school being out, they have added a whole bunch of children’s books which includes many of the classic. Might be time to review some Mark Twain or Hemingway.
Learn a language. If you are, or live with, a student of any level, both Rosetta Stone and Babbel are offering 3 free months of courses in a lot of languages.
If you have been laid off, furloughed, or have had to step away from work to care for a loved one, you are eligible for unemployment benefits. Who is available has been expanded by Congress and they are supplementing the weekly benefit by up to $600. I’m not so polished on the details, but this APTA page explains some of the details and links to the Department of Labor who is ultimately in charge of implementing the changes.
Congress included the gig-economy and contract workers in this expansion. I have to imagine there are Unemployment Benefits that extend to travelers given those two area of focus. It is also likely further expansions of unemployment will come.
That’s all I have in me for now. I have the intention to write the second piece to examine what positive changes our profession and our society can take from this experience… we’ll see what comes of that as the next couple weeks progress.
This is a grave time, historic in all the worst ways. I hope our profession can pivot to meet this time’s needs and come out stronger on the other side. Stay safe out there. Take care of yourself. Take care of each other. We’re going to get through this, and PTs will be VERY busy in a couple months.