Getting Patient Buy-In When They Don’t Want Help

WEBVTT

00:00:00.726 --> 00:00:02.968
you're listening to the pg pinecast where

00:00:03.028 --> 00:00:05.089
smart people in healthcare come to make

00:00:05.149 --> 00:00:10.474
noise here's your host jimmy mckay want to

00:00:10.513 --> 00:00:12.435
say thanks to u.s physical therapy look

00:00:12.455 --> 00:00:14.156
you've built something meaning meaningful

00:00:14.176 --> 00:00:16.678
but scaling or planning what's next can

00:00:16.718 --> 00:00:18.260
sometimes feel overwhelming

00:00:19.001 --> 00:00:21.344
US Physical Therapy helps you grow while

00:00:21.364 --> 00:00:22.225
staying in control.

00:00:22.265 --> 00:00:24.367
Find out more at USPH.com.

00:00:24.407 --> 00:00:27.190
That's USPH.com.

00:00:27.289 --> 00:00:29.050
And if your EMR slows you down,

00:00:29.711 --> 00:00:31.873
Empower EMR gives you faster

00:00:31.914 --> 00:00:33.534
documentation, cleaner workflows,

00:00:34.036 --> 00:00:35.817
and support that actually responds.

00:00:35.878 --> 00:00:40.182
Find out more at EmpowerEMR.com.

00:00:40.521 --> 00:00:42.923
They know switching an EMR is never simple

00:00:43.084 --> 00:00:43.524
or easy.

00:00:44.304 --> 00:00:45.765
But kick the tires and see what you

00:00:45.805 --> 00:00:47.506
might be leaving out in terms of money

00:00:47.566 --> 00:00:48.106
or time.

00:00:48.186 --> 00:00:49.726
Both of those things are valuable if you

00:00:49.746 --> 00:00:50.228
run a clinic.

00:00:50.268 --> 00:00:53.149
Again, empoweremr.com.

00:00:53.548 --> 00:00:55.090
Today, well, here's the idea.

00:00:55.189 --> 00:00:56.929
Most physical therapists or healthcare

00:00:56.950 --> 00:00:59.631
providers in general are trained to help

00:00:59.670 --> 00:01:00.752
fix problems.

00:01:00.832 --> 00:01:03.152
But what happens when the patient you're

00:01:03.192 --> 00:01:06.293
working with doesn't even want your help?

00:01:06.713 --> 00:01:08.254
What are you supposed to do?

00:01:08.334 --> 00:01:10.335
In hospitals across the country right now,

00:01:11.188 --> 00:01:13.373
Clinicians are walking into rooms where

00:01:13.414 --> 00:01:16.319
patients are understandably tired,

00:01:16.560 --> 00:01:17.161
frustrated,

00:01:17.561 --> 00:01:19.406
and just counting the minutes until they

00:01:19.426 --> 00:01:20.287
get to go home.

00:01:20.768 --> 00:01:21.209
And yet...

00:01:22.072 --> 00:01:24.073
Clinicians are expected to motivate

00:01:24.114 --> 00:01:25.435
movement, build trust,

00:01:25.454 --> 00:01:28.117
and drive outcomes fast.

00:01:28.798 --> 00:01:30.698
Today's guest has spent years navigating

00:01:30.718 --> 00:01:31.739
that exact tension,

00:01:32.099 --> 00:01:34.802
figuring out what actually works when

00:01:34.882 --> 00:01:38.084
patients might be hesitant or resistant to

00:01:38.144 --> 00:01:38.364
care.

00:01:38.385 --> 00:01:39.286
What are you supposed to do then?

00:01:39.605 --> 00:01:42.207
From acute care floors to the classroom,

00:01:42.227 --> 00:01:45.170
he's developed a practical framework PTs

00:01:45.189 --> 00:01:46.751
can use immediately.

00:01:46.971 --> 00:01:48.591
Let's welcome to the show, Dr.

00:01:48.673 --> 00:01:49.393
Sidney Stoddard.

00:01:49.433 --> 00:01:50.493
Sid, welcome to the program, man.

00:01:51.254 --> 00:01:52.296
Hey, Jimmy, thanks for having me.

00:01:52.316 --> 00:01:53.635
I appreciate you bringing me on.

00:01:53.676 --> 00:01:56.137
Looking forward to our conversation today.

00:01:56.216 --> 00:01:56.456
Yeah.

00:01:56.557 --> 00:01:57.477
I mean, people are looking for,

00:01:57.498 --> 00:01:58.737
when I hear the word framework, I'm like,

00:01:58.897 --> 00:01:59.358
great.

00:01:59.478 --> 00:02:01.900
It's not rules telling me what to do,

00:02:02.000 --> 00:02:04.001
but it means that someone recognizes that,

00:02:04.120 --> 00:02:05.281
yeah, this is a problem.

00:02:05.361 --> 00:02:06.221
This is difficult.

00:02:06.262 --> 00:02:08.263
This is simple, but not easy.

00:02:22.391 --> 00:02:23.393
we need them to do.

00:02:23.712 --> 00:02:26.253
So we've got that paradigm to be able

00:02:26.274 --> 00:02:27.354
to motivate people.

00:02:27.514 --> 00:02:29.575
So let's start with a strong take.

00:02:30.076 --> 00:02:30.497
Hey, listen,

00:02:31.016 --> 00:02:32.277
no one wants to see a PT in

00:02:32.318 --> 00:02:33.038
the hospital.

00:02:34.019 --> 00:02:36.681
I did a rotation there and I recognize

00:02:36.741 --> 00:02:38.562
that this was not a small problem.

00:02:38.622 --> 00:02:41.103
This walked into the room before I did.

00:02:41.824 --> 00:02:42.843
Let's start with belief.

00:02:43.344 --> 00:02:44.885
What led you to that belief or what

00:02:44.925 --> 00:02:46.926
was your experience to say, hey,

00:02:47.806 --> 00:02:48.907
I got to figure out a way to

00:02:48.927 --> 00:02:50.209
get past this or overcome this?

00:02:51.194 --> 00:02:52.156
Yeah, I think, you know,

00:02:52.616 --> 00:02:54.356
in my time being in the hospital,

00:02:54.437 --> 00:02:56.218
it's one of those things where we're all

00:02:56.239 --> 00:02:58.520
going to encounter patients who maybe

00:02:58.561 --> 00:03:00.062
don't necessarily want to be there.

00:03:00.081 --> 00:03:01.223
And I think it's not even the hospital,

00:03:01.282 --> 00:03:02.783
it's the outpatient setting as well.

00:03:03.183 --> 00:03:03.364
You know,

00:03:03.383 --> 00:03:05.286
you're going to encounter somebody that is

00:03:05.466 --> 00:03:07.146
taking time out of their day if it's

00:03:07.167 --> 00:03:08.768
in the outpatient setting to come and fix

00:03:08.807 --> 00:03:10.310
a problem they didn't anticipate.

00:03:10.629 --> 00:03:11.651
And so we have to find a way

00:03:11.670 --> 00:03:12.450
to navigate that.

00:03:12.491 --> 00:03:13.252
And in the hospital,

00:03:13.491 --> 00:03:15.193
it's even worse in that they've been taken

00:03:15.252 --> 00:03:17.495
out of their typical routine and placed in

00:03:17.534 --> 00:03:19.796
a situation that breaks their habits.

00:03:21.018 --> 00:03:23.860
kind of puts them at the pace of

00:03:23.900 --> 00:03:25.700
how the hospital is moving versus how they

00:03:25.741 --> 00:03:26.360
want to move.

00:03:26.681 --> 00:03:27.981
And so there's obviously going to be some

00:03:28.002 --> 00:03:28.782
frustration there.

00:03:28.823 --> 00:03:30.584
And even some of the best hospitals in

00:03:30.604 --> 00:03:32.906
the nation still suffer from these types

00:03:32.945 --> 00:03:33.445
of problems.

00:03:33.485 --> 00:03:35.366
And so my personal experience has been

00:03:35.447 --> 00:03:36.407
just, you know,

00:03:36.448 --> 00:03:39.250
having worked during COVID in some

00:03:39.310 --> 00:03:40.430
critical care type settings,

00:03:40.469 --> 00:03:42.050
as well as some medical surgical settings,

00:03:42.611 --> 00:03:44.693
I had a lot of experiences where patients

00:03:44.772 --> 00:03:46.394
were, they couldn't have family members,

00:03:46.433 --> 00:03:47.835
they couldn't have,

00:03:48.174 --> 00:03:48.834
Visitors,

00:03:49.594 --> 00:03:50.875
they really were kind of cut off from

00:03:50.895 --> 00:03:51.975
the outside world, right?

00:03:52.015 --> 00:03:53.656
And really the only experiences they were

00:03:53.675 --> 00:03:54.956
getting were interacting with the

00:03:54.997 --> 00:03:55.956
healthcare providers,

00:03:56.397 --> 00:03:59.818
albeit in a very awkward and masked way.

00:04:00.158 --> 00:04:03.760
And so really what I started to develop

00:04:03.820 --> 00:04:05.701
is like, how do I recognize that like,

00:04:05.741 --> 00:04:07.021
yeah, this sucks, right?

00:04:07.042 --> 00:04:08.983
Like the patient doesn't want to be here.

00:04:09.282 --> 00:04:11.924
Like this is not their ideal situation,

00:04:12.024 --> 00:04:13.905
but I know how I can help them

00:04:14.004 --> 00:04:16.326
to get back to doing what they want

00:04:16.365 --> 00:04:17.687
to do, whether that's to go home,

00:04:18.250 --> 00:04:19.531
or whether that's in the outpatient

00:04:19.552 --> 00:04:21.033
setting to improve their function,

00:04:21.052 --> 00:04:22.735
whatever their functional limitations are.

00:04:23.115 --> 00:04:25.377
So I think really like the first thing

00:04:25.456 --> 00:04:27.077
I think about is like this idea of

00:04:27.117 --> 00:04:28.559
like embracing the suck, right?

00:04:28.639 --> 00:04:29.279
As PTs,

00:04:29.319 --> 00:04:31.862
we really need to focus on thinking about

00:04:32.341 --> 00:04:34.043
how, what we're doing.

00:04:35.124 --> 00:04:35.324
Yes,

00:04:35.363 --> 00:04:36.584
we have our goals in mind that we

00:04:36.605 --> 00:04:37.906
want to do, but at the same time,

00:04:37.966 --> 00:04:40.387
nobody that has a Foley catheter,

00:04:40.427 --> 00:04:41.988
three IV lines, you know,

00:04:42.048 --> 00:04:43.670
just recently got extubated is going to

00:04:43.690 --> 00:04:44.951
want to just get up and walk around.

00:04:44.971 --> 00:04:46.432
That's not on their to-do list today.

00:04:46.492 --> 00:04:46.593
Like,

00:04:47.235 --> 00:04:48.497
And so what we need to do is

00:04:48.536 --> 00:04:50.978
just recognize, hey, you know what?

00:04:51.379 --> 00:04:52.019
It does suck.

00:04:52.120 --> 00:04:53.440
I recognize that, you know,

00:04:53.461 --> 00:04:55.141
what you're going through is not the most

00:04:55.482 --> 00:04:56.502
entertaining thing in the world.

00:04:56.562 --> 00:04:59.064
It's not the most fun thing in the

00:04:59.105 --> 00:04:59.404
world.

00:04:59.485 --> 00:05:02.507
But all of our patients have goals, right?

00:05:02.526 --> 00:05:04.028
Like they all want to get back to

00:05:04.088 --> 00:05:04.649
doing something.

