For the past twelve weeks, I’ve had the pleasure of completing a clinical rotation at Children’s Specialized Hospital.
Before this blog gets rolling, I need to express how grateful I am for the opportunity to work at such an amazing organization with such awesome children (and families) under the guidance and mentorship of two remarkable physical therapists.
These past twelve weeks have been hectic, tiring and demanding. There were long nights, challenging treatments and many days where I felt beaten up and worn down. However, despite all that, I wouldn’t trade my experience for the world. I’ve been able to have a positive impact on so many children, I’ve met some incredible people and had plenty of rewarding moments. Above all, my time here at Children’s Specialized Hospital has helped me gain some valuable insight not only into the world of pediatric physical therapy, but life in general… did you expect anything else?
Without further ado, here’s what I learned and how it transcends physical therapy and applies to life in general. I hope that you can take something valuable away from the words that follow, or, at the very least, get a laugh at some of the situations that I found myself in.
Things Probably Won’t Go As Planned
Going into this clinical rotation, I’ve had hundreds of hours of clinical experience and I know that when dealing with humans, things don’t always go as planned. However, within the first hours of treating children, I realized that things won’t go as planned.
Much like treating infants, we have to learn that the picture-perfect plan that we conjure up in our minds probably isn’t going to be how it plays out in real life.
“Life is what happens to you while you’re busy making other plans.” – Allen Saunders.
Whether in pediatric physical therapy or in life, we have to be ready to accept the reality that life happens in spite of our plans. We have to be prepared to handle unexpected circumstances and do so with grace. We need to be able to go with the flow and adapt to obstacles, adversity and challenges as they present themselves.
Prepare For The Unexpected
Keeping with the theme of plans, let’s talk about preparation.
For those of you who know me, you know that I put in the work to things that I care about. I do everything in my power to be prepared and stay ahead of the game so that I never have to play ‘catch up’ because that’s a terrible feeling.
However, despite my best efforts, I felt as if I were in over my head since day one of this clinical rotation… and that feeling is something I haven’t experienced in a long time.
I quickly realized that I had two options:
1. I could throw up my hands, curl up into a ball and struggle through this twelve week rotation
2. I could accept the fact that this would be difficult, I could put my head down and I could do everything that I needed to do in order to be successful
While it might seem like a choice, it wasn’t.
For me, the first option didn’t truly exist. There is no way in this world that I was going to give anything less than my best effort for this clinical rotation. That’s how I approach all of my commitments and it’s not a hard approach to take when you realize that your actions impact others.
I knew that I could get through this clinical rotation either way. I could put in the work or I could slack and I would probably pass with both paths. However, I felt obligated to do my best.
I felt an obligation to myself to give my best effort because that’s who I am and that’s what I preach.
I felt an obligation to every single person who had ever given their best for me.
I felt (most of all) an obligation to give my best effort for the patients who I would have the opportunity to treat… I needed to give my best so that I could help them because they would be trusting me with their time, their vulnerability and their hope.
Every single morning, without exception, I got to the clinic an hour before the first patient to prepare my thoughts and plans for the day. Every single night, without exception, I spent time at home reflecting on the past day and preparing for the next. Overall, I sacrificed a lot of sleep and a lot of personal time for the sake of this clinical. I didn’t have to, but I felt obligated to. It wasn’t easy and I wouldn’t necessarily want to do it again (at least not before some much needed time off), but I don’t regret a thing.
“By failing to prepare, you are preparing to fail.” – Benjamin Franklin
“You cannot get through a single day without having an impact on the world around you. What you do makes a difference, and you have to decide what kind of difference you want to make.” – Jane Goodall
I put in the work and prepared so that I could be the best that I could be and I did it because it was my obligation: to me, the those who invested in me and to the people who I was serving.
I hope that this blog can serve as a reminder that you’ve got people counting on you… act accordingly.
Be Comfortable Being Uncomfortable
When it comes to outpatient physical therapy (with adults), crying is not the norm. Yes… you’ll get the occasional middle-aged man who balls his eye out with manual therapy after a total kneel replacement (it’s warranted), but, for the most part, it’s not common to see tears in the clinic.
