There I stood.

 

Diploma in hand, toes hanging off the edge of a cliff and not sure how to get to the other side.

 With an academic career to my back and a vision of a confident, competent clinician across the gap, there was no safety net in sight and no blueprint in hand.

 

I knew that I had to get to the other side but I didn’t know how.

 

If you haven’t yet realized, there was no cliff and I had no physical leap to make. This is a metaphor for how it felt to graduate school and look ahead into the daunting world of independent clinical practice.

 

This blog is about the gap between what I learned in school and what I felt that I needed to become a confident and competent clinician who could make a real difference for the patients who I had the privilege to treat.

 

 

Before I discuss the role that the Level Up Initiative played in helping me bridge this gap, let me set the stage with a short story... 

 

It was my first year of PT school and I was engrossed with social media. One day, I came across a post by a PT who made a claim that I didn’t agree with. I decided to comment on the post and voice my opinion. Within minutes, I received a direct message from this PT asking me for my phone number because “he wanted to talk to me.” I thought to myself “this couldn’t be good.” Yet, something inside of me compelled me to get on the phone and I soon realized that this PT, Zak Gabor, wasn’t upset with me. In fact, he was thrilled that I had challenged him. He explained that he felt that conflict was an opportunity for growth and we quickly struck up a friendship. Within a few months of talking to Zak for the first time, he told me about his idea for The Level Up Initiative and in my gut, I knew that this would change healthcare and I wanted to be along for the ride. I was fortunate enough to be placed in Zak’s group for the first ever Level Up cohort in the Fall of 2017 and I knew from the start that this was going to be more than a mentorship. 

 

Now that the stage has been set, let me explain to you how the Level Up Initiative helped me make the leap from academics to clinical practice. In short, the answer is that it provided me with confidence and courage to embrace the gray, be human and put people first. However, let me give you a more in depth look into some of the concepts that helped me grow and allowed me to step foot into the clinic full of confidence. 

 

Words Matter.

 

Sticks and stones can break your bones but words can do some damage too.

Coming out of school, it can be easy to focus on what is “wrong with the patient.” We are trained to look for deficits, problems and impairments and there is value in that. However, discussing these things at length brings with them negative language that can instill fear in the people who hear them. I’m not arguing that we should ignore the “negatives,” but what I am saying is that we should make an effort to spend more time focusing on the “positives.” I believe that we should emphasize strengths just as much (if not more) than we point out “weaknesses.” We are the stories that we tell ourselves and as healthcare professionals, we are in a perfect position to help people re-write their stories in a way that benefits them. Our words hold immense power to the people that we tell them to and we (as PTs) are in the perfect position to reassure our patients, encourage them and empower them. Through our dialogue, we can help shift their perspective, build their confidence and foster resilience. Those things are all associated with more positive outcomes, and that shouldn’t be a surprise. It is imperative that we choose our words carefully

The Level Up Mentorship provided me with the opportunity to practice using positive language and encouraging narratives because those things really do change the game when it comes to stellar patient care.

 

Embrace Uncertainty.

 

If there’s one thing that I’ve learned since being out of school, it’s this: we don’t have all of the answers. To be more precise, we don’t have most of the answers.

The world of (outpatient) physical therapy (as well as life in general) is filled with uncertainty and that can be a scary thing, especially for patients who are experiencing pain, feeling vulnerable and are suffering. It’s important to realize that even when we don’t have all of the answers, we can still make a positive difference for the people that we treat. We can still choose to have confidence even when we don’t feel confident because deep down, we can choose to believe in our ability to be compassionate human beings who do their best for the people who need us the most.

It’s become apparent to me that we don’t need to “figure things out” right away. It’s even become clear to me that sometimes, we don’t even have to figure things out all the way. I’ve come to realize that a large part of our job (as PTs) isn’t to fix people or find all of the answers, but rather, to walk hand in hand with our patients through the uncertainty that they are experiencing. People need a guide.

 

The Level Up Initiative gave me the opportunity to practice becoming more comfortable with uncertainty and developing strategies for dealing with it. 

 

Meet Them.

 

Everybody in this world is coming from a different place. Our job is to meet people where they are so we can take them where they want to be.

Meet people where they are. We all see the world through a different lens. Everybody has a different perspective and no two people are in the same place. Because of this, different people need different things. To maximize effectiveness, communication needs to be tailored to the individual sitting in front of us. In order to do that, we need some level of social awareness. We need to be able to understand where people are coming from so that we can meet people where they are, not where we expect them to be.

Take them where they want to be. Whether you think so or not, [outpatient] physical therapy is a customer service profession. It is our job to help take people where they want to be, not where we think that they should be. If a patient wants to be able to do something, it is our job to help them get there, not to tell them that they can’t [exceptions exist].

 

The Level Up Initiative helped me learn more about the psychological aspect of human interaction, it helped arm me with effective communication strategies and it helped me to develop better social awareness.

 

Know Them.

 

Creating genuine human connection drives positive patient experiences (and outcomes). What’s important to the patient should be important to us, and we can’t know that until we know them.

If we want to be effective physical therapists, we need to build a relationship with our patients that is set on a foundation of genuine interest, compassionate caring and empathetic love. In the most basic terms, we need to get to know our patients and actually care about them so that they feel comfortable and compelled to invest their time, energy and effort into letting us help them.

With few exceptions, people who seek healthcare services are vulnerable on some level and it is a privilege to be able to help people who are in that position. One way to strengthen therapeutic relationships is to be open and vulnerable as healthcare practitioners ourselves [in an appropriate manner]. The bottom line is this; each person is a new story that we’ve never heard and our job is to understand that story so that we can have a positive influence on it.

 

The Level Up Initiative allowed me to practice building healthy, safe and supportive relationships in meaningful and practical scenarios. It emphasized the importance of human connection and relationship building. 

 

It’s Different.

 

Pain is not the same as suffering.

I’ve always known this deep down; I think we all do. However, it didn’t take a long time for me to be reminded that while pain and suffering can happen together, they are by no means the same thing.

 

“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” Viktor Frankl

 

Pain has been defined as “an unpleasant sensory or emotional experience.” Suffering is how we respond to that experience. Part of our job as PTs is to recognize suffering and to help people respond differently [more positively] to their pain. Part of our power as PTs lies in how we are positioned to reassure patients and help reframe their perspective. It is our job (and a privilege) to be there for our patients and to help them rewrite their narratives.

 

The Level Up Initiative helped open my eyes to the human experience, the psychology of suffering and it helped me improve my ability to deliver empathetic and effective care to vulnerable people in need of hope.

 

In an effort to keep things concise, I will stop here. The Level Up Initiative afforded me with enough valuable skills and lessons that it could fill a book. However, maybe the most important takeaway from the Level Up Initiative has been the amazing connections that I have been able to make with other like-minded, compassionate and driven clinicians. These connections will last a lifetime and they are part of what makes this more than a mentorship. 

 

To sum it up, I feel as good as I can as a new clinician, and much of that is thanks to The Level Up Initiative. However, I want to be clear; The Level Up Initiative has not been the bridge between academics and clinical practice. Rather, it has given me the tools to build confidence and close the gap and I am so grateful for that.

 

I cannot recommend this mentorship more to any healthcare student or clinician. It has changed the trajectory of my career and I know that it will do the same for you. 

 

Thank you so much for reading! 

 

All the best, 

 

Joe Rinaldi, PT, DPT

IG: @joerinaldi.dpt