"Most people don't realize that there is a right way and a wrong way
to get out of the bed in the morning," says Paulette Peloquin, a 45-year-old
physical therapy assistant who works in an outpatient clinic on Rhode Island.
Most people won't learn the technique until they strain their lower back.
Physical therapy assistants (PTAs) are trained to rehabilitate bones, joints
and muscles in the human body. While a doctor often puts the pieces back together,
it is the physical therapist (PT) and PTA who teach a person how to use once-broken
parts or how to use them correctly without so much pain.
Peloquin has a unique approach to therapy: "You have to make it a game,
because everyone loves to play games."
Peloquin first became interested in the profession when she was working
as a rehabilitation aide in a nursing home. "As a PTA, you can do everything
you do as an aide, but you understand more. You can progress the patient to
another level," she explains.
Teresa Gilley became a PT assistant after volunteering in a hospital's
PT department. "I decided that as a PTA, I would have more hands-on direct
patient care than as a PT," Gilley says.
PTs often become bogged down with paperwork and deal less with the patient.
"I prefer direct patient contact," she says.
A PTA reports directly to a licensed PT but, for the most part, both Gilley
and Peloquin say PTs allow their assistants to make on-the-spot decisions.
"You are responsible for following the PT's plan and evaluation -- however,
you have to be independent and know when to go to the primary therapist with
your suggestions and have valid educated reasons for making a change," says
Gilley.
An outgoing attitude, patience and understanding are traits needed to become
a good PTA. Gilley finds her outgoing personality the most important asset.
"A patient may be in your clinic for a torn ACL [a major ligament in the
knee] but they are also unable to do normal activities and are required to
exercise for two to three hours a day. You have to make their rehab not only
functional, but fun. They need to enjoy coming to therapy, not dread it,"
she says.
A touch of emotional strength is needed as well. If you choose to work
with older people in nursing homes, says Peloquin, death becomes a part of
your life. "I worked in a nursing home for more than 20 years. It's not
that you have a heart of stone, but it becomes an everyday part of your life."
Peloquin suggests that those who work as PTAs in a nursing home may have
a hard time coping at first.
For the most part, individuals who are injured want to get better. The
PTA helps athletes return to the game, the employed return to work and young
adults attend classes again.
However, there are people who fight rehabilitation. That's where the
challenge of being a PTA comes in -- and the frustration, says Peloquin. "Particularly
older people," she says. "They just feel that after a stroke, they want to
give up. They just don't see the point."
One patient, a 100-year-old woman, believed that she would not get better
because the nursing home aides were not giving her gelatin. All her life,
she believed she had survived because she took gelatin, which supposedly was
making her bones strong. Once that was taken away, her bones weakened and
she injured herself.
Gilley agrees that nursing homes are tough for a PTA. "In a nursing home,
it gets frustrating. You have to accept that although you may help those patients
get better, they won't necessarily get well or go home."
Nick Cioloti, a PTA in an outpatient orthopedic clinic in New York, says
athletes also take their injuries hard because they want to compete and are
not used to limitations.
His biggest learning experience came from a young man in his early 30s
who was diagnosed with lymphoma. At the time, Cioloti was working in a hospital
in New York. The man, says Cioloti, was literally dying of the disease. "All
he wanted was to go home -- to be with his wife and family."
Cioloti greeted the man with a smile each morning and tried to help him
stay mobile and relatively active. Meanwhile, the patient was undergoing extensive
chemotherapy treatment. "He lashed out at me. At the time, I demanded an apology,"
says Cioloti.
However, experience now tells him that sometimes you have to respect the
wishes of the patient. "He was dying. I had to think how he felt to see this
guy he doesn't know come into his room every morning smiling," explains
Cioloti.
For the most part, though, says Peloquin, there have been a lot of successes.
"There are people who thought they could never feed themselves, get out of
a chair unaided, or climb stairs to their house again. They didn't think
they could do it, and then they do and feel better about themselves," she
explains.
That is the payoff. "It feels good to know that you've allowed someone
to live with a little less pain. I think I've made a lot of people happy."
Gilley agrees that her job is fulfilling. "I think anything you do that
helps someone return to what they want to do or love is important." Not all
is rosy -- there are hurdles in this job and frustration, but success too.
In the end, you will have made a difference.
Not being able to do more is Gilley's regret. Because of financial
restrictions, sometimes she can only treat people for a limited amount of
time. "Then the insurance company won't pay anymore."
Schools with PTA programs look for well-rounded individuals,
those who can relate to people, not just books. Community service is starting
to make a difference in some schools' decisions. "They say it shows that
you can function with people in all varieties of life," says Gilley.
Cioloti strongly recommends observing PTAs at work in a nursing home or
long-term care facility because this is where a large percentage of PTAs will
find work. "See what's involved on a daily basis."