Reflections – Part 5

dana-headshot_newBy Dana Mandel, PT, PCS



I would like to thank everyone that has responded to me about my series of posts in the previous months’ Lifespan E-newsletters.  I have continued to appreciate your congratulations and enjoy learning of your perspectives and experiences related to my 30 years of practice.  Given the interest and response, I shall continue to share the story.


When I left you last month, I had begun my training at the Physical Therapy Program at SUNY Stony Brook. There was a heavy emphasis on the technical science classes that were necessary to provide a strong foundation to build upon when we began the clinical education training in physical therapy.  I found this coursework to be challenging and tedious, and continually tried to look beyond it to the time when my clinical training would begin.  In additional to the classroom clinical training, there would be three clinical internships required to graduate.


My first clinical education internship was at Mather Hospital in Port Jefferson, NY.  The setting was an acute care hospital and my patient population was primarily inpatients on the Cardiac Care, Intensive Care, Vascular, Orthopedic, and Long Term Care Units.  The patients were escorted in wheelchairs to the Physical Therapy Department, where we provided our treatments and then sent them with an attendant back to their respective units.  There were also rotations where I treated my patients bedside due to their inability to be transported because of medical complications.  Most heart wrenching was the opportunity I had to practice on a busy burn unit.  Most fascinating was the orthopedic and neurologic surgeries I was able to observe.  Most satisfying was the hospital cafeteria that served excellent meals at a 50% discount to students.


Although I found the Hospital treatment setting to be an excellent educational experience, there was something lacking for me personally.  The overwhelming sentiment of the patients was frustration at having to be in the hospital and a strong desire to go home.  As much as I tried to connect and rehabilitate, the institutional confinements and requirements made it difficult to motivate my patients.  Everyone wanted to be home instead of the in the hospital, and whatever simulations I created of real world situations fell woefully short.  Trying to train patients to effectively return to their homes, communities, careers, and lifelong routines while in an institutional setting left much to be desired and did not provide much motivation.  After having worked in State Developmental Centers and other large centralized medical facilities, my belief was that this type of environment was, by design, an efficient arrangement for the direct care staff, but doomed to fail the majority of the patients it was intended to serve.


My instincts told me that there must be a better way to provide physical therapy services to achieve the gains that I hoped to see in my patients.  I was hopeful that my next clinical affiliation would offer more food for my soul.


Stay tuned until next month…