Candance Turner

PTA 1010SP16
04/05/2016

Observation Reflection Paper

For my observation, I spent time at Hand and Orthopedic Specialists in

Murray. During my time at the clinic, I have come to know that I absolutely LOVE
physical therapy. Steve Crandall, and his staff are not only amazing people, but
they were so kind to help me understand this program on a deeper level. Having
hands on experience has opened my eyes to what Physical Therapy requires, and it
makes me excited to pursue my education in the PTA field. Throughout my paper, I
will go through some patients clinical therapy, without disclosing names due to
HIPPA violation.
The first patient that I observed was a 67 year old female. She had a frozen
shoulder with adhesions a few years ago that they did a procedure under
anesthesia, and broke the adhesions by lifting her arm above her head. She
previously went through PT for this procedure and regained full range of motion.
She told me that it was the worst experience of her life and that she does not want
to go through that again. Recently she had a pace maker put in due to heart
problems. She is now experiencing the same pains she had with her frozen
shoulder, as well as not being able to lift her arm up. The patient is worried that
with the placement of the pace maker, that it will cause more adhesions in this

previously injured shoulder, and it will become locked again. She knows the
importance of PT, and is hoping to get full mobility back again. She is however, not
very happy about the situation she is in. She expressed many negative words due
to her situation, and I tried my best to encourage her that she is doing the right
thing by coming to physical therapy.
We started with heat to warm up her joints when she got to the clinic, using
the heat packs that were in the hydocollator, and then the PTA aides walked her
through her therapy exercises.

She was doing external rotations and internal

rotations on a row arm machine, as well as using bands to pull, and stretch her
shoulder joint. She used both lateral, and medial exercises, as well as extension
exercises. She also did extensions of the effected shoulder with the use of a pulley
system, which had her extending her arm higher than she could on her own. After
her exercises, the PTA used the goniometer to check her measurements compared
to her previous appointments. She also used manipulation of the joint, and then did
a manual massage on her shoulder. Lastly, we used the game ready ice machine
to help with any swelling and help her shoulder joint feel more comfortable.
What I learned by watching and observing this patient is that although she
was in a lot of pain, she was able to have a little more mobility in her shoulder by
the time we stopped. She was a little grumpier than most patients I was able to
work with and didnt really smile throughout the appointment. I could tell she was
in a lot of pain though, and I am sure that fear and pain were the reasons she was
feeling this way. I tried to encourage her, and let her know that the physical
therapy will help her, but it would take time. She still was grumpy, and left feeling
grumpy. The PT and PTA both told me that the patients have to be invested both

physically and mentally with the program, and we can only give them the skills and
encouragement just like I had done. It is the ultimately the patient that has to be
the one to make the decision to heal.
The next patient is a 49 year old female, which was in a car accident. I was
able to observe her more than once because she happened to be there on more
than one of my observation days. She was unfortunately recently in this car
accident, and is doing physical therapy because of it. She was the driver, and was
hit on the driver side of her vehicle (T-Boned). She sustained shoulder and neck
injury due to it. Again, when she first arrives we apply heat to the effected shoulder
and her neck. She actually hates the heat, because it makes her more hot. We only
keep her on for half of the time, so only 5 minutes. When I first came in, she
complained of numbness in her arm into her hand, and was unable to raise her arm
up above her head, and could not really turn her head to the left.
Her first exercise we did was putting a beach ball under her head and having
her just look left to right. She did 3 sets of 15 for this exercise, with a break in
between each set. We then used stretch band and placed one side under her head
and she would stretch it across her forehead, pulling with the opposite arm. The
first visit, she could not do this by herself, so the PTA aide assisted her. By the third
visit, she was able to do it by herself. When I talked to her about it, and told her I
noticed how much she had improved, she was very happy that I had told her so.
She was upset that she was not progressing, but I pointed out the positives to help
her spirits.
As we continued with small weights and other smaller exercises, she talked to
me about her life and really opened up to me. The staff was happy to see her
3

spirits lifted, and we talked about common ground that we both have in our life. I
think that when you can relate to the patients in another way outside their injury (of
course if the patient is the first to open up and ask you more questions), then it
helps them feel like they are going to be okay and get through this injury. She
explained to me that she is not a very patient person when it comes to things that
are out of her control.
Time commitments of her family life is huge, and PT takes time. This is one
thing that she is down about, because she just doesnt know how much time it will
take to heal. I explained to her that if she would not stress about the time it will
take her to heal, but she would focus on the healing aspect, then her body could
heal faster. Stress is one thing that affects their healing process, and I know its
easier said than done, but you can heal faster if you recognize that the body takes
time to heal. The last time I worked with her she had a little set back with trying to
do too much, but again I told her that she will get through this and get better. She
smiled and we flew through her exercises together.
What I really enjoyed with this patient, was being able to talk to her as I was
able to help her with exercises. I was able to talk to her about my class as well,
and she asked me questions about my goals within the PTA program. This helped
me to focus on what I was learning and if I really want to do this program. Talking
through the aspects of my class, and the way I was feeling intimidated with being
much older than the other students in our class helped. I also shared with her that
it makes me worry about applying to the program, and the aspect of me being out
of the workforce for so many years really concerns me. She helped me to
understand that I definitely want to do this program, and she even turned the

advice of not stressing about my situation and timeline. She told me my life skill of
being a stay home mom for 18 years makes me more personable to her, and she as
a patient appreciates that.
The one on one time with the patients really is valuable to everyone involved.
PTs, PTAs, and PTA aides all have to work together in order to help the patient
progress, but the patient also needs to be invested in the program as well. The
differences in attitude even with the patients previously mentioned, made a huge
impact on their learning and ability to really push themselves and progress in their
programs. As we have talked about the ethics of the patients care and how we as
PTAs really can make a difference in how the care is perceived IF the patient is
open to it. Both patients obviously are in different times in their life, as well as
different circumstancesbut, the attitude of both really made the difference in how
their healing was progressing.
Obviously, I worked with many more patients then just these two. Observing
everything from mirror therapy, pool therapy, unloading machine therapy, and
many other exercises with all ages of patients. One gentleman promised to dance
the waltz with me when his therapy was over, because I offered my hand during one
of his exercises, and I asked him teasingly if he would like to dance. The tears in his
eyes made me realize that I can make a difference in this field of study. He told me
no one has asked him to dance in 50 years, and he appreciated me lightening his
mind with this small gesture. He told me it was hard to get old, and lose control of
his body and him not being able to balance. I gave him a smile, and said that I
looked forward to that dance.

The Oswestry test that we talked about in chapter 8 with musculoskeletal

conditions is something that I understood in the clinic because of our class
discussion as I went in to observe. I knew immediately what the paper was for, and
was able to explain the paper to the physical therapist before he explained it to me.
It was nice to apply classroom knowledge and he was impressed. One thing that I
wish we could learn in class, is more hands on exercises. I want to know why a
certain exercise is used for muscle groups versus another one. I am sure that is
what will be talked about in the PTA program itself, but knowing the hows and why
really helps me understand how to help patients more.
Due to the observation time done in the clinic, I applied to become an aide at
this clinic. I was hired and now I get to learn hands on and I feel like I understand
other topics we are learning in class because of the opportunity I have to work. I
have gained such a love for my job, and I love working with the patients. I truly look
forward to applying to the program, and for the new knowledge I will gain as we go
through the classes to teach us more about physical therapy assisting.