Stacey Roberts

Stacey Romney
PTA-1010-001
21 April, 2015
Reflection Paper
Shadowing Experience
Having the opportunity to shadow at my physical therapy clinic has been a very
rewarding and benefiting experience. I was able to take everything I have learned in class and
relate it to what I saw in the clinic. I shadowed at an inpatient long term care facility. I learned
that physical therapists work in a variety of settings such as home health, hospitals,
outpatient/inpatient care facilities, care centers/nursing homes, and schools. There main job is to
diagnose patients who have difficulties performing daily tasks. In class I learned about the code
of ethics the physical therapists should abide by. All of the principles included in the physical
therapy code of ethics have been adhered to in this clinic. All the staff members were friendly
and made the environment enjoyable. I gained a great deal of knowledge during my time spent
there. Over the last two months my passion towards the physical therapy career field has tripled.
Shadowing has definitely provided me with an insight of my future career choice.
The majority of elderly individuals in an inpatient facility such as this one have had a
CVA (stroke). About seventy-five percent of the stroke patients were in wheelchairs and had one
side of their body affected. I also learned that if the right side of your brain was affected then the
left side of your body would be physically affected and have problems such as a curled up hand,
or a speech impairment. Working with stroke patients was very educational in the aspect that I
learned about a disease and got to see first-hand how the therapist dealt with it. I also witnessed

many other diseases and disorders such as Parkinsons disease, dementia, Hemiplegia,
Paraplegia, total knee replacements, expressive aphasia, and patients with severe diabetes. I
observed the physical therapist treat a middle-aged lady who had Parkinsons disease. She would
twitch and fidget while sitting and walking. She would walk really fast and had a hard time
balancing while walking. The therapist worked on big, exaggerated movements and came up
with a very creative treatment plan which involved dance therapy and balancing techniques. I
observed her over four weeks and noticed how much her Parkinsons disease improved from the
first day to now. Every week she improved immensely and by the last treatment session she was
able to sit without fidgeting as often.
I also observed an elderly Chinese lady who had a CVA right side affected. She did not
know English, did not have a translator, and was unable to speak to anyone. Every session the
PT, PTA, and OT would try to open her hand because it was curled up really tightly against her
side. The therapist had to rely on facial expressions, body language, and sounds in order to
understand how she was feeling. Her situation broke my heart a little bit; I cannot even imagine
what it would be like to be in her shoes. Not being able to speak to anyone would be an
extremely hard task - let alone not being able to understand what anyone is telling you.
Communicating with others on a daily basis can make or break your mood.
Another case I observed was a seventy-five year old women who had surgery on her
back. During surgery, the surgeon hit one of her nerves and made her paralyzed from the waist
down. This individual was very active and independent. Now she is in a wheel chair for the rest
of her life. This story hit me hard because I am a very independent athletic individual and not
being able to walk again would feel like the end of the world. The impact of her life had an
impact on my life. When I would create small talk with her I could tell how much on an impact

this had on her life. Cycling and gardening are her two favorite hobbies. She may never be able
to do them the same again but with therapy, modifications, help from her family, and other
inventions she will be able to get back to the things she loves. I observed many other cases like
this, and it makes me realize how beneficial therapy is.
Based on the ethics I have learned about in physical therapy, I have concluded that this
facility has done a pretty good job. The only thing I might suggest for them to work on is
sanitizing the equipment after every patients use. All the therapists performed good ethics by
knocking on the door before entering and asking for the patients permission to treat them. The
therapists kept all the information confidential. An example of this is whenever the therapist
would explain a diagnosis to me he/she would take me aside privately and inform me on the
patients circumstance. When observing the patients treatment sessions, the therapists would
introduce me to the patient and ask them if it was okay that I observed. The patients in this
facility had therapy for the amount of time their insurance provided. They followed the insurance
Medicare policies, plan A and plan B. In the physical therapy code of ethics the therapists did an
excellent job on abiding by the principles.
In this facility, the therapists would treat about six to eight patients a day. I noticed that
several of the patients would go to a wide variety of healthcare professionals. I had the
opportunity to observe the PT (physical therapist), PTA (physical therapist assistants), OT
(occupational therapist), COTA (certified occupational therapist assistant), SLP (speech language
pathologist), and the nurses. All of these health care professionals have the same goal on how to
treat the patients. The physical therapist worked on initial evaluations, joint mobilizations, and
mainly high risk patients. The physical therapy assistant worked with the same patients on a
regular basis and focused on the lower extremities. The occupational therapist and certified

occupational therapist assistant dealt with the upper extremities, cognitive impairments, and
worked on activities of daily living. They worked closely with the physical therapist and helped
the patients on basic AIDLs (going to the bathroom, feeding themselves, getting dressed, and
bed transfers, etc.). There was only one speech language therapist at this facility, she works with
the elderly patients, stroke patients, and patients with breathing difficulties. As for the nurses
they brought the patients down to the physical therapy gym, administered medications, fed the
patients, checked the patients oxygen levels, and cleaned the rooms.
From the insight that I have gained, I have learned in an inpatient setting you need to be
very patient, tolerant, understanding, and kindhearted. Many times I would see the therapists
encouraging the patients to participate in therapy by using positive language and just having an
overall good attitude. Many times it is like pulling teeth to get the patients down to therapy - let
alone doing the set of exercises. We encountered this patient with severe dementia who was very
difficult to comply with our exercise programs. She would refuse to do the set of exercises which
made it difficult to treat her. Some of the ways we got patients to come to therapy would be
bribing, compromising, and good persuasive skills. I perfected these skills during my time spent
with an elderly lady. Every morning I had to bribe her with apple juice to get her to participate in
her exercise program. I have learned that you have to be very understanding with the patients
conditions.
Empathy, sympathy, and overall good communication skills are essential in this career
field. The therapist should have good communication skills with the patients and staff members.
The physical therapist, physical therapist assistant, occupational therapist, and nurses all work
together on a daily basis. The staffs teamwork makes a big difference with how smoothly the
day goes by. An example of this is, we had a physical therapist come in to sub for the main

therapist. The day was not hectic, but did not run as smoothly as it usually does. The staff
members made sure he was familiar with everything in the facility and informed him on little
things such as where the charts are, placement of equipment, etc.
By the end of my shadowing experience. The patients diagnosis became easier to
identify. Learning about these disorders in class and being able to see them in real life was very
eye opening. I was able to distinguish what set of exercises needed to be performed by the
patients evaluations and diagnosis. For example, if someone just had a knee replacement the
first thing you do is warm them up on a stationary bike. Once they progress you move them onto
an exercise program with includes quad, hip and glute exercises. I noticed the clinic used a
variety of modalities such as electrical stimulation, laser light therapy, hot packs, cold packs and
ultrasound. I learned about these modalities in class and saw the real application in the clinic.
To conclude, having the opportunity to shadow at a physical therapy clinic has become
very beneficial to my insight about the career. I really enjoyed working with the elderly and
became attached to the feeling of excitement every time I returned. I learned a variety of things
during my time spent there that will benefit me greatly. Some of the main skills I have mastered
are my communication and persuasive skills. Some practical applications I learned about are
modalities, rehabilitation techniques for long-term improvement and continuing therapy. The
healthcare workers adhered to the ethics and integrity expected in their field. The cohesiveness of
the facility demonstrates how efficiently this team works together. My shadowing experience
gave me insight on how the field operates day to day.