00:05:04.809 --> 00:05:05.410
In the hospital,

00:05:05.529 --> 00:05:07.190
most of the time they want to leave,

00:05:07.271 --> 00:05:07.550
right?

00:05:07.610 --> 00:05:09.091
And that's kind of like my second point

00:05:09.151 --> 00:05:11.233
is like they want to leverage, like,

00:05:11.704 --> 00:05:13.605
what they want when we're trying to get

00:05:13.625 --> 00:05:14.466
them to do things.

00:05:14.507 --> 00:05:16.028
So, and that's to leave the hospital.

00:05:16.127 --> 00:05:17.569
And we know a lot of different ways

00:05:17.730 --> 00:05:18.831
as physical therapists, right?

00:05:18.850 --> 00:05:19.932
We're movement experts.

00:05:20.271 --> 00:05:21.494
We know a lot of different ways that

00:05:21.533 --> 00:05:23.975
we can go about trying to help patients

00:05:23.995 --> 00:05:26.699
to improve their mobility in an effort to

00:05:26.718 --> 00:05:27.338
get them home.

00:05:27.379 --> 00:05:29.540
And I think if we can really kind

00:05:29.600 --> 00:05:30.622
of help them to understand,

00:05:30.642 --> 00:05:32.343
we recognize this is not an ideal

00:05:32.384 --> 00:05:34.966
situation for you to kind of embrace that

00:05:35.026 --> 00:05:35.226
suck.

00:05:35.642 --> 00:05:37.627
and then also start to leverage some of

00:05:37.648 --> 00:05:39.651
those, those goals that the patients have,

00:05:39.672 --> 00:05:40.795
which is to leave,

00:05:41.276 --> 00:05:42.939
we can really kind of make a breakthrough

00:05:42.959 --> 00:05:44.202
in that communication barrier that

00:05:44.242 --> 00:05:45.406
sometimes presents itself.

00:05:45.764 --> 00:05:46.305
Well, it sounds like,

00:05:46.326 --> 00:05:47.305
and we'll get into this sort of this

00:05:47.346 --> 00:05:48.466
six-step approach that you have,

00:05:48.487 --> 00:05:49.928
but it sounds like what you've already

00:05:49.968 --> 00:05:52.831
started to do is put yourself in their

00:05:52.870 --> 00:05:54.892
shoes or in their bed or where they

00:05:54.973 --> 00:05:55.954
are, right?

00:05:56.014 --> 00:05:57.975
You're starting to think like, gosh,

00:05:57.995 --> 00:05:59.596
before I walk in this room, man,

00:05:59.637 --> 00:06:01.317
what is this patient going through, right?

00:06:01.338 --> 00:06:03.160
Before I write down patient noncompliant,

00:06:03.180 --> 00:06:05.762
this person's likely in a hospital

00:06:05.781 --> 00:06:07.483
situation going through

00:06:08.310 --> 00:06:10.172
like one of the worst experiences of their

00:06:10.271 --> 00:06:11.291
life maybe, right?

00:06:11.333 --> 00:06:12.473
And not because of the care,

00:06:12.492 --> 00:06:13.593
but because of the reason that they're

00:06:13.634 --> 00:06:13.853
there.

00:06:14.153 --> 00:06:14.593
Number one,

00:06:14.634 --> 00:06:16.355
it sounds like you're trying to put

00:06:16.394 --> 00:06:17.995
yourself in their shoes or their,

00:06:18.315 --> 00:06:21.216
you know, no slip socks, building empathy,

00:06:21.538 --> 00:06:23.798
which is critical for improving or even

00:06:23.838 --> 00:06:25.899
beginning to improve engagement and

00:06:26.000 --> 00:06:26.500
outcomes.

00:06:27.019 --> 00:06:28.560
So that's sounds like step one,

00:06:28.600 --> 00:06:30.262
but where does your six step approach

00:06:30.541 --> 00:06:30.841
begin?

00:06:30.901 --> 00:06:32.023
Is that number one or is that even

00:06:32.043 --> 00:06:33.502
before the approach?

00:06:33.523 --> 00:06:34.644
So I think really like,

00:06:35.165 --> 00:06:35.985
from what I've seen,

00:06:36.045 --> 00:06:37.485
sometimes it's easy for physical

00:06:37.526 --> 00:06:39.247
therapists to forget that patients are

00:06:39.427 --> 00:06:40.187
people, right?

00:06:40.387 --> 00:06:42.369
Like sometimes we think of them as a

00:06:42.428 --> 00:06:42.668
number.

00:06:42.728 --> 00:06:43.930
I've heard you talk about it on this

00:06:43.949 --> 00:06:44.329
show.

00:06:44.389 --> 00:06:45.971
Like we sometimes get in this habit of

00:06:45.990 --> 00:06:48.031
like metrics driven and there's a time and

00:06:48.072 --> 00:06:49.612
place for that, not arguing that.

00:06:49.892 --> 00:06:51.072
But I think we kind of forget that

00:06:51.132 --> 00:06:53.194
main idea that like these are people that

00:06:53.213 --> 00:06:55.615
have been removed from whatever part of

00:06:55.656 --> 00:06:56.956
life they're going through at this time

00:06:56.995 --> 00:06:58.437
and placed in a situation that's less

00:06:58.516 --> 00:06:58.916
ideal.

00:06:59.297 --> 00:07:00.817
How I like to personally think about it

00:07:00.898 --> 00:07:01.538
is like, one,

00:07:01.639 --> 00:07:03.298
if I was in that patient's shoes,

00:07:03.399 --> 00:07:04.339
how would I feel right now?

00:07:05.057 --> 00:07:05.677
Or two,

00:07:05.858 --> 00:07:08.439
if I had a family member that was

00:07:08.478 --> 00:07:09.240
in this situation,

00:07:09.279 --> 00:07:11.100
how would I feel observing how I'm

00:07:11.161 --> 00:07:12.322
interacting with that patient?

00:07:12.762 --> 00:07:13.983
And so I think if we can do

00:07:14.023 --> 00:07:16.144
that before we even get into these six

00:07:16.165 --> 00:07:17.545
steps and just put ourselves in this

00:07:17.625 --> 00:07:20.406
mindset of like, I'm just going,

00:07:20.447 --> 00:07:21.567
I want to be treated how I would

00:07:21.588 --> 00:07:24.610
want to be treated or how I would

00:07:24.629 --> 00:07:25.310
want to be treated.

00:07:25.391 --> 00:07:28.033
I think that's like step point five,

00:07:28.072 --> 00:07:28.333
right?

00:07:28.773 --> 00:07:30.074
So I think that's an early,

00:07:30.194 --> 00:07:31.535
early starting point for sure.

00:07:32.300 --> 00:07:33.942
Yeah, that's the golden rule, right?

00:07:33.961 --> 00:07:36.423
Treat others and remembering this is a

00:07:36.483 --> 00:07:37.903
person, not a patient.

00:07:38.163 --> 00:07:39.845
It was hammered into us in PT school,

00:07:39.985 --> 00:07:40.264
right?

00:07:40.685 --> 00:07:41.625
But as soon as you saw it,

00:07:41.646 --> 00:07:43.646
the ICF model makes complete sense, right?

00:07:43.687 --> 00:07:45.728
Like the person should be at the center,

00:07:46.869 --> 00:07:48.129
which humanizes everything.

00:07:48.149 --> 00:07:50.610
That one scene from Patch Adams comes to

00:07:50.649 --> 00:07:51.050
mind.

00:07:51.091 --> 00:07:51.990
If you haven't seen it,

00:07:52.050 --> 00:07:53.291
like that's on my top ten.

00:07:53.312 --> 00:07:54.172
If you're going to go into healthcare,

00:07:54.192 --> 00:07:55.572
you need to watch Patch Adams,

00:07:55.653 --> 00:07:56.552
Robin Williams, and Champ.

00:07:57.233 --> 00:07:58.574
And they're asking all these questions

00:07:58.595 --> 00:07:59.754
about the condition, the condition,

00:07:59.795 --> 00:08:00.274
the condition.

00:08:00.334 --> 00:08:00.755
And of course...

00:08:01.596 --> 00:08:03.117
you can't even see robin williams he's in

00:08:03.156 --> 00:08:04.416
a group of doctors and he's what's the

00:08:04.456 --> 00:08:05.877
person's name they're like why would we

00:08:05.918 --> 00:08:07.517
want to know that it's like well it's

00:08:08.177 --> 00:08:10.980
kind of important man yeah and i think

00:08:11.000 --> 00:08:12.399
it's too easy you know we just get

00:08:12.420 --> 00:08:13.841
in the habit of like okay we have

00:08:13.860 --> 00:08:15.380
these eight patients we need to see or

00:08:15.420 --> 00:08:17.002
ten patients that we need to see and

00:08:17.021 --> 00:08:18.482
you just start looking through medical

00:08:18.541 --> 00:08:19.882
records and picking out who you want to

00:08:19.923 --> 00:08:21.583
see and you kind of lose track of

00:08:21.622 --> 00:08:24.244
that that that person that's behind all

00:08:24.283 --> 00:08:25.785
those charts and all those notes that

00:08:25.805 --> 00:08:27.745
you're reading and so i think you really

00:08:27.766 --> 00:08:29.225
need to kind of put yourselves back in

00:08:29.266 --> 00:08:30.947
those shoes whether you're a new therapist

00:08:31.416 --> 00:08:32.517
or an experienced therapist.

00:08:32.557 --> 00:08:34.177
I think we can all sometimes be reminded

00:08:34.197 --> 00:08:35.918
of the importance of remembering that.

00:08:36.219 --> 00:08:36.458
Yeah.

00:08:36.658 --> 00:08:36.938
All right.

00:08:36.958 --> 00:08:38.019
So hit me with the paradigm, man.

00:08:38.038 --> 00:08:39.179
I mean, you work in education too.

00:08:39.220 --> 00:08:40.440
I think this is vitally important.

00:08:40.700 --> 00:08:41.899
It's something to stick to.

00:08:42.221 --> 00:08:44.260
It's an approach, which means it's not,

00:08:44.640 --> 00:08:45.782
you have to do all six,

00:08:45.802 --> 00:08:46.101
but it's a,

00:08:46.501 --> 00:08:47.822
it's something to sort of follow and get

00:08:47.861 --> 00:08:48.282
good at.

00:08:49.082 --> 00:08:49.322
Yeah.

00:08:49.403 --> 00:08:50.663
And my goal, I think is not,

00:08:50.702 --> 00:08:52.183
this is not going to necessarily improve

00:08:52.203 --> 00:08:53.004
your clinical,

00:08:53.163 --> 00:08:55.205
your clinical skills from like a hands-on

00:08:55.245 --> 00:08:55.684
perspective.

00:08:55.725 --> 00:08:57.304
This is more from a communications

00:08:57.365 --> 00:08:57.846
perspective.

00:08:57.865 --> 00:08:58.346
And really like,

00:08:59.630 --> 00:08:59.890
You know,

00:09:00.371 --> 00:09:01.974
I haven't delved into the research behind

00:09:01.994 --> 00:09:02.394
any of this.

00:09:02.455 --> 00:09:03.836
I think this is just more what I've

00:09:03.875 --> 00:09:05.999
seen and what I've seen good therapists do

00:09:06.058 --> 00:09:06.318
well.

00:09:06.379 --> 00:09:07.541
And so I'd like to share that with

00:09:07.581 --> 00:09:07.941
everybody.

