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Things I learned from Mentorship
715 Plays2 years ago
Josh and Miranda share some tidbits and pearls they have learned from many amazing mentors.
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Transcript
Introduction and Value of Mentorship
00:00:08
Speaker
Hi, I'm Josh McDonald. And I'm Miranda Materi, and we are Ham Therapy Academy. So one of the things that most therapists have the opportunity to have happen, and maybe you haven't, is learning from mentors. We talk about how much, all the stuff we share with most of our members and therapists that we've trained is how much we learn from other people. And rarely do we come up with an idea entirely by ourselves. So we wanted to share some of the stuff we've learned from our mentors.
Lessons from Pediatric Therapy
00:00:35
Speaker
Yeah, so Josh, tell me one of your favorite things that you've learned from a mentor. My first one that I have is I was at a conference and it was while I was doing pediatrics and Debbie Hines was another pediatric therapist in our area here in Phoenix. He owned another company and she was at the same conference and just in conversation she made some comment about like finishing the evaluation at a later visit. And I had this like, wait a minute, wait a minute.
00:01:02
Speaker
You have things you need to do in the evaluation that you didn't do on eval day and you save them for later. She's like, yeah, I can't get through everything all the time in the first, in the first shot. So I just saved some stuff for the next time and finished it later. And I had, as a newer therapist, this was just kind of like this epiphany for me of I had always thought I had to cram it all into the first shot of one visit, getting it all in there. And it was so stressful.
00:01:23
Speaker
to think, hey, I can hit the high points, but let some things go for the next one and maybe make a case note so I can find it easier. But maybe I didn't get to sensory testing or I forgot sensory testing, or I can still test at the next visit. And maybe it's not the exact same thing, but I focused on what was important for that patient in the moment, giving them home programs or whatever it is. So that was a huge help for me. Yeah. How about you? What's one of your favorite tips from a mentor or a guide?
Learning through Feedback and Encouragement
00:01:50
Speaker
Um, I would say one thing that when I was a new graduate and I got my first job at a county hospital and they wanted me to do outpatient hands because I was, I had the most experience, even though that was only 16 weeks in my hand therapy fellowship at Mayo. So it wasn't, I didn't have a ton of experience, right? And they brought on this new hand surgeon. So they wanted me to like.
00:02:11
Speaker
you know see all his post-op patients but i had no idea what i was doing and i just remember him um he was like an older guy and i remember him saying like hey it's gonna be okay i i trust you but i'm also gonna verify what you're doing
00:02:26
Speaker
And to me, that was so comforting because I knew, you know, he knew I was new and I probably knew I didn't know what I was doing, but he's like, I trust you, but just, I'm going to verify all the stuff that you're doing. And that really taught me a lot because after I would do a splint, he'd be like, Hey, once you're done with that splint, I want you to have that patient walk back by my charting area. And then the patient would walk by and then he would go out and take a look and
00:02:48
Speaker
he would give me feedback. And if it wasn't good, then we'd go back in that room and do some modifications. So, um, it, you know, if you, some people said that sounds so intimidating, but honestly, the way he did it, it wasn't. And I use that with my students now, you know, all kinds of joking. We say like, I trust you, but I'm going to be right here verifying what you're doing. Yeah. Yeah. And that's an excellent mentor role that he was able to do that without compromising your authority with that patient, you know, just make it kind of a,
00:03:16
Speaker
an incidental interaction with that patient, but he knows he's doing it to verify, but he's not like calling you out and saying, every patient is sent by me because I don't trust. And so the patient still sees you as a role of authority on the topic. Yeah. And then he would just kind of be like, he would just like pop out there when they're walking by, you know, ready for it. