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Spotlight: Home Health Physical Therapy for the New Grad

by Guest Poster

young-woman-doctor-older-man-patient-smiling

Today's article features home health PTs working at Foreman Therapy Services in Dallas, TX. We asked them about their experiences, struggles and recommendations regarding working in this setting, so we can help other new grad physical therapists in home health.

Ramzi Abbassi, PT, DPT

What is the biggest struggle of being a home health physical therapist? If you are a new grad, please elaborate how that has impacted your experience as a PT in home health.

"My biggest struggle is taking responsibility for all the patients, as they are homebound and dependent on you to be able to do a lot of things. While taking this responsibility, you will also have to communicate with everyone involved with the patient's case, such as the family members, caregivers, nurses, and other therapists, and all this can get overwhelming, especially when you add documentation to all that."

What skills have you seen improve the most during your time working as a home health physical therapist? They can be personal, professional or both.

"Ability to encourage patient, tell the good/bad news, ability to modify activities and exercises to fit the patients needs and to improve their current condition. Also, being more familiar with all the medical conditions that you typically don't deal with in a clinical setting, such as diseases and comorbidities."

When you have a question about a patient, where do you get the information or mentorship that you need to create a good treatment plan?

"I either go online to trusted websites, go back to my notes or, if it is a clinical question, ask my co workers that have worked longer than I have."

What are the five most important articles for any new grad to carry in their home health physical therapy tool chest? We realize part of being a home health PT is bringing your clinic with you to patients' homes, and we're curious what you think is most important.

"Treatment table, resistance bands, TENS unit, Respirator (peddler or exercise bike), KTAPE."

Do you have any time saving tips for new grad PTs working in home health?

"Make sure to schedule and stay organized. I use an app called Home Health Manager, which helps me a bunch. It gives the fastest route to see my patients, which cuts down on drive time. Make sure to schedule your first two patients the day before, and call ahead before you go see the rest (they should be home). Don't spend too much time scheduling every single patient (unless they need it). Focus on effective treatments, think about what you’re going to do with the patient on your way there, and treat your exercises like they are actual interventions."

“Ramzi's Tip: Schedule your first two patients the day before, and call ahead before you go see the rest (they should be home). Don't spend too much time scheduling every single patient (unless they need it ).”

 

Matt Hurlbutt, PT, DPT

What is the biggest struggle of being a home health physical therapist? If you are a new grad, please elaborate how that has impacted your experience as a PT in home health.

"It can be difficult to create all of your own care plans in a setting where you have little experience. For your basic patients, you won’t have trouble making the POC. A patient with multiple comorbidities may be difficult to treat, especially without another therapist there to bounce ideas off of. One difficulty can be when trying to learn how to communicate effectively with a patient. You will occasionally have a patient that is non-compliant and wants nothing to do with therapy. In that case, patients like this will require a higher level of education and more motivation to participate. Communication is key in that aspect and is a learned skill through home health. Being polite, educating the patient, and telling them the 'whats' and the 'whys' of what to expect will make patients more receptive to therapy with you."

What skills have you seen improve the most during your time working as a home health physical therapist? They can be personal, professional or both.

"I have developed both personally and professionally . Professionally, I have grown by treating a patient to be as functional as possible in their home; this is something that the home health setting can do better than any other type of PT. Because you are seeing a patient in their own home and own environment you are able to point out the areas with safety concerns or where the patient lacks independence that other therapists may not have the advantage of seeing. Personally, I have become much more adept with my scheduling and organization skills. In home health you do the majority of your own scheduling. I can now set a schedule and stick to it. I find myself more punctual in the work setting and even in my personal life."

When you have a question about a patient, where do you get the information or mentorship that you need to create a good treatment plan?

"Colleagues and other therapists are the greatest resource. During my mentorship at Foreman Therapy Services, I was always a phone call away from a therapist, who was able to provide some help. I remember one time I had a patient who was known to be a malingerer that was unresponsive at arrival. He was seeming to have a severe reaction/ side effect to his medications and I didn’t know what to do. The first thing I did was reach out to my mentor though the company, then other PTs in the company and the office staff. I found that reaching out to these individuals gave me confidence to make the right decision. This may be an extreme case, but even when you're just making simple decisions and creating treatment plans, having those type of people available makes me a better therapist."

What are the five most important articles for any new grad to carry in their home health physical therapy tool chest? We realize part of being a home health PT is bringing your clinic with you to patients' homes, and we're curious what you think is most important.

"The most important tools to bring are a gait belt, BP cuff, goniometer, pulse oximeter, pen, and a tablet. A tablet with internet access is key to documenting quickly. Also, it is a great way to search any diagnoses, treatment techniques, and quick ways to educate the patient." Do you have any time saving tips for new grad PTs working in home health? "Make sure to keep a calendar. Electronic calendars are best. Take the time to plan out your day. You can’t just wing it. Have your day planned out first thing in the morning and do your best to keep to your schedule. In home health, you have to be flexible as well. There are times when the patient doesn’t want to see you; sometimes they have a doctor’s visit and sometimes things unexpectedly happen, so try to be flexible and creative at the same time."

“Matt's Tip: A tablet with internet access is key to documenting quickly. Also, it is a great way to search any diagnoses, treatment techniques, and quick ways to educate the patient.”

Nate Foreman, PT, DPT

What is the biggest struggle of being a home health physical therapist? If you are a new grad, please elaborate how that has impacted your experience as a PT in home health.

"The biggest struggle is that you don’t have a team to work with directly, face to face. In other settings, you are working with other therapists, but in the home health setting you don’t anyone you work with directly. There are people you can contact, but coworkers not being present is the most challenging thing. This is something that applies to both new grads and seasoned physical therapists across the board."

What skills have you seen improve the most during your time working as a home health physical therapist? They can be personal, professional or both.

"Personally, my bedside manner with geriatrics has improved. My organizational skills have improved drastically, just by having to schedule patients, make my own schedule, and even account for driving time when trying to see patients."

"Professionally, my home evaluation skills have improved. My ability to make more functional plans of care has improved. My differential diagnosis skills have also improved."

When you have a question about a patient, where do you get the information or mentorship that you need to create a good treatment plan?

"You are doing a lot of coordination with all of the disciplines when you work in home health PT.  For example, you will communicate with OTs, STs, nurses, doctors, social workers and aides, so there is a lot of coordination among the providers. I would have to communicate with all of them to provide the best care. When it comes to finding information about a patient and needing help to treat them, I would reach out to other PTs that are doing home health in my company. I would also reach out to the patient's physician, to make sure I had the information to treat the patient. Reaching out to any coworkers for help or any other information in treating the patient is always helpful. There are some other companies that don’t provide adequate support and communication among therapists, but with FTS, I’m able to have the support.

What are the five most important articles for any new grad to carry in their home health physical therapy tool chest? We realize part of being a home health PT is bringing your clinic with you to patients' homes, and we're curious what you think is most important.

"The top things I carry are a gait belt, goniometer, blood pressure cuff, pulse oximeter, and therabands."

Do you have any time-saving tips for new grad PTs working in home health?

"Be super organized. It’s very hard to get caught up, so be organized to stay on top of notes and documentation. And make sure to download the Home Health Manager app. It’s the key to faster routes and keeping track of important dates!"

“Nate's Tip: "Be super organized. It’s very hard to get caught up, so be organized to stay on top of notes and documentation.

Wondering how home health compares to other settings for new grad physical therapists? Check out our comprehensive article about physical therapy settings to learn more!

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