00:09:07.980 --> 00:09:09.823
It's really five steps and then like a

00:09:09.903 --> 00:09:12.005
six bonus step at the end that kind

00:09:12.025 --> 00:09:13.067
of ties this all together,

00:09:13.107 --> 00:09:14.188
no matter what setting you're working.

00:09:14.596 --> 00:09:16.538
So really that first step I was talking

00:09:16.557 --> 00:09:18.499
about is the idea of embracing the suck.

00:09:18.619 --> 00:09:20.779
Like we have to recognize that our

00:09:20.820 --> 00:09:23.541
patients are not going to be happy because

00:09:23.561 --> 00:09:25.121
they've just been poked and prodded all

00:09:25.162 --> 00:09:25.442
night.

00:09:25.822 --> 00:09:26.062
You know,

00:09:26.081 --> 00:09:27.923
they've been woken up every hour for blood

00:09:27.962 --> 00:09:28.283
draws,

00:09:28.323 --> 00:09:29.923
or they've been looking up every hour for

00:09:29.964 --> 00:09:30.565
vital signs.

00:09:30.585 --> 00:09:31.945
They haven't gotten a good night's sleep.

00:09:31.985 --> 00:09:33.485
The hospital bed's likely going to be

00:09:33.566 --> 00:09:34.566
uncomfortable for them.

00:09:34.907 --> 00:09:36.687
They may not be eating the same types

00:09:36.726 --> 00:09:38.268
of foods they typically like to eat at

00:09:38.307 --> 00:09:38.607
home.

00:09:38.989 --> 00:09:39.869
I think any of us,

00:09:39.908 --> 00:09:41.370
if we put ourselves in those shoes are

00:09:41.389 --> 00:09:42.070
going to realize like,

00:09:42.471 --> 00:09:43.712
this kind of sucks, right?

00:09:43.753 --> 00:09:44.653
Like we're, we, we,

00:09:44.793 --> 00:09:47.413
we don't want to necessarily be here.

00:09:47.673 --> 00:09:48.995
Now we may know that we need to

00:09:49.014 --> 00:09:50.535
be there because we have a medical issue,

00:09:50.556 --> 00:09:52.236
but that doesn't mean we necessarily want

00:09:52.277 --> 00:09:53.076
to be there.

00:09:53.397 --> 00:09:55.477
And so I think by embracing that suck

00:09:55.577 --> 00:09:57.278
and helping our patients to almost in a

00:09:57.418 --> 00:09:59.159
certain way, embrace that suck too,

00:09:59.539 --> 00:10:01.160
we can kind of get past that initial

00:10:01.201 --> 00:10:03.101
barrier where they might be a little bit

00:10:03.142 --> 00:10:04.542
disgruntled or they might be a little bit

00:10:04.581 --> 00:10:04.942
frustrated.

00:10:04.962 --> 00:10:06.543
It's like, okay, Hey, I get it.

00:10:06.822 --> 00:10:08.303
I understand why you're frustrated.

00:10:08.384 --> 00:10:10.105
I recognize that, you know,

00:10:10.623 --> 00:10:11.923
you're going through something that you

00:10:11.962 --> 00:10:12.844
didn't plan for.

00:10:13.063 --> 00:10:15.524
And now I'm potentially a barrier to you

00:10:15.563 --> 00:10:17.445
going home based on how you're moving

00:10:17.465 --> 00:10:17.865
around.

00:10:18.184 --> 00:10:19.605
And if we can help get past that

00:10:19.644 --> 00:10:20.085
a little bit,

00:10:20.164 --> 00:10:21.586
I think we can really start to tap

00:10:21.605 --> 00:10:23.625
into figuring out what the patient's wants

00:10:23.745 --> 00:10:24.505
and needs are,

00:10:24.865 --> 00:10:26.267
which I think is super important.

00:10:26.667 --> 00:10:29.827
And embrace the suck is, you know,

00:10:29.908 --> 00:10:31.268
sort of a line that I know David

00:10:31.307 --> 00:10:33.227
Goggins uses that he's a famous, you know,

00:10:33.307 --> 00:10:35.629
like motivational ex namey seal.

00:10:37.097 --> 00:10:38.259
can take it to the extreme,

00:10:38.278 --> 00:10:39.779
which I saw is sort of his thing.

00:10:39.820 --> 00:10:42.961
But what we've seen is people that can

00:10:43.282 --> 00:10:44.802
understand like, okay,

00:10:44.822 --> 00:10:45.583
I'm going to level with you.

00:10:45.844 --> 00:10:46.423
This sucks.

00:10:47.024 --> 00:10:47.684
But like,

00:10:47.804 --> 00:10:49.926
you've now just explained that you see

00:10:49.966 --> 00:10:50.567
where I am.

00:10:50.746 --> 00:10:51.506
People want to be seen,

00:10:51.606 --> 00:10:52.368
heard and understood.

00:10:52.788 --> 00:10:52.988
Right.

00:10:53.688 --> 00:10:53.908
You know,

00:10:54.649 --> 00:10:56.429
I now recognize what you're going through

00:10:56.450 --> 00:10:57.169
and I realize, hey,

00:10:57.210 --> 00:10:58.730
maybe I might be asking you something

00:10:58.769 --> 00:11:00.091
that's not ideal.

00:11:00.250 --> 00:11:01.471
If you have the choice between sitting

00:11:01.490 --> 00:11:03.172
still and doing nothing or doing what I'm

00:11:03.251 --> 00:11:04.011
asking you to do,

00:11:04.432 --> 00:11:05.952
I recognize that the thing I'm asking you

00:11:05.972 --> 00:11:07.952
to do, it's going to be even suckier.

00:11:08.493 --> 00:11:11.374
But the next step is it will lead

00:11:11.413 --> 00:11:13.414
to something you want even more.

00:11:13.475 --> 00:11:13.794
Yes.

00:11:13.855 --> 00:11:16.076
And I think that then gets into step

00:11:16.096 --> 00:11:17.596
two of this whole paradigm,

00:11:17.615 --> 00:11:19.216
which is leveraging what the patient

00:11:19.256 --> 00:11:19.836
really wants.

00:11:20.269 --> 00:11:21.110
You know, at the end of the day,

00:11:21.129 --> 00:11:22.289
sure, we as PTs,

00:11:22.330 --> 00:11:23.811
we have goals that we want to achieve

00:11:23.831 --> 00:11:24.370
for patients.

00:11:24.410 --> 00:11:25.311
We know, okay,

00:11:25.671 --> 00:11:27.172
we got to find out their home setup.

00:11:27.292 --> 00:11:28.471
We have to go ahead and then try

00:11:28.511 --> 00:11:29.892
to work on it if they have stairs,

00:11:29.932 --> 00:11:31.472
making sure they're safe to do the stairs,

00:11:31.513 --> 00:11:32.673
making sure they're safe to get around.

00:11:32.753 --> 00:11:33.052
Cool.

00:11:33.173 --> 00:11:34.633
Those are our goals.

00:11:34.952 --> 00:11:37.033
What about what the patient's goal is,

00:11:37.114 --> 00:11:38.933
which is typically to leave, right,

00:11:38.974 --> 00:11:39.875
as soon as possible.

00:11:39.894 --> 00:11:40.615
They want out.

00:11:40.975 --> 00:11:42.794
And so what can we do to try

00:11:42.835 --> 00:11:44.855
to leverage that a little bit and figure

00:11:44.895 --> 00:11:45.716
out what's going on?

00:11:46.229 --> 00:11:47.969
And so what I like to think about

00:11:48.089 --> 00:11:49.289
is asking my patients, like,

00:11:49.309 --> 00:11:50.370
what's the first thing you're going to do

00:11:50.389 --> 00:11:51.389
when you get out of the hospital?

00:11:53.130 --> 00:11:53.350
Sure,

00:11:53.370 --> 00:11:54.431
you're going to get discharged at some

00:11:54.451 --> 00:11:55.211
point, you're doing well,

00:11:55.250 --> 00:11:56.091
things are going well.

00:11:56.150 --> 00:11:56.951
So what do you want to do when

00:11:56.971 --> 00:11:57.971
you first get out of the hospital?

00:11:58.011 --> 00:11:59.011
And sometimes I'll hear,

00:11:59.032 --> 00:11:59.991
I want to take a shower.

00:12:00.452 --> 00:12:00.893
Great.

00:12:00.972 --> 00:12:01.153
Well,

00:12:01.173 --> 00:12:02.113
you know what you need to do if

00:12:02.153 --> 00:12:02.832
you take a shower?

00:12:02.852 --> 00:12:04.293
You need to be able to stand for

00:12:04.494 --> 00:12:05.134
five minutes.

00:12:05.354 --> 00:12:06.933
You need to have good static and dynamic

00:12:06.953 --> 00:12:07.333
balance.

00:12:07.394 --> 00:12:08.634
You need to be able to walk in

00:12:08.654 --> 00:12:09.375
and out of the shower,

00:12:09.394 --> 00:12:10.815
potentially get over a shower lip.

00:12:11.034 --> 00:12:12.836
Those are all functional things that we

00:12:12.875 --> 00:12:14.515
can work on in a acute care setting.

00:12:15.014 --> 00:12:16.575
that we can then relate back to that

00:12:16.615 --> 00:12:17.315
patient's goal.

00:12:17.335 --> 00:12:17.654
Like, hey,

00:12:17.715 --> 00:12:18.875
I want to help you take that shower

00:12:18.894 --> 00:12:19.456
when you get home.

00:12:19.495 --> 00:12:21.155
I want you to do well at getting

00:12:21.176 --> 00:12:22.057
in and out of that shower.

00:12:22.136 --> 00:12:23.317
I don't want you to fall into the

00:12:23.376 --> 00:12:24.498
back in here and then I have to

00:12:24.538 --> 00:12:25.158
see you again.

00:12:25.518 --> 00:12:25.677
Like,

00:12:25.717 --> 00:12:27.119
we want to get you home and ready

00:12:27.139 --> 00:12:27.538
to go.

00:12:27.619 --> 00:12:29.359
And so if we kind of can then

00:12:29.479 --> 00:12:32.461
take those patient goals and incorporate

00:12:32.480 --> 00:12:33.480
them into our treatment,

00:12:33.780 --> 00:12:35.642
I think that that's really how we can

00:12:35.682 --> 00:12:37.701
kind of improve that buy-in with patients.

00:12:37.741 --> 00:12:38.682
Because then, like you said,

00:12:38.702 --> 00:12:39.442
they feel heard.

00:12:40.102 --> 00:12:41.964
And then it also helps us to accomplish

00:12:41.984 --> 00:12:42.344
their goals.

00:12:42.364 --> 00:12:43.745
Because guess what I'm doing while I'm

00:12:43.804 --> 00:12:44.264
walking them

00:12:44.774 --> 00:12:45.556
you know, in the hallway,

00:12:45.596 --> 00:12:47.136
I'm talking about, Hey, how does it,

00:12:47.317 --> 00:12:48.857
how does it to get into your shower?

00:12:48.878 --> 00:12:50.278
Do we have to go around any turns?

00:12:50.318 --> 00:12:51.779
Is your bathroom on the second floor?

00:12:51.799 --> 00:12:52.519
Things like that.

00:12:52.879 --> 00:12:53.980
So I think if we can just kind

00:12:54.000 --> 00:12:55.881
of break past that barrier and figure out

00:12:56.022 --> 00:12:56.982
how do our goals,

00:12:57.863 --> 00:12:59.384
like design our goals to meet our

00:12:59.423 --> 00:13:00.105
patient's goals,

00:13:00.802 --> 00:13:01.802
we'll be able to get them to buy

00:13:01.822 --> 00:13:02.844
in a lot more to what we're trying

00:13:02.864 --> 00:13:03.823
to do with them that day.

