I’ve been wanting to write about this topic for a while. A few recent events compelled me to put some thought down on proverbial paper.
The 3 things that compelled me: 1. Working in the ER, 2. Attending ER PT meeting at CSM, 3. Chatting with a friend at CSM who is an ER Physician.
I need to define my nomenclature before I get rolling here. I use ER (emergency room) because while I acknowledge this area of a hospital is larger than one room, the abbreviation ED makes me giggle.
I like working in the ER. Things happen in an ER that you don’t see anywhere else on this earth. Bring use you mangled, your acutely and traumatically injured, your impossibly intoxicated, and (most importantly) your clinically insane. I like the ER because it is exciting and it breaks up the day.
At this recent meeting at CSM…
I must break for a moment and fly my APTA flag. 13,000 PTs, PTAs, and students attended CSM this year. This is the most ever, and the numbers have been growing by a large margin every year. In addition to CSM attendance, APTA membership has risen over 80,000 with 22% of those members belonging to my favorite section, Orthopaedics. One last quick plug before I move along: If you’re a PT or PTA and not an APTA member, you’re missing out on being a part of one of the greatest times for our profession. The public is learning how well educated and trained Physical Therapists are and the entire healthcare community is realizing how unique and essential our skill set is in every setting.
At this recent meeting at CSM, a group of PTs who work in the ER go together and discussed exactly what it is we do. The answers were varied, some PTs are dedicated full-time to the ER, but many are there on an as needed basis. Some PTs are there as a musculoskeletal first line, diagnosing and practicing true direct access PT, but the majority are there as another part of the team following physician orders.
I have already written more than I like to in these purposefully-brief blogs, so I think the best I can do is to share my experiences in the ER. On my very first travel assignment back in Lowell, MA, we were occassionally called to the ER when the decision to admit or discharge was based on mobility. This is my 3rd at the hospital hear in Aspen where we are called to the ER multiple times every day to address the many LE injuries that occur in a town with four ski mountains. We typically are called in for gait training and brace fitting, but our greatest gift to the patients is what we teach them. We have a knowledge of their impending recovery and rehab that no one else offers. While surgery is a frequently necessary and vital part of their journey back to health, it only consumes a few hours. We are the experts on the rest of their 2, 4, or 6 months of pain, healing, and ultimate return to activity. Research shows that with PT involvement in the ER patient recovery is faster, patient satisfaction is higher, and costs over the course of this patient’s injury are lower. PT should be an important part of every emergency room. I have some work to do in the ER here to increase referrals for conditions outside of the legs. On your next assignment you can ask about the ER and see how much PT is used.
The group of PTs that held the meeting at CSM have an online list serve where PT and ERs are discussed. If you have any interest in Emergency Room PT or are just curious, you can sign up at: http://health.groups.yahoo.com/group/ptined/