With outpatient orthopedics being my background, man was I taken back. Between babies crying and toddlers screaming, I couldn’t even hear myself think. The first day of my clinical rotation I remember feeling overwhelmed and uncomfortable with the noise. I wasn’t quite sure how to handle the crying and screaming… quite frankly, I just wanted it to stop. In the first weeks of my clinical rotation I cut treatments short and gave up (prematurely) on tasks simply because the crying made me uncomfortable. I soon learned to differentiate crying (because something is hard) from crying (because something is wrong).
After enough time, the crying (because something is hard) became white noise. You realize that the tears aren’t because something is wrong, but because the infant is working hard and they don’t like it… you realize that the crying is an outward manifestation of discomfort, and you realize that it’s ok to work through some tears.
Much like infants in physical therapy, we (adults) need to work through some (tears) difficult things to get where we want to be.
It’s OK to be uncomfortable and sometimes it’s even OK to complain.
However, it’s time that we start embracing discomfort for what it is: an indication that we’re pushing our limits and struggling toward growth.
“Inaction breeds doubt and fear. Action breeds confidence and courage. If you want to conquer fear, do not sit home and think about it. Go out and get busy.” – Dale Carnegie
If we want to grow, we need to get comfortable with being uncomfortable.
Push your boundaries.
Go out and get after it.
It Takes A Village
I’ve heard it time and time again, but I never appreciated what it meant.
“It takes a village”
Let’s be honest, most adults don’t do their home exercises let alone children. In pediatric physical therapy, the children are still dependent on their parents and therefore, the family is so important for success.
In pediatric physical therapy, it’s all about teamwork.
Just like in pediatric physical therapy, in life, nobody can do it alone. We all need our team.
“Walk with the dreamers, the believers, the courageous, the cheerful, the planners, the doers, the successful people with their heads in the clouds and their feet on the ground.” Wilfred Peterson
Look for those who build you up and people who make you better.
Spend more time with these people and less time with the people who tear you down.
Find your people and build your team.
Just Out Of Reach
I had the pleasure of watching and helping multiple infants take their first steps (man that’s a great feeling).
One of the ways that physical therapists and parents will encourage children to take their first steps is to put something JUST out of reach in order to coax the child into stepping out of their comfort zone. With uncertainty coursing through their veins, the child’s hesitant movements express the very real dilemma that they face:
“I want this toy, but it’s a little too far away…. I need to take a step to get there… but I’ve never done that before… what if I fall?”
For some children, the dilemma lasts minutes and for others it lasts weeks. But in the end, they almost always take the step. They stretch their comfort zone for something they want (toy) and in the process, they risk falling down.
Fall after fall, they get back up and make another attempt. Eventually they stumble to the target and a smile ensues. Naturally, as pediatric physical therapists, we have them try again, this time with the toy even further out of reach (they don’t like this).
Before you know it, the child goes from taking one step to taking multiple steps to walking all alone. In the blink of an eye, they’re walking, running and climbing ups stairs…. And it all started with one step out of their comfort zone.
This is a lesson for all of us.
Maybe we’ll fall, but if we’re not willing to step out into faith for those things JUST out of reach, we’ll never get them and we’ll never grow.
“Those who wish to sing will always find a song.” – Celtic Proverb
Where there’s a will, there’s a way. Find something worth pursuing and don’t stop signing… you’ll find your song.
Be grateful for the opportunity.
In every physical therapy setting, you have the opportunity to change the course of a life, but nowhere does that idea become as tangible as pediatric physical therapy where the patients (infants and children) are at such a crucial time in their growth and development.
No matter how tired I was or how challenging the day, I was always able to smile at least once. I smiled because I was so grateful for the opportunity to help people who so desperately needed it.
When you work with children with such complex and serious “problems” and you see how happy they are despite their “issues,” you gain a new appreciation for what you have and what it means to be happy. Working in a pediatric setting helped me develop an attitude of gratitude for all that I have in my life.
