CHAPTER THREE What to expect when on placement
First days and first impressions
So you have done some preparation for your placement, you have found out what time you start and all the other small details and you turn up on your first day, then what happens?
The first day is often quite laid back and will let you suss out the environment you will be working in. You should be shown round the department and introduced to the physiotherapy team and any other people you will be working with. You should get information, where appropriate, regarding: bleep system, emergency telephone numbers, fire procedures/exits, departmental policies and procedures, profile and staffing structure (Chartered Society of Physiotherapy 2003). You might discuss your learning objectives, observe patient treatments or possibly assess a patient on your own.
Getting along with your clinical educator
Most people will get on really well with their Clinical Educators (CE). CEs usually choose to take on students and are therefore very willing to teach you and share their knowledge and experience.
Showing that you are enthusiastic about learning and interacting with the team and the patients will always go down well. Don’t be afraid to ask questions and admit it if you don’t know something, even when you’re a junior. They are there to help you and make you a better physiotherapist so take advantage of it. Bear in mind that it’s not unusual for your CE to ask you a question back to help you work out the answer yourself. Therefore, put a little bit of thought into your question first. If you really don’t know the answer, then mention that you will look it up that night, and then if you get asked again you’ll know the answer.
Also be aware of the variation between CEs when it comes to marking. There are variations between universities on the marking scheme as well. Try to gauge at the start what your CE expects of you. If you have any problems or don’t agree with their appraisal then try to resolve this with them as soon as possible, for example at a mid-way review. If the issue still isn’t resolved then your university should be able to provide the appropriate support.
What each environment is like
Every placement you complete will be very different and individual. The environment that you will be working in will vary across individual hospitals within the same Trust/Health Board and will vary between Trusts/Health Boards. The people that you work with and your CE will also have a significant impact on your working environment. Even the time of year can affect the number of patients needing care. It is, therefore, impossible to explain what every placement is going to involve but the sections below should help you get some sort of idea.
It is likely that you will be working alongside other health professionals as part of a multidisciplinary team (MDT) including nursing staff, health care assistants, specialist nurses, ward clerk, occupational therapist, speech therapist, podiatrist, dietician, social worker, ward doctors and consultants. The MDT may work closely with each other and have regular planned meetings or you may be expected to liaise with them as appropriate. Whatever the set up on your particular placement it is useful to know what role other members of the team have. You may also be involved with referring patients to other teams or services, for example, community rehabilitation or pain team, falls or osteoporosis service. Each hospital will vary in the services it offers; however, your CE should be able to inform you of what is available in your area.
To read more about the daily working experiences of physiotherapists log onto the Physio buddies blogs at www.physiobuddies.co.uk
Acute hospital environment
This might include placements in surgical or medical respiratory, orthopaedics, combined assessment or acute receiving unit and other regional specialties. The physiotherapy team that you will be part of may cover a number of wards depending on the set up of the hospital. This environment tends to be very fast paced and busy due to bed demand. Depending upon what year you are in and how many placements you have done you may be given a list of a few patients to see by yourself. The number of patients will be at the discretion of your CE and depend upon how they feel you are getting on in the placement.
Rehabilitation ward
This could be an elderly rehabilitation ward, stroke rehabilitation ward or spinal injuries ward for example. Within this environment the pace may be a bit slower depending on staffing levels and patient numbers. It’s likely that you will have a bit more time to spend with patients and will therefore see fewer patients during the course of a day than you would in a busy acute ward.
Community/domiciliary setting
Placements in the community are generally varied. It may involve seeing patients with neurological conditions, orthopaedic problems and elderly people with mobility problems. As a student you will always be with your CE, visiting people in their homes. The placement may also involve attending an orthopaedic clinic in the hospital for example. You can see anything from 4 to 12 patients a day, spending between 15 minutes and 1 hour with a patient.
It can be a very different experience from seeing patients in hospital as it is important to consider all aspects of the patient and address any psychosocial issues. This may involve liaising with GPs, nurses, occupational therapists and social workers. You also have to adapt your assessment and treatment to suit the patient in their home. Household tasks can be utilized as treatment to make rehabilitation more functional.
Related posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
