Why I hate and, once in a while, love my job.

Today something kind of awesome happened at work. I actually helped make a significant difference in my patient's quality of life. I have been working with this patient since I came to Jacksonville six weeks ago, and he was on therapy for at least a month prior to that. When I started working with him he was not able to get out of his bed and into his wheelchair without extensive help, due to physical disabilities and several other issues. Today I could tell him that he no longer needed physical therapy because he can now safely get in and out of bed and into his wheelchair with the use of a sliding board (a tool used in therapy, for patients who are not able to stand or or support their body weight on their legs). To some people, this may not seem like a big deal, because we take for granted that we are able to get out of bed on our own strength every day. For this man, this was a HUGE accomplishment. Imagine being a grown person, and yet having to rely on other people to physically lift you out of bed because you can't do it yourself. This man is now able to regain a little of his dignity because, after months of therapy, he is now able to get out of bed on his own, without physical help. When I told him he had officially graduated from therapy, he was a little quiet, didn't say much...but later, he came back with tears in his eyes and thanked me for pushing him so hard and making him "stick with it." He even said he was going to miss coming to therapy. This is so significant because he was a very difficult patient...when I started working with him, he had an irrational fear of falling, to the point that he was terrified to sit on the edge of the bed. There were many times were I was sure he hated me, because I really pushed him hard, never giving in to his fears, but making him face them every day, many times until he was close to tears. He has not completely conquered all his fears yet, but he is so much better, and he was able to get past them enough that he could learn how to transfer himself using the board. He told me that he never believed that he could do it until I believed in him, and that just made my day, my week, and probably my month.

You must be wondering why I hate my job, then. Here's why...this ALMOST NEVER HAPPENS! If I could treat patients like this every day, all day, I would LOVE my job. Wait, you say? I'm a physical therapist, this should be happening all the time, it's what I do for a living, right? This is exactly what I THOUGHT when I graduated, too. However, that is not the case, not even close. For every patient like this, I have ten patients that are the complete opposite. These are the patients that couldn't care less about therapy, that are completely content to remain at the level of care they are in and have no desire to get better. They complain all day, every day, find every excuse in the book to not do the things that I am trying to teach them to do. They don't want to put in an ounce of effort, and are only in therapy because that is the only way their insurance will allow them to remain in the nursing home without significant financial loss. (If the nursing home can show that a patient needs the skilled services of physical therapy, most insurances will pay for a patient to stay in the nursing home for a certain period of time, as opposed to the patient paying for it.) And since, of course the nursing home wants the money, I'm required to treat these patients whether or not they really need or want the therapy, and whether or not they can significantly benefit from it. So I basically have a lot of "filler" patients that are making the nursing home and rehab companies money, but that are entirely unmotivated, undeserving and unqualified for therapy. For every patient that thanks me, I have dozens more that glare at me, grumble constantly, and even several that flat out just curse at me. And since the rehab department is basically required to bring in a certain percentage of the income for the nursing home, if we don't have enough patients on our caseload to make the grade, we have to "find" more patients, which is usually done by "screening" the nursing home residents and finding the ones that have "declined," in order to bring the caseload up. It's such a joke, and it's hard to go to work every day when I rarely get the chance to actually put my skills to work and really make a difference in someone's life. Which is why I get so excited when I actually do...