“Enjoy the little things, for one day you may look back and realize they were the big things.” —Robert Brault
“Feeling gratitude and not expressing it is like wrapping a present and not giving it.” —William Arthur Ward
“Some people grumble that roses have thorns; I am grateful that thorns have roses.” —Alphonse Karr
If nothing else, I hope that this blog encourages you to take a second to pause. STOP and take time (even a few minutes) to think about what you’re grateful for. You’d be surprised to see how it can change your day and with some consistency, change your life.
You Will Never Know Unless You Try
There were times during this clinical rotation where I felt lost. I wasn’t sure what to try next and for a long time, I was afraid to push patients too far with consideration of their medical complexity. I quickly learned, that sometimes (especially in pediatric physical therapy) you just have to try something and see if it works.
As my clinical instructor explained to me; it could be an absolute train wreck but it could also work well... you never know until you try. Sometimes in life the same applies.
‘ “You miss 100% of the shots you don’t take” – Wayne Gretzky ’ – Michael Scott
If Michael Scott said it, it must be true.
Meet People Where They Are
If you know me, then you know that I’m all about pushing the limits of the human body and mind. As much as I love encouraging people to move past what they once thought possible, I was quickly and repeatedly reminded in the pediatric setting that not everybody is ready for that… especially children.
Time and time again, I saw potential in a patient and pushed them accordingly. Time and time again, I was let down to see children shut down, get discouraged and lose interest in the task. I needed the reminder that these children didn’t care about pushing their boundaries, growing and getting better… they just wanted to have fun.
I needed to adjust my approach to meet these kids where they were so that I could take them where they needed to be. In other words, I had to play games, make things fun and make things easier when they were more than the child was ready for. In the moment, this strategy felt like a step back, but in the end, it got the children to buy in. It helped them engage in therapy and as a result, they jumped forward and made progress towards their goals.
“Meet people where they are, not where you want them to be” – unknown
Whether with children or adults, in physical therapy or life in general, when you want to help someone, you’ve got to meet them where they are and so that you can take them to where they want to be.
Act Like A Role Model, Because You Are One
Being the ONLY male physical therapist across two facilities attracts a lot of attention from children… especially the ones who lack a positive male role model in their life.
Time and time again, I found that many of these children looked up to me for an example. The constant eyes watching my every move made me ever more aware that people are watching. Kids and adults alike look for examples. As human beings, we naturally like to imitate others whether we realize it or not. Speaking to what I talked about earlier with obligation… I was reminded every day that I had to obligation to always do my best and always do the right thing because I had kids who were looking up to me. I needed to be their Superman, not just on Halloween, but everyday.
“Be the person you needed when you were younger.”― Ayesha Siddiqi
Whether you realize it or not, there is somebody in this world who looks to you for an example. Choose to do the right thing and to set a good example so that person(s) is better off as a result.
Energy Is Contagious
Part of what makes pediatric physical therapy so difficult is the fact that you have to be on all of the time.
Kids are like sharks, they can smell blood in the water from miles away. They can sense when you’re not all there and when your energy and effort are lacking. When they know you’re not 100% then you’re in real trouble.
Whether in pediatric physical therapy or in life, people sense energy and energy affects those around you. We all have the ability to choose the energy we bring to any given situation and what I’ve learned from my clinical experience, is sometimes, you just need to muster up all the positive energy you’ve got and things will roll from there.
“Energy is contagious: either you affect people or you infect people.” – Anonymous
Remember that your attitude and your energy directly impact the people around you, positive or negative. If you want some positive results, bring the positive energy.
These past twelve weeks weren’t easy, and in the thick of it, it was sometimes hard to put my patented positive spin on things. However, now that I’ve reached the “end of the tunnel” so to speak, I couldn’t be more grateful for my experience and all that it taught me. As always, its quote time:
“It is easier to build strong children than to repair broken men.” – Frederick Douglass
Whether it’s children or adults, people are people and with everything we say and everything we do, we have the potential to build someone up or break someone down. No matter what our exteriors express, we all need encouragement.
Make the choice today to build others up with every step and every word.
Thank you again for reading and I’ll be back soon!
Joe Rinaldi, PT, DPT
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