00:13:03.844 --> 00:13:04.043
Yeah.

00:13:04.163 --> 00:13:04.283
Yeah.

00:13:04.323 --> 00:13:05.244
If content is king,

00:13:05.283 --> 00:13:07.544
context is queen and putting those things

00:13:07.625 --> 00:13:09.505
in context to make your,

00:13:09.765 --> 00:13:11.625
the things you're asking them to do in

00:13:11.645 --> 00:13:13.787
the suck aligned to what they want to

00:13:13.826 --> 00:13:15.327
do when they're out of this.

00:13:15.528 --> 00:13:16.148
That's the fastest.

00:13:16.227 --> 00:13:17.168
It's the only way through, uh,

00:13:17.187 --> 00:13:18.148
through the suck is through.

00:13:18.688 --> 00:13:19.609
There's no around.

00:13:20.239 --> 00:13:21.058
Yes, you're here now.

00:13:21.119 --> 00:13:22.259
You're going to go through it, right?

00:13:22.899 --> 00:13:23.921
So how do we get you out of

00:13:23.941 --> 00:13:25.561
this as quickly but as safely as we

00:13:25.600 --> 00:13:27.402
possibly can and get you back to doing

00:13:27.442 --> 00:13:28.682
what it is that you want to do,

00:13:28.701 --> 00:13:31.323
which is live your life without whatever

00:13:31.364 --> 00:13:33.163
medical condition brought you in here or

00:13:33.244 --> 00:13:34.924
with that being as managed as well as

00:13:34.945 --> 00:13:36.066
we can?

00:13:36.105 --> 00:13:37.365
And I think the other thing is, too,

00:13:37.686 --> 00:13:39.767
too often you have patients being like,

00:13:39.807 --> 00:13:40.047
oh,

00:13:40.086 --> 00:13:41.268
I'll be fine when I go home or

00:13:41.307 --> 00:13:41.628
whatever.

00:13:41.668 --> 00:13:42.067
It's like, well,

00:13:42.087 --> 00:13:43.469
tell me what you usually do during the

00:13:43.509 --> 00:13:43.749
day.

00:13:43.808 --> 00:13:44.009
Well,

00:13:44.109 --> 00:13:46.190
I walk from the kitchen to my living

00:13:46.210 --> 00:13:46.330
room.

00:13:46.350 --> 00:13:47.549
And then I like to watch TV.

00:13:47.590 --> 00:13:48.530
But then I'll have to get up and

00:13:48.610 --> 00:13:49.291
use the restroom

00:13:49.855 --> 00:13:50.635
things like that.

00:13:50.655 --> 00:13:52.015
So, okay, well, guess what?

00:13:52.376 --> 00:13:53.957
If I'm the only thing standing between you

00:13:53.998 --> 00:13:54.778
and getting out of here,

00:13:54.817 --> 00:13:55.818
and the doctor said, hey,

00:13:56.239 --> 00:13:58.240
until PT sees you, we can't discharge you,

00:13:58.360 --> 00:14:00.501
and now they're just waiting for me,

00:14:00.841 --> 00:14:02.383
and then I show up, and they're like,

00:14:02.403 --> 00:14:02.543
hey,

00:14:02.604 --> 00:14:03.423
I need you to get me out of

00:14:03.464 --> 00:14:04.404
here ASAP, great.

00:14:04.485 --> 00:14:04.625
Well,

00:14:04.644 --> 00:14:05.885
then show me you can walk a hundred

00:14:05.905 --> 00:14:07.447
fifty feet without falling over.

00:14:07.486 --> 00:14:09.368
Show me that you're safe with navigating a

00:14:09.408 --> 00:14:11.710
carpet or an uneven surface.

00:14:12.009 --> 00:14:13.490
Show me how you navigate your kitchen,

00:14:13.530 --> 00:14:14.951
which has a big island in the middle

00:14:14.971 --> 00:14:15.932
of the room that you have to use

00:14:15.952 --> 00:14:16.613
your walker around.

00:14:17.113 --> 00:14:18.173
So I think if you kind of lay

00:14:18.214 --> 00:14:19.073
those things out, like, Hey,

00:14:19.094 --> 00:14:20.575
this is how you get out of here

00:14:20.615 --> 00:14:23.096
that I'm happy to provide my safety

00:14:23.155 --> 00:14:25.057
recommendation based on seeing what you

00:14:25.096 --> 00:14:25.537
can do.

00:14:25.836 --> 00:14:27.337
Your patients are usually going to be much

00:14:27.398 --> 00:14:28.418
more willing to do that.

00:14:28.498 --> 00:14:29.538
And I found that they'll, you know,

00:14:29.558 --> 00:14:30.820
they'll start throwing the covers off.

00:14:30.840 --> 00:14:31.899
They're ready to jump right out of the

00:14:31.960 --> 00:14:33.140
bed because they're like, great.

00:14:33.561 --> 00:14:34.660
I can go home now if I just

00:14:34.701 --> 00:14:36.341
do these four or five things.

00:14:36.442 --> 00:14:37.942
So I think that's super important,

00:14:38.003 --> 00:14:39.823
especially in the acute care setting to

00:14:39.884 --> 00:14:41.384
think about that as we go through it.

00:14:41.424 --> 00:14:41.565
Yeah.

00:14:41.585 --> 00:14:42.164
All right.

00:14:42.205 --> 00:14:42.945
What's up next on your,

00:14:43.065 --> 00:14:43.745
on your six pack.

00:14:44.346 --> 00:14:46.427
So next I got, so I, you know,

00:14:47.014 --> 00:14:47.774
I'm sure everybody,

00:14:47.833 --> 00:14:48.573
or maybe not everybody,

00:14:48.594 --> 00:14:50.394
I'm sure most people have seen Shrek,

00:14:50.455 --> 00:14:50.715
right?

00:14:50.754 --> 00:14:51.154
So like,

00:14:51.195 --> 00:14:52.654
I always say patients are like onions,

00:14:52.674 --> 00:14:54.335
they have layers, right?

00:14:54.394 --> 00:14:56.475
So too often, I mean, how many times,

00:14:56.495 --> 00:14:56.716
you know,

00:14:56.735 --> 00:14:58.176
you said you did a clinical rotation.

00:14:58.235 --> 00:14:59.216
Do we, you know,

00:14:59.557 --> 00:15:00.976
always go talk to our nurse partners

00:15:01.017 --> 00:15:01.277
first?

00:15:01.317 --> 00:15:02.496
Hey, I want to see, you know,

00:15:02.636 --> 00:15:03.797
bed two, three, four,

00:15:04.197 --> 00:15:05.197
how are they doing today?

00:15:05.278 --> 00:15:06.937
And you get the, oh,

00:15:07.317 --> 00:15:08.158
you're going to go see them.

00:15:08.258 --> 00:15:08.677
Okay.

00:15:08.697 --> 00:15:09.438
Good luck with that.

00:15:09.958 --> 00:15:11.078
And you're like, well, what's going on?

00:15:11.099 --> 00:15:12.719
It's like, well, they're super frustrated.

00:15:12.759 --> 00:15:13.999
They're super agitated.

00:15:14.038 --> 00:15:14.860
You know, they don't, you know,

00:15:14.879 --> 00:15:16.080
they're very grumpy right now.

00:15:16.100 --> 00:15:16.779
It's like, okay, well,

00:15:17.557 --> 00:15:17.996
That's fine,

00:15:18.037 --> 00:15:18.918
but I still got to see him.

00:15:18.998 --> 00:15:20.818
So how do I break through that in

00:15:20.899 --> 00:15:22.499
order to try to still get the patient

00:15:22.519 --> 00:15:24.340
to participate in therapy at a level that

00:15:24.360 --> 00:15:26.682
will be beneficial to them and also helps

00:15:26.741 --> 00:15:28.883
me achieve my goals of trying to determine

00:15:28.903 --> 00:15:30.342
whether they're safe to go home or not.

00:15:30.803 --> 00:15:32.323
And so I think about like the onions,

00:15:32.364 --> 00:15:33.585
like you got to peel off that first

00:15:33.625 --> 00:15:34.144
layer, right?

00:15:34.785 --> 00:15:36.326
You're cooking, you go, you buy an onion.

00:15:36.365 --> 00:15:36.927
When you get it home,

00:15:36.966 --> 00:15:38.346
it doesn't look very appetizing, right?

00:15:38.366 --> 00:15:40.447
It's got all those scrunchy layers on the

00:15:40.567 --> 00:15:42.288
outside, maybe a bruise or so.

00:15:42.369 --> 00:15:43.370
And then you cut it and you start

00:15:43.389 --> 00:15:44.610
to peel it and suddenly it looks like

00:15:44.629 --> 00:15:45.650
a good onion, right?

00:15:46.057 --> 00:15:47.479
And so our patients are the same way.

00:15:47.818 --> 00:15:49.178
I like to say like, well,

00:15:49.198 --> 00:15:49.759
what's going on?

00:15:49.798 --> 00:15:51.460
Why, like, you know, why are you upset?

00:15:51.539 --> 00:15:52.460
Or why are you,

00:15:52.721 --> 00:15:53.921
why are you angry right now?

00:15:54.020 --> 00:15:54.581
And, you know,

00:15:54.841 --> 00:15:56.981
they'll usually tell you because one,

00:15:57.162 --> 00:15:58.442
you're the first person to ask them that.

00:15:59.623 --> 00:16:01.203
And two, you know, they're,

00:16:01.303 --> 00:16:02.803
they're happy to share their complaints

00:16:02.823 --> 00:16:03.164
with you.

00:16:03.205 --> 00:16:04.764
And it might be something like, well,

00:16:04.945 --> 00:16:05.325
you know,

00:16:05.565 --> 00:16:07.105
I came in here because I fell and

00:16:07.145 --> 00:16:08.687
now I had to use the bedpan all

00:16:08.746 --> 00:16:08.986
night.

00:16:09.147 --> 00:16:10.427
And I just, you know,

00:16:10.506 --> 00:16:11.187
I can't stand that.

00:16:11.288 --> 00:16:12.687
I was walking to the bathroom at home.

00:16:13.187 --> 00:16:13.788
No problem.

00:16:14.089 --> 00:16:14.969
All I did was trip.

00:16:15.559 --> 00:16:16.421
You know, and now I'm in here,

00:16:16.441 --> 00:16:17.381
I can't even use the bathroom.

00:16:17.422 --> 00:16:18.182
It's like, well, great.

00:16:18.442 --> 00:16:20.044
You know what was on my agenda today?

00:16:20.264 --> 00:16:21.546
I wanted to try to do the stairs.

00:16:21.586 --> 00:16:22.106
However,

00:16:22.407 --> 00:16:23.168
you know what we could do on the

00:16:23.207 --> 00:16:23.828
way to the stairs?

00:16:23.849 --> 00:16:25.289
Why don't we swing by the bathroom and

00:16:25.309 --> 00:16:26.751
I'll make sure that you're safe with doing

00:16:26.772 --> 00:16:26.991
that.

00:16:27.412 --> 00:16:29.615
And then you kind of almost use what

00:16:29.654 --> 00:16:31.817
those concerns or those complaints were.

00:16:32.255 --> 00:16:34.096
in order to kind of help achieve your

00:16:34.116 --> 00:16:35.778
goals while also making the patient happy

00:16:35.798 --> 00:16:36.018
too.

