To my surprise, I really enjoyed working in the SNF setting.

One of the main “ah-hah” moments

I had during this clinical was that therapy does not have to be complicated. At the beginning of

my clinical experience, I felt like I had all of these “therapy tools” in my brain, but I did not

know how to apply them. I was just making it more complicated than it needs to be. Many of the

patients we saw were very low functioning, so their therapeutic activities and exercises did not

need to be very intense. Every day I felt more comfortable in the setting and was able to take

most patients through their full treatment sessions. One of my favorite moments from my clinical

was working with a lady who had fallen at home and was now at the facility to rehab and get

stronger. She struggled with the sit to stand transfer due to fear and anxiety about falling, so she

did not lean far enough forward to stand up. We were trying to practice her sit to stand transfer,

but she still was not leaning far enough forward with verbal cues. I had the idea for her to just

practice leaning forward by reaching for the plinth in front of her while securely sitting. She did

this for a few reps and saw how far forward she needed to lean, and on the next transfer attempt,

she stood up! It was just a small, neat experience that helped me gain a little bit of confidence in

my clinical intervention decision making.

I was able to work for an outpatient orthopedic clinic for a year, so I am very familiar with

orthopedic rehab. We had quite a few patients during my clinical experience that I was able to

utilize my orthopedic skills with. One patient had been complaining of symptoms of sciatica. My

CI had been doing a piriformis stretch with her in supine, and I suggested trying sciatic nerve

glides. I taught the patient and my CI how to do the nerve glides at varying tensions, and they

both loved it. The next day, the patient thanked me for showing her the exercises because she

was able to get out of bed that morning without any pain! I also was able treat a patient who had

a reverse shoulder replacement and implement some grade I and II oscillations and PROM at
both the shoulder and the elbow which had been stuck in a sling for weeks. I finally felt like I

was getting a hang of the whole “therapy” thing!

I also realized that physical therapy is largely psychological. We had been dealing with many

patients who struggled to get motivated or had cognitive issues. Helping these patients

participate in therapy can be quite a task! My clinical instructor was really good at handling

those types of situations though, so I learned a lot from her. One thing that I learned from her is

that it is important for patients to build trust with their therapist and feel like they are genuinely

cared about. My instructor is always willing to do little things for our patients like helping them

brush their teeth, put on a wig, or fill up their water. These little things seem so simple but end

up creating a large amount of trust between therapist and patient. She was so kind and caring

towards her patients but still maintained a professional relationship with them. Most patients

would tend to respond well to her after she helped them and showed that she cared about them as

a person. I determined that I want to be that type of therapist; the type that treats the patient as a

whole and unique individual.