Initial Entry (21/03/2010)

On the eve of the first day at my second 4th year clinical placement I feel nervous and a bit uneasy about what I’m about to face over the next 5 weeks. I do feel more relaxed than this time 6 weeks ago, which is probably due to my confidence still being pretty high following my previous placement, which I think is a good thing. My self-imposed nervous feelings are probably a bit of an overreaction to this being my neuro placement and being situated on a stroke ward because I found the 3rd year PHTY 314 neuro unit to be one of, if not the hardest of the course. My grade for this unit however wasn’t too bad, so I’m hoping that I won’t have as much trouble putting the theory of this unit into practice as I’m telling myself I will. From all accounts so far though, this seems to be a very enjoyable and beneficial placement, so I am really looking forward to getting the most out of it as I possibly can.

I expect that the nature of this placement will be similar to that of previous ones, but just with slightly inflated expectations of me because of it being a 4th year placement. I believe I will be expected to progress and grow as a therapist as each week passes and as my confidence and skills improve I will be expected to take on more responsibility and varied roles. I have heard that my facility is very realistic with its expectations of students and what they can successfully manage and I very much hope this is the case. In terms of structure, I expect to have a supervisor who I will be working in tandem with and as time goes by I will progressively have less and less supervision and guidance from my supervisor. I am hoping though, that my supervisor will initially take the time to introduce me to how the facility is run and how they go about their business, because I do know that each facility does things differently, so the earlier I can become familiar with this particular format the better and easier things will be for me. The facility information on blackboard has also been very beneficial in my preparation thus far and has informed me well as to the structure and expectations of me. For example, in week 1, I will be performing the “assessment of patients, subjective, objective and use of outcome measures –COVS, TUG, BERG Balance scale, Stroke Outcome measures,” followed by more treatment based objectives in my second week and then really focusing on “consolidation of independence in these areas,” by my third week. I realise that this has been provided more as a guide, but it is still very encouraging to see how well the facility appears to treat the students there on placement. On my role as a student, I expect that as time progresses I will be seen as less and less of a student there on placement and more and more as part of the team, which will also reflect my increasing degree of independence with my case load.

My overwhelming feeling right now though is that I am very nervous about going on a neuro prac, which is my main concern. As I mentioned previously, I found the neuro unit in third year quite challenging and despite reviewing all my resources from this and other units I still don’t feel confident that I know enough about this very complex area of physiotherapy work. Particularly neuroanatomy continues to puzzle me and I’m not sure if I have the capabilities to draw on the required knowledge at the appropriate time to be a really effective therapist in this field. I am hoping however, that with more exposure to this side of things, that it will become easier and make a bit more sense. My fingers are crossed about this one!

I also worry about my ability to handle a large case load under time restraints because on my previous placement this was one aspect I really identified as being something I need to improve. I am hoping that with issues such as this my supervisor will be able to offer strategies about aspects such as time management and patient prioritisation that will assist me to manage my case load on the ward. At this point in time, I definitely feel I need to become faster with my interactions with patients to increase my efficiency and effectiveness, but this should come with experience and exposure to different situations.

Another issue I have is that on my previous placements I have always been quite heavily supervised or had someone very nearby who was available to assist or provide suggestions whenever I felt I needed it. I’m not sure if I will have this ‘luxury’ so much on this placement as I expect to be much more independent, particularly in my final weeks than I have been previously. At this point in time, this is a concern for me because it will be up to me to control the situations that come my way and I just hope that I can handle it. The other way of looking at this though, is that it will be a good thing and will enable me to grow and develop my own methods and techniques of dealing with different scenarios to some extent, which as I said will be good for my development as a therapist. I will have to see how I feel about this one after the 5 weeks are up.

I am definitely a mixture of emotions at this point in time, I only hope that I can put these feelings aside and focus my energy to being an effective therapist and getting as much out of this placement as I can. I am sure I will learn plenty of new things over the 5 weeks and if I can enjoy myself as much as possible at the same time then that will be a bonus!