00:16:36.337 --> 00:16:37.097
Because chances are,

00:16:37.118 --> 00:16:38.058
they're going to be willing to get out

00:16:38.078 --> 00:16:39.499
of that bed then and go use the

00:16:39.538 --> 00:16:39.918
restroom.

00:16:39.940 --> 00:16:41.240
And then while you're up, once they're up,

00:16:41.320 --> 00:16:42.801
chances are you could redirect them over

00:16:42.821 --> 00:16:44.721
to the stairs and achieve your goal as

00:16:44.761 --> 00:16:45.961
well for the treatment session.

00:16:46.042 --> 00:16:47.903
Yeah, I love the onion analogy.

00:16:47.942 --> 00:16:49.624
Number one, great Shrek reference.

00:16:49.724 --> 00:16:53.184
Number two, the whole journey,

00:16:53.225 --> 00:16:54.645
like there's nothing in the middle.

00:16:54.946 --> 00:16:56.226
There's no pit to get to.

00:16:57.027 --> 00:16:58.967
The purpose of an onion is the entire

00:16:59.048 --> 00:17:00.208
onion and it's layered.

00:17:00.869 --> 00:17:02.971
And I also like, so the purpose,

00:17:03.010 --> 00:17:04.570
the journey is the destination, right?

00:17:04.590 --> 00:17:06.491
It is about the peeling, right?

00:17:06.913 --> 00:17:08.292
The other thing I like is if you

00:17:08.333 --> 00:17:09.433
try to skip steps,

00:17:09.453 --> 00:17:10.674
if you try to just cut your way

00:17:10.694 --> 00:17:11.734
to the middle of the onion,

00:17:12.316 --> 00:17:13.355
that's when you start to cry.

00:17:13.455 --> 00:17:14.136
Like it doesn't,

00:17:14.836 --> 00:17:17.417
going faster doesn't necessarily work.

00:17:17.478 --> 00:17:19.199
In fact, it probably hurts.

00:17:19.640 --> 00:17:21.701
So looking at conversations or

00:17:21.740 --> 00:17:23.382
interactions like this, like an onion,

00:17:24.122 --> 00:17:26.303
is that you know chef's kiss you know

00:17:26.403 --> 00:17:28.184
no notes on that analogy it's perfect it

00:17:28.224 --> 00:17:31.747
fits yeah i think too like what i

00:17:31.787 --> 00:17:33.728
found most times is that like grumpy

00:17:33.887 --> 00:17:35.749
patient that everybody oh that's that he's

00:17:35.890 --> 00:17:37.651
you know disgruntled or he's grumpy well

00:17:37.671 --> 00:17:39.311
chances are once you just talk to him

00:17:39.471 --> 00:17:40.952
and maybe address some of those basic

00:17:40.992 --> 00:17:42.394
needs that he's looking to get addressed

00:17:42.413 --> 00:17:44.234
or she's looking to get addressed chances

00:17:44.295 --> 00:17:45.915
are you take off those couple external

00:17:45.955 --> 00:17:47.836
layers it's perfectly a good onion right

00:17:48.096 --> 00:17:49.097
so you know i think

00:17:49.433 --> 00:17:50.535
as much as we don't want to compare

00:17:50.555 --> 00:17:51.634
our patients to food, you know,

00:17:51.694 --> 00:17:52.556
I think it's, like you said,

00:17:52.596 --> 00:17:54.537
a good analogy because chances are,

00:17:54.557 --> 00:17:55.477
they're going to end up being just a

00:17:55.517 --> 00:17:56.917
normal person underneath and all that.

00:17:56.938 --> 00:17:58.278
And they're just in a situation they

00:17:58.298 --> 00:17:59.278
didn't plan to be in.

00:17:59.679 --> 00:18:02.280
They're in a setting that maybe is not

00:18:02.320 --> 00:18:03.901
conducive to how they'd like to live their

00:18:03.941 --> 00:18:05.961
typical lifestyle on a day-to-day basis.

00:18:06.383 --> 00:18:07.863
And so if you can just navigate that

00:18:07.883 --> 00:18:08.324
a little bit,

00:18:08.364 --> 00:18:09.763
you might have some good success in

00:18:09.784 --> 00:18:10.845
getting them to, to,

00:18:11.164 --> 00:18:13.506
to meet your goals and also meet their

00:18:13.546 --> 00:18:14.047
goals too.

00:18:14.067 --> 00:18:15.467
It's all about the onions.

00:18:15.487 --> 00:18:16.647
We're all layers.

00:18:16.667 --> 00:18:16.887
All right.

00:18:16.907 --> 00:18:17.929
What's up next on the list.

00:18:17.949 --> 00:18:18.489
What's number four.

00:18:19.186 --> 00:18:20.449
So this kind of gets a little bit

00:18:20.489 --> 00:18:21.711
into what I was talking about earlier,

00:18:21.731 --> 00:18:23.334
but it's like the why behind the walls,

00:18:23.414 --> 00:18:23.734
right?

00:18:23.755 --> 00:18:25.317
So figuring out like what,

00:18:25.722 --> 00:18:26.663
are the patient's goals.

00:18:26.682 --> 00:18:27.864
And I talked a little bit about how

00:18:28.064 --> 00:18:28.884
asking them, like,

00:18:28.923 --> 00:18:30.204
what is your goal when you get out

00:18:30.265 --> 00:18:31.045
of the hospital?

00:18:31.065 --> 00:18:31.986
What do you want to do there?

00:18:32.086 --> 00:18:33.707
I think it's also looking at like, well,

00:18:33.727 --> 00:18:35.607
what do you typically do outside of the

00:18:35.647 --> 00:18:36.087
hospital?

00:18:36.127 --> 00:18:37.387
Besides, you know,

00:18:37.428 --> 00:18:38.328
we tend to look at it from a

00:18:38.388 --> 00:18:39.769
home setup standpoint, right?

00:18:39.788 --> 00:18:41.230
But most of our patients aren't just

00:18:41.329 --> 00:18:41.990
living in a home.

00:18:42.009 --> 00:18:43.530
They're going out into the community.

00:18:44.951 --> 00:18:45.771
They're moving around.

00:18:45.791 --> 00:18:47.073
They're engaging in different things.

00:18:47.093 --> 00:18:48.772
You know, I'm down in Savannah, Georgia.

00:18:48.813 --> 00:18:49.854
We have a very active

00:18:50.233 --> 00:18:52.515
retired population up in Hilton Head and

00:18:52.615 --> 00:18:54.335
they're very active individuals.

00:18:54.355 --> 00:18:56.256
They spend very little time in their home.

00:18:56.675 --> 00:18:58.935
And so what I found is that you

00:18:58.976 --> 00:19:00.416
need to find out exactly what they're

00:19:00.436 --> 00:19:00.757
doing,

00:19:00.797 --> 00:19:02.237
because if they're going out on the golf

00:19:02.257 --> 00:19:02.576
course,

00:19:02.616 --> 00:19:03.696
they need to be able to walk on

00:19:03.777 --> 00:19:04.637
uneven surfaces,

00:19:04.778 --> 00:19:06.157
even if they're using a golf cart.

00:19:06.337 --> 00:19:08.159
And so I wouldn't know that unless I

00:19:08.318 --> 00:19:09.219
asked them, like,

00:19:09.358 --> 00:19:11.358
what are you doing outside of just your

00:19:11.398 --> 00:19:13.579
house or outside of these hospital walls?

00:19:13.955 --> 00:19:15.958
So understanding how we could then tie

00:19:15.978 --> 00:19:17.920
that into what we're trying to accomplish

00:19:17.940 --> 00:19:18.941
in the acute care setting,

00:19:19.280 --> 00:19:21.022
I think is gonna be critical to getting

00:19:21.042 --> 00:19:22.163
them to buy into things.

00:19:22.183 --> 00:19:24.625
So we use the shower example earlier.

00:19:25.086 --> 00:19:25.487
However,

00:19:25.547 --> 00:19:27.648
I think like more of a recreational

00:19:27.689 --> 00:19:29.529
activity like golf or pickleball or

00:19:29.569 --> 00:19:30.951
something like that is another great

00:19:30.991 --> 00:19:33.253
example of how we can get patients to

00:19:33.314 --> 00:19:34.734
buy into what we're trying to do.

00:19:35.576 --> 00:19:36.817
If you find out somebody is a golfer,

00:19:36.836 --> 00:19:38.238
you could easily start to use golf

00:19:38.278 --> 00:19:39.920
analogies or talk about,

00:19:40.923 --> 00:19:42.625
i've even just had conversations with them

00:19:42.805 --> 00:19:44.626
about golf to take their mind off of

00:19:44.646 --> 00:19:46.087
what we're actually doing from a

00:19:46.147 --> 00:19:48.029
functional standpoint and it tends to

00:19:48.049 --> 00:19:50.551
distract them yeah chris voss who's

00:19:50.592 --> 00:19:51.833
somebody i reference a lot he wrote a

00:19:51.873 --> 00:19:53.515
book about negotiation he was a hostage

00:19:53.555 --> 00:19:55.557
negotiator i'm not saying that this is a

00:19:55.636 --> 00:19:58.419
hostage situation but he framed he frames

00:19:58.459 --> 00:20:00.761
it as every conversation is a negotiation

00:20:00.801 --> 00:20:03.644
for information so before i ever ask you

00:20:03.663 --> 00:20:04.305
to do anything

00:20:05.442 --> 00:20:06.262
I want to know who you are,

00:20:06.702 --> 00:20:08.163
what's preventing you from maybe

00:20:08.203 --> 00:20:09.265
preventing you from doing that thing.

00:20:09.285 --> 00:20:10.144
Do you want to do that thing?

00:20:10.164 --> 00:20:11.086
Do you know how to do that thing?

00:20:11.465 --> 00:20:12.606
Why don't you want to do that thing?

00:20:12.906 --> 00:20:13.607
Who am I?

00:20:14.208 --> 00:20:14.688
Who am I?

00:20:14.768 --> 00:20:15.969
Why am I asking you to do that

00:20:16.009 --> 00:20:16.229
thing?

00:20:16.650 --> 00:20:18.230
And these are all simple things to do,

00:20:18.250 --> 00:20:19.632
but not necessarily easy.

00:20:19.692 --> 00:20:22.153
But if you're moving humans or asking

00:20:22.192 --> 00:20:23.993
humans to move or do something,

00:20:26.096 --> 00:20:27.076
it's typically not.

00:20:27.156 --> 00:20:28.978
Bribing only works if you got a bag

00:20:29.018 --> 00:20:30.179
of candy and a seven-year-old.

00:20:30.199 --> 00:20:30.659
You know what I mean?

00:20:30.699 --> 00:20:30.858
Like,

00:20:31.278 --> 00:20:32.480
bribing is only going to get you so

00:20:32.519 --> 00:20:32.880
far.

00:20:33.260 --> 00:20:35.142
So these are communication skills.

00:20:36.221 --> 00:20:36.321
Yeah.

00:20:36.342 --> 00:20:37.623
And I think if you think about like

00:20:37.742 --> 00:20:38.383
even, you know,

00:20:38.403 --> 00:20:39.683
a non-hospitalized patient,

00:20:39.723 --> 00:20:40.364
just like you said,

00:20:40.384 --> 00:20:41.804
when we're going about our day to day,

00:20:41.844 --> 00:20:43.244
we're going to be much more engaged in

00:20:43.305 --> 00:20:45.266
something that we understand why we need

00:20:45.286 --> 00:20:47.086
to be engaged in that situation.

