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?