00:20:47.487 --> 00:20:48.727
You know, so like, for example,

00:20:49.047 --> 00:20:51.468
if I'm driving my car, you know,

00:20:51.587 --> 00:20:53.249
I know that if I start trying to

00:20:53.288 --> 00:20:54.429
text or something like that,

00:20:54.608 --> 00:20:56.430
I'm going to have an issue where I'm

00:20:56.450 --> 00:20:57.349
not going to be paying attention to the

00:20:57.369 --> 00:20:58.570
road and something bad could happen.

00:20:58.590 --> 00:20:59.810
And so by understanding that,

00:20:59.871 --> 00:21:01.172
why it gives me a reason not to

00:21:01.211 --> 00:21:01.571
do it.

00:21:01.652 --> 00:21:03.112
It's the same situation, I think,

00:21:03.152 --> 00:21:04.512
in the health care environment where,

00:21:05.054 --> 00:21:07.296
If you can help a patient understand why

00:21:07.435 --> 00:21:09.198
participating in whatever activities

00:21:09.218 --> 00:21:10.459
you're trying to get them to do will

00:21:10.499 --> 00:21:12.441
lead to an outcome that matches what they

00:21:12.480 --> 00:21:13.061
want to do.

00:21:13.481 --> 00:21:14.844
You're automatically going to have better

00:21:14.884 --> 00:21:16.325
buy in because they're going to understand

00:21:16.345 --> 00:21:17.806
that why they're going to see how that

00:21:17.967 --> 00:21:20.568
step A gets to step B to that

00:21:20.808 --> 00:21:21.390
in between.

00:21:21.549 --> 00:21:23.451
And that's that's I think where I've seen

00:21:23.471 --> 00:21:24.071
a lot of people.

00:21:24.092 --> 00:21:25.032
I don't want to say struggle,

00:21:25.053 --> 00:21:26.654
but like they lose that concept.

00:21:27.164 --> 00:21:28.964
And I think when you lose that concept,

00:21:29.005 --> 00:21:30.306
that's when you start just saying, well,

00:21:30.326 --> 00:21:31.945
get on the stairs or we're going to

00:21:31.965 --> 00:21:32.625
go for, you know,

00:21:32.645 --> 00:21:33.905
take a walk around the hallway.

00:21:34.105 --> 00:21:34.826
And the patient's like, well,

00:21:34.886 --> 00:21:35.747
why do I have to do that?

00:21:35.906 --> 00:21:37.166
I haven't gotten all sleep all night.

00:21:37.527 --> 00:21:39.208
So if you don't give them that why,

00:21:39.288 --> 00:21:40.367
it's not going to work out for you.

00:21:40.728 --> 00:21:40.928
Right.

00:21:40.988 --> 00:21:43.508
And all these things are, they're,

00:21:43.627 --> 00:21:45.009
they're, they're not perfect, right?

00:21:45.048 --> 00:21:47.009
Doing these things is not a hundred

00:21:47.048 --> 00:21:48.169
percent of the time going to lead to

00:21:48.229 --> 00:21:48.730
success.

00:21:49.730 --> 00:21:51.069
But I think, you know, I put,

00:21:51.250 --> 00:21:51.690
you know,

00:21:51.710 --> 00:21:52.930
at least start in the inning on second

00:21:52.950 --> 00:21:53.250
base.

00:21:53.269 --> 00:21:53.691
You know what I mean?

00:21:53.730 --> 00:21:55.151
Like you get, you get a better chance.

00:21:56.218 --> 00:21:58.159
of success when you're understanding this

00:21:58.618 --> 00:21:59.199
process.

00:21:59.618 --> 00:22:00.519
All right, so we got two more.

00:22:00.759 --> 00:22:02.019
What's next on your list?

00:22:02.500 --> 00:22:04.060
So next on my list is,

00:22:04.181 --> 00:22:05.421
and this is something my students,

00:22:05.461 --> 00:22:06.781
if they're ever listening,

00:22:06.801 --> 00:22:08.221
they'll be laughing because they hear me

00:22:08.241 --> 00:22:09.422
say this all the time in class,

00:22:09.482 --> 00:22:10.363
but I always say,

00:22:10.663 --> 00:22:12.844
don't be afraid to wear different hats,

00:22:13.084 --> 00:22:13.364
right?

00:22:13.384 --> 00:22:15.163
So we all have our communication style.

00:22:15.223 --> 00:22:16.704
I'm a pretty extroverted guy,

00:22:17.144 --> 00:22:18.125
fairly outgoing.

00:22:18.244 --> 00:22:19.685
I tend to do well with those patients

00:22:19.726 --> 00:22:22.307
that love to interact quite a bit in

00:22:22.346 --> 00:22:23.326
the hospital setting.

00:22:23.547 --> 00:22:24.367
They love to talk.

00:22:24.667 --> 00:22:25.647
I'm happy to talk with them.

00:22:26.643 --> 00:22:28.344
But then we'll get those patients that

00:22:28.384 --> 00:22:30.085
don't really respond well to that because

00:22:30.105 --> 00:22:30.644
each patient,

00:22:30.664 --> 00:22:32.465
just like each therapist has a

00:22:32.506 --> 00:22:33.126
personality,

00:22:33.247 --> 00:22:34.907
each patient has a personality as well.

00:22:35.327 --> 00:22:37.328
And so you really need to recognize that

00:22:37.608 --> 00:22:39.529
sometimes the personality that you're

00:22:39.650 --> 00:22:41.111
best,

00:22:41.131 --> 00:22:43.392
that you're most used to navigating in the

00:22:43.412 --> 00:22:45.413
hospital setting with from a communication

00:22:45.432 --> 00:22:47.794
standpoint may not match with every

00:22:47.894 --> 00:22:48.875
patient's personality.

00:22:49.234 --> 00:22:50.576
This is something that I learned from a

00:22:50.615 --> 00:22:51.276
mentor of mine.

00:22:51.675 --> 00:22:53.416
He explained it quite a bit, you know,

00:22:53.436 --> 00:22:54.758
when I was a student working with him.

00:22:55.292 --> 00:22:56.413
And it's really like, you know,

00:22:56.473 --> 00:22:58.015
what you say to one patient may not

00:22:58.055 --> 00:22:58.934
work with the other patient.

00:22:59.035 --> 00:22:59.796
And so we have to be able to

00:22:59.836 --> 00:23:01.395
take off one hat and put on another

00:23:01.455 --> 00:23:02.237
one pretty quickly.

00:23:02.317 --> 00:23:03.597
Like I may find out quickly,

00:23:03.637 --> 00:23:05.259
this patient does better with like more of

00:23:05.298 --> 00:23:06.838
like a handholding type thing.

00:23:07.119 --> 00:23:08.460
Like, Hey, it's going to be all right.

00:23:08.559 --> 00:23:09.780
We're going to get through this.

00:23:09.921 --> 00:23:10.882
I understand that, you know,

00:23:10.942 --> 00:23:11.842
you're worried about this.

00:23:11.882 --> 00:23:11.981
Like,

00:23:12.001 --> 00:23:13.762
let's talk about this a little versus,

00:23:14.304 --> 00:23:14.564
you know,

00:23:14.584 --> 00:23:15.804
a personality that does better with

00:23:15.844 --> 00:23:17.484
cracking jokes and things like that.

00:23:17.605 --> 00:23:19.165
You really have to be able to adapt

00:23:19.185 --> 00:23:21.067
that communication style for a lot of this

00:23:21.086 --> 00:23:23.048
to work because you could go all out

00:23:23.147 --> 00:23:24.088
extrovert style.

00:23:24.642 --> 00:23:26.542
And then you have an introverted patient

00:23:26.563 --> 00:23:27.943
that just doesn't respond well to it.

00:23:27.963 --> 00:23:29.224
So you got to adjust.

00:23:29.305 --> 00:23:30.786
Yeah, we've all been there.

00:23:30.826 --> 00:23:32.086
We've seen that, right?

00:23:32.627 --> 00:23:34.528
One size fits all does not fit anybody,

00:23:34.669 --> 00:23:34.949
right?

00:23:35.470 --> 00:23:36.691
It doesn't make anybody feel good.

00:23:36.750 --> 00:23:39.452
So I think part of along with that,

00:23:39.732 --> 00:23:42.134
with the four steps before that,

00:23:42.174 --> 00:23:43.255
or even before we started with that,

00:23:43.275 --> 00:23:45.557
with point five is understand who you're

00:23:45.576 --> 00:23:49.220
talking to and start to try to figure

00:23:49.380 --> 00:23:51.441
out which strategies might be best for

00:23:51.500 --> 00:23:52.582
this patient.

00:23:52.781 --> 00:23:55.583
person because again as you so eloquently

00:23:55.643 --> 00:23:57.282
put before these people these are not

00:23:57.583 --> 00:23:59.124
patients these are not diagnosis codes

00:23:59.144 --> 00:24:01.784
these are not numbers so number five is

00:24:02.265 --> 00:24:03.924
bring in different hats and be prepared to

00:24:03.944 --> 00:24:05.184
wear different hats yeah you got to be

00:24:05.204 --> 00:24:06.586
ready to wear different hats because if

00:24:06.605 --> 00:24:07.786
you don't you're going to get thrown out

00:24:07.806 --> 00:24:09.346
of a room you know patients gonna be

00:24:09.365 --> 00:24:11.086
like get lost i'm not doing pt today

00:24:11.106 --> 00:24:12.426
so you got to be able to adapt

00:24:12.747 --> 00:24:14.147
on the fly i think a lot of

00:24:14.167 --> 00:24:15.788
that comes too from just being able to

00:24:15.827 --> 00:24:17.489
talk to patients and getting to know them

00:24:17.509 --> 00:24:19.128
before you even get into what your goals

00:24:19.169 --> 00:24:19.269
are

00:24:20.171 --> 00:24:21.291
So asking them, how are you doing?

00:24:21.412 --> 00:24:22.452
Are you from around here?

00:24:22.492 --> 00:24:23.073
You know what?

00:24:23.093 --> 00:24:24.434
You know what brings you in here today?

00:24:24.494 --> 00:24:25.335
All those things.

00:24:25.655 --> 00:24:26.856
Talk to them about what they'd like to

00:24:26.896 --> 00:24:27.176
do.

00:24:27.396 --> 00:24:28.978
Did they catch the basketball game last

00:24:28.998 --> 00:24:29.798
night on TV?

00:24:30.138 --> 00:24:31.359
That will help you to get an idea

00:24:31.380 --> 00:24:32.981
of the type of personality that might be.

00:24:33.082 --> 00:24:34.883
So then you could start at least maybe

00:24:34.903 --> 00:24:36.505
trying to put the correct hat on first

00:24:36.545 --> 00:24:38.506
before you have to switch it off and

00:24:38.526 --> 00:24:39.666
then go in that direction.

00:24:40.087 --> 00:24:40.448
Agreed.

00:24:40.548 --> 00:24:40.907
All right.

00:24:40.968 --> 00:24:41.949
Last one on your six.

00:24:41.969 --> 00:24:42.809
So there was a bonus one.

00:24:43.279 --> 00:24:44.260
Yeah, this is the bonus one.

00:24:44.320 --> 00:24:44.981
So, you know,

00:24:45.021 --> 00:24:46.522
as much as I'm talking about things from

00:24:46.542 --> 00:24:47.804
an acute care standpoint,

00:24:47.983 --> 00:24:50.365
this is for you to outpatient PTs out

00:24:50.385 --> 00:24:50.626
there.

00:24:50.767 --> 00:24:51.086
All right.

00:24:51.166 --> 00:24:52.909
As much as I'm talking about getting buy

00:24:52.929 --> 00:24:55.371
in from a hospital setting and patients

00:24:55.391 --> 00:24:56.271
who don't want to be there.

00:24:56.592 --> 00:24:56.811
I mean,

00:24:56.872 --> 00:24:58.773
nobody blows out their ACL is like,

00:24:58.854 --> 00:25:00.755
I can't wait to get into physical therapy

00:25:00.776 --> 00:25:02.836
for my blown out ACL or nobody like

00:25:03.337 --> 00:25:04.578
bends over to pick something up,

00:25:04.739 --> 00:25:05.680
throws out their back.

00:25:06.000 --> 00:25:06.461
It's like, you know,

00:25:06.641 --> 00:25:08.201
I can't wait to see a PT three

00:25:08.221 --> 00:25:09.403
times a week for, you know,

00:25:09.563 --> 00:25:10.324
one hour session.

00:25:10.748 --> 00:25:11.107
Like, no,

00:25:11.188 --> 00:25:13.089
nobody wants to be an outpatient PT

00:25:13.190 --> 00:25:13.509
either.

00:25:13.710 --> 00:25:16.491
And so all of these principles can still

00:25:16.511 --> 00:25:18.732
be applied in a similar fashion.

00:25:18.952 --> 00:25:20.253
You just have to be able to apply

00:25:20.273 --> 00:25:21.815
them to the functional goals you're trying

00:25:21.835 --> 00:25:23.856
to achieve in the outpatient setting or

00:25:23.876 --> 00:25:25.577
the neuro setting or the pediatric

00:25:25.617 --> 00:25:25.877
setting.

00:25:25.917 --> 00:25:27.499
Like we're all we all have our

00:25:27.538 --> 00:25:28.180
specialties,

00:25:28.240 --> 00:25:29.901
but these principles are just basic

00:25:29.941 --> 00:25:31.261
communication one on one.

00:25:31.602 --> 00:25:32.602
And so I think if we can do

00:25:32.622 --> 00:25:33.423
a good job of that,

00:25:33.442 --> 00:25:35.023
you're going to get your improved buy in

00:25:35.183 --> 00:25:36.404
no matter what setting you're working.

00:25:38.959 --> 00:25:39.880
Person's got a choice.

00:25:40.980 --> 00:25:42.041
I make suggestions.

00:25:42.541 --> 00:25:43.663
You make decisions.

00:25:44.262 --> 00:25:46.885
Me yelling at you probably doesn't work.

00:25:46.905 --> 00:25:48.166
I mean, maybe if somebody does work,

00:25:48.227 --> 00:25:48.446
right?

00:25:48.686 --> 00:25:51.209
But I make suggestions.

00:25:51.288 --> 00:25:52.849
I also heard someone say the other day,

00:25:54.592 --> 00:25:56.693
I can't care more about your recovery than

00:25:56.733 --> 00:25:58.894
you.

00:25:58.994 --> 00:26:00.656
And not to give people like a pass

00:26:00.676 --> 00:26:01.237
to not try,

00:26:01.277 --> 00:26:04.039
not giving clinicians a pass to give up,

00:26:04.559 --> 00:26:06.181
but it's like understanding who am I

00:26:06.201 --> 00:26:06.721
working with?

00:26:07.449 --> 00:26:07.628
Right.

00:26:07.648 --> 00:26:09.209
Because you have a finite amount of time

00:26:10.150 --> 00:26:11.009
in a hospital setting.

00:26:11.049 --> 00:26:11.849
I know you guys are.

00:26:12.750 --> 00:26:12.990
I mean,

00:26:13.750 --> 00:26:15.371
it's productivity requirements to the

00:26:15.411 --> 00:26:15.830
extreme.

00:26:15.851 --> 00:26:16.371
I mean,

00:26:16.611 --> 00:26:17.711
there's not a minute that's not

00:26:18.291 --> 00:26:20.251
unaccounted for in some of those things.

00:26:21.313 --> 00:26:22.833
And how do you speed some of these

00:26:22.873 --> 00:26:23.492
things up?

00:26:24.854 --> 00:26:25.314
Yeah,

00:26:25.334 --> 00:26:26.354
I think the person in front of you.

00:26:27.074 --> 00:26:28.375
Yeah, I couldn't agree more.

00:26:28.414 --> 00:26:29.555
And I think that, you know.

00:26:30.281 --> 00:26:31.763
lot of times like people say oh

00:26:31.884 --> 00:26:33.285
productivity is the reason a lot of these

00:26:33.305 --> 00:26:35.126
communication styles get lost and i would

00:26:35.166 --> 00:26:36.607
disagree with that because a lot of the

00:26:36.647 --> 00:26:38.450
types of things that i'm talking about you

00:26:38.490 --> 00:26:40.392
can do as you're starting to find out

00:26:40.451 --> 00:26:42.074
more about the patient from a subjective

00:26:42.114 --> 00:26:44.395
history standpoint and so like you don't

00:26:44.435 --> 00:26:45.738
have to take twenty minutes just to

00:26:45.798 --> 00:26:47.298
establish a communication style with a

00:26:47.318 --> 00:26:48.881
patient you could do that as you guys

00:26:48.921 --> 00:26:50.142
you're learning about their home setup

00:26:50.854 --> 00:26:52.434
So I agree.

00:26:52.474 --> 00:26:53.474
Productivity is a big thing,

00:26:53.494 --> 00:26:55.115
but it's not an excuse to lose.

00:26:55.634 --> 00:26:56.955
That's not going away.

00:26:57.036 --> 00:26:58.455
So you can complain about it all you

00:26:58.476 --> 00:26:58.655
want.

00:26:58.675 --> 00:26:59.176
You can bitch about it.

00:26:59.196 --> 00:26:59.696
What are you going to do?

00:26:59.717 --> 00:27:00.737
What are we going to do about it?

00:27:01.096 --> 00:27:02.278
Embrace the suck on that.

00:27:02.317 --> 00:27:02.917
That sucks.

00:27:03.357 --> 00:27:03.917
Moving on.

00:27:03.958 --> 00:27:04.758
What are we going to do about it?

00:27:05.178 --> 00:27:06.999
In your experience from being a clinician

00:27:07.058 --> 00:27:07.838
and in education,

00:27:07.979 --> 00:27:10.859
which one of those steps do clinicians

00:27:11.059 --> 00:27:13.881
struggle with the most in real world

00:27:13.921 --> 00:27:17.142
situations?

00:27:17.541 --> 00:27:18.843
That's a good question.

00:27:19.042 --> 00:27:19.643
I would say

00:27:21.484 --> 00:27:22.664
I think it depends on the therapist,

00:27:22.704 --> 00:27:24.046
but on average,

00:27:24.165 --> 00:27:26.287
I think that helping patients to

00:27:26.406 --> 00:27:28.247
understand the why behind what we're

00:27:28.267 --> 00:27:31.949
trying to get them to accomplish is simply

00:27:31.989 --> 00:27:33.868
because from a time management standpoint,

00:27:34.088 --> 00:27:36.329
that takes time to explain the why instead

00:27:36.349 --> 00:27:37.111
of just saying, Hey,

00:27:37.131 --> 00:27:38.230
let's walk to the bathroom,

00:27:38.830 --> 00:27:40.451
explaining to them why that's important to

00:27:40.491 --> 00:27:40.932
do so.

00:27:41.380 --> 00:27:42.280
is super valuable,

00:27:42.300 --> 00:27:43.721
but I think it often gets lost.

00:27:43.821 --> 00:27:45.884
And so that's one thing where this isn't

00:27:45.923 --> 00:27:47.565
like a playbook for new grads.

00:27:47.585 --> 00:27:49.267
This is a playbook for any PT.

00:27:49.386 --> 00:27:50.688
And I think we can all be reminded

00:27:50.748 --> 00:27:51.769
of it, myself included.

00:27:51.848 --> 00:27:53.990
I find myself making the same mistakes on

00:27:54.009 --> 00:27:54.590
a busy day.

00:27:54.631 --> 00:27:55.971
I'm just trying to get through things.

00:27:56.352 --> 00:27:57.413
But I think if we could take that

00:27:57.452 --> 00:27:58.894
step back and recognize that,

00:27:59.075 --> 00:28:00.375
and if we do get a patient who's

00:28:00.395 --> 00:28:02.436
a little grumpy and is getting even more

00:28:02.477 --> 00:28:03.178
grumpy with us,

00:28:03.498 --> 00:28:05.119
take that moment to step back and say,

00:28:05.140 --> 00:28:05.480
hey, wait,

00:28:06.112 --> 00:28:07.992
Am I not communicating appropriately with

00:28:08.012 --> 00:28:09.913
this patient before I just say, oh,

00:28:09.972 --> 00:28:10.972
he's a grumpy patient.

00:28:11.032 --> 00:28:11.634
It is what it is.

00:28:11.673 --> 00:28:13.114
I can't do anything about it.

00:28:13.193 --> 00:28:14.594
Yeah, agreed.

00:28:14.653 --> 00:28:16.035
So and I think from a new grad

00:28:16.075 --> 00:28:16.615
standpoint,

00:28:16.734 --> 00:28:19.155
it's the being afraid to change different

00:28:19.175 --> 00:28:19.516
hats.

00:28:19.955 --> 00:28:21.796
I think that that is something that comes

00:28:21.816 --> 00:28:24.277
with experience and time and being mindful

00:28:24.297 --> 00:28:25.096
of it is important.

00:28:25.176 --> 00:28:25.938
But, you know,

00:28:26.557 --> 00:28:27.817
for all those new grads out there,

00:28:27.857 --> 00:28:29.858
as you're going through your evaluations

00:28:29.898 --> 00:28:30.699
and things like that,

00:28:31.141 --> 00:28:31.280
Like,

00:28:31.340 --> 00:28:33.502
don't be afraid if the conversation isn't

00:28:33.542 --> 00:28:34.603
going the way you want it to,

00:28:34.663 --> 00:28:36.545
to try a different communication style.

00:28:36.904 --> 00:28:37.704
Because that's how, one,

00:28:37.746 --> 00:28:39.247
you're going to get more experience at it.

00:28:39.406 --> 00:28:39.807
But two,

00:28:39.826 --> 00:28:40.887
that's how you're going to get better at

00:28:40.907 --> 00:28:41.188
relating

00:28:42.307 --> 00:28:42.827
Sure.

00:28:43.087 --> 00:28:43.667
Mike Tyson,

00:28:43.688 --> 00:28:44.969
everybody's got a plan until you get

00:28:45.009 --> 00:28:45.750
punched in the mouth.

00:28:45.809 --> 00:28:47.211
Everybody's got a plan until you get

00:28:47.250 --> 00:28:48.813
somebody who throws a bedpan at you and

00:28:48.833 --> 00:28:50.493
says, get the hell out or drops F-bombs.

00:28:50.513 --> 00:28:51.335
I mean, again,

00:28:51.375 --> 00:28:54.397
I did a short rotation in inpatient and

00:28:55.137 --> 00:28:57.279
I heard and saw some things.

00:28:57.299 --> 00:28:58.721
I was like, yeah, the same for me.

00:28:58.801 --> 00:29:00.143
I ain't going to last here.

00:29:00.182 --> 00:29:02.224
But see some wild stuff.

00:29:02.244 --> 00:29:03.506
You see some people in inpatient,

00:29:03.526 --> 00:29:06.607
especially at their absolute low or again,

00:29:06.669 --> 00:29:07.930
going through or coming out of

00:29:08.904 --> 00:29:09.105
you know,

00:29:09.125 --> 00:29:10.405
some of the worst times in their lives,

00:29:10.766 --> 00:29:12.886
simple, not easy though.

00:29:13.106 --> 00:29:15.386
So this gives you some skills because half

00:29:15.426 --> 00:29:15.487
of,

00:29:15.587 --> 00:29:16.807
I think what you've explained is

00:29:16.968 --> 00:29:18.669
recognizing who that person is or trying

00:29:18.689 --> 00:29:20.388
to figure out who that person is not

00:29:20.429 --> 00:29:21.650
in whole in that moment.

00:29:21.690 --> 00:29:23.130
That's sort of the moment that only

00:29:23.170 --> 00:29:23.611
matters.

00:29:24.330 --> 00:29:26.311
Yeah, no, I couldn't agree more with that.

00:29:26.332 --> 00:29:27.332
And I think if we do a good

00:29:27.352 --> 00:29:27.832
job of that,

00:29:27.872 --> 00:29:29.093
you're going to find that your buy-in is

00:29:29.113 --> 00:29:29.553
going to go up.

00:29:29.593 --> 00:29:30.512
Will it work for everybody?

00:29:30.732 --> 00:29:30.972
No,

00:29:31.333 --> 00:29:32.433
but I bet you're going to have a

00:29:32.473 --> 00:29:34.355
lot better success rate of trying to get

00:29:34.394 --> 00:29:36.015
patients to engage with you and

00:29:36.055 --> 00:29:37.236
participate in what you're trying to get

00:29:37.256 --> 00:29:38.236
them to participate in.

00:29:38.911 --> 00:29:39.211
Agreed.

00:29:39.731 --> 00:29:40.011
Excellent.

00:29:40.051 --> 00:29:40.333
All right.

00:29:40.373 --> 00:29:42.095
So we have a tradition on the show.

00:29:42.174 --> 00:29:45.459
It is called the parting shot.

00:29:45.519 --> 00:29:47.541
This is the parting shot.

00:29:48.102 --> 00:29:49.483
One last mic drop moment.

00:29:50.164 --> 00:29:50.965
No pressure.

00:29:51.405 --> 00:29:53.528
Just your legacy on the line.

00:29:54.989 --> 00:29:56.550
no pressure uh parting shot brought to you

00:29:56.570 --> 00:29:57.991
by our friends at sarah health find them

00:29:58.031 --> 00:29:59.413
online at sarahhealth.com it's

00:29:59.613 --> 00:30:02.836
s-a-r-a-health.com get paid more between

00:30:02.875 --> 00:30:06.099
visits and finally uh keep track of those

00:30:06.119 --> 00:30:09.241
things uh sarah helps pts ots ortho pain

00:30:09.281 --> 00:30:11.565
practices engage with patients between

00:30:11.585 --> 00:30:13.787
appointments through simple text messaging

00:30:14.166 --> 00:30:16.428
which means no apps and no lost passwords

00:30:16.468 --> 00:30:17.028
or anything like that.

00:30:17.387 --> 00:30:18.288
Improving outcomes,

00:30:18.689 --> 00:30:20.769
increasing plan of care completion rates,

00:30:20.788 --> 00:30:23.049
and unlocking meaningful reimbursement for

00:30:23.089 --> 00:30:24.289
stuff you're already doing.

00:30:24.329 --> 00:30:26.711
Find them online at sarahhealth.com.

00:30:26.951 --> 00:30:28.392
All right, Sid, parting shot.

00:30:28.412 --> 00:30:29.132
What do you want to leave with the

00:30:29.172 --> 00:30:30.352
audience today as we wrap up?

00:30:30.452 --> 00:30:31.073
All right,

00:30:31.093 --> 00:30:32.532
so you talked about how you were looking

00:30:32.553 --> 00:30:33.333
for some hot takes.

00:30:33.393 --> 00:30:35.594
I got a potentially slightly controversial

00:30:35.713 --> 00:30:35.814
one.

00:30:37.095 --> 00:30:37.494
Now,

00:30:37.855 --> 00:30:39.315
there may be some audience members that

00:30:39.395 --> 00:30:40.855
don't agree with what I'm about to say,

00:30:40.935 --> 00:30:42.396
but I firmly believe this,

00:30:42.416 --> 00:30:43.757
and I tell my students the same thing.

00:30:44.747 --> 00:30:47.208
It is well within PT's scope of practice

00:30:47.268 --> 00:30:49.308
to perform self-care on patients.

00:30:49.409 --> 00:30:51.148
It is not the nurse's job.

00:30:51.308 --> 00:30:52.650
It is our job, too.

00:30:52.869 --> 00:30:55.050
And the reason I get on my soapbox

00:30:55.070 --> 00:30:56.770
with this is because not only is it

00:30:56.810 --> 00:30:58.211
a safety issue for patients,

00:30:58.332 --> 00:31:00.772
but if we're trying to treat patients like

00:31:00.792 --> 00:31:01.232
a person,

00:31:01.272 --> 00:31:02.673
like we just talked about for the last

00:31:02.712 --> 00:31:03.393
half hour,

00:31:04.034 --> 00:31:06.914
why would we go and then just leave

00:31:06.954 --> 00:31:07.875
a patient and say, you know what,

00:31:07.994 --> 00:31:10.415
I understand that you have a soil brief,

00:31:10.476 --> 00:31:11.875
but I'll let the nurse know she'll be

00:31:11.935 --> 00:31:13.257
in in thirty minutes or so to get

00:31:13.297 --> 00:31:13.676
you changed.

00:31:14.209 --> 00:31:15.409
Would you appreciate that?

00:31:15.949 --> 00:31:16.509
Probably not.

00:31:17.230 --> 00:31:18.349
I wouldn't appreciate that either.

00:31:18.390 --> 00:31:19.570
So why would we do that to our

00:31:19.611 --> 00:31:20.030
patients?

00:31:20.411 --> 00:31:23.132
So hot take is pouring shot is it

00:31:23.172 --> 00:31:24.731
is well within our scope of practice to

00:31:24.751 --> 00:31:25.231
do so.

00:31:25.311 --> 00:31:26.712
And I think that that not only is

00:31:26.732 --> 00:31:27.813
going to build rapport with your

00:31:27.873 --> 00:31:28.472
coworkers,

00:31:28.833 --> 00:31:30.634
but also going to build rapport with your

00:31:30.673 --> 00:31:31.653
patients as well.

00:31:31.753 --> 00:31:33.954
And I will give one quick example of

00:31:34.535 --> 00:31:35.335
why I say this.

00:31:35.830 --> 00:31:36.791
When I was a student,

00:31:37.031 --> 00:31:38.272
I had a doctor come in.

00:31:38.452 --> 00:31:39.513
I was working with the patient.

00:31:39.554 --> 00:31:40.615
He didn't want to interrupt me.

00:31:41.035 --> 00:31:42.296
I was getting the patient cleaned up.

00:31:42.336 --> 00:31:42.757
And I said,

00:31:42.856 --> 00:31:43.576
if you just give me a minute,

00:31:43.596 --> 00:31:44.438
I'll finish up here.

00:31:44.738 --> 00:31:45.558
He said, no, you know what?

00:31:45.598 --> 00:31:46.419
I'll give you a hand.

00:31:46.619 --> 00:31:48.201
And he actually did it on his own

00:31:48.221 --> 00:31:49.201
and just asked me to roll it.

00:31:49.241 --> 00:31:50.702
And I remember that to this day,

00:31:50.903 --> 00:31:52.364
twelve years ago or whatever it is.

00:31:52.743 --> 00:31:54.105
So if I remember that to this day,

00:31:54.145 --> 00:31:55.547
just think about how your patients are

00:31:55.567 --> 00:31:56.467
going to think about that.

00:31:56.827 --> 00:31:57.067
Yeah.

00:31:57.208 --> 00:31:58.489
You're going for trying to get them to

00:31:58.528 --> 00:31:59.549
buy into what you're trying to do.

00:31:59.942 --> 00:32:02.203
Patients, coworkers,

00:32:03.023 --> 00:32:04.664
patient in the moment because again,

00:32:05.365 --> 00:32:06.585
if it were you or your mother or

00:32:06.605 --> 00:32:07.385
your father or grandma,

00:32:07.405 --> 00:32:08.066
what would you want?

00:32:08.705 --> 00:32:09.786
Coworkers are going to be there for the

00:32:09.826 --> 00:32:13.928
long haul and people pay attention to

00:32:13.968 --> 00:32:15.907
stuff like that.

00:32:15.928 --> 00:32:17.528
You remember that from twelve years ago.

00:32:17.588 --> 00:32:20.049
People remember these things and that's

00:32:20.069 --> 00:32:22.830
important about building everything is

00:32:22.871 --> 00:32:23.871
people remember these things.

00:32:24.550 --> 00:32:25.491
Our nurse partners,

00:32:25.571 --> 00:32:26.652
I love our nurse partners.

00:32:27.087 --> 00:32:29.849
And that's not their only job.

00:32:29.890 --> 00:32:31.891
They have other responsibilities as well.

00:32:32.010 --> 00:32:33.672
And so who do we go to when

00:32:33.692 --> 00:32:34.612
we need to get bailed out of a

00:32:34.652 --> 00:32:35.452
sticky situation?

00:32:35.853 --> 00:32:36.353
The nurses.

00:32:36.772 --> 00:32:39.194
So why would we not help them in

00:32:39.234 --> 00:32:40.275
an effort to try to build that

00:32:40.295 --> 00:32:41.776
relationship so that when we need help,

00:32:41.955 --> 00:32:43.037
they're more willing to help us?

00:32:43.297 --> 00:32:44.758
I think that alone is also a great

00:32:44.778 --> 00:32:47.439
way to build camaraderie amongst staff.

00:32:47.459 --> 00:32:48.740
Got to get these on a t-shirt, man.

00:32:48.799 --> 00:32:50.901
Sid's six steps.

00:32:50.941 --> 00:32:51.981
It rolls off the tongue.

00:32:52.781 --> 00:32:52.961
Siddy,

00:32:52.981 --> 00:32:54.462
I appreciate you dropping by and sharing

00:32:54.482 --> 00:32:54.923
this with us.

00:32:55.223 --> 00:32:55.784
Thanks so much, man.

00:32:56.327 --> 00:32:57.807
Yes, sir.

00:32:57.867 --> 00:32:59.048
Have a great day.

00:32:59.068 --> 00:33:00.169
That's it for this one.

00:33:00.628 --> 00:33:02.108
We're just getting warmed up.

00:33:02.569 --> 00:33:04.509
Smash follow, send it to a friend,

00:33:04.710 --> 00:33:06.351
or crank up the next episode.

00:33:06.871 --> 00:33:07.830
Want to go deeper?

00:33:08.250 --> 00:33:12.271
Hit us at pgpiecast.com or find us on

00:33:12.332 --> 00:33:14.873
YouTube and socials at pgpiecast.

00:33:15.292 --> 00:33:17.573
And legally, none of this was advice.

00:33:17.653 --> 00:33:19.574
It's for entertainment purposes only.

00:33:19.614 --> 00:33:21.634
See, Keith?

00:33:21.854 --> 00:33:22.914
We read the script.

00:33:23.194 --> 00:33:23.855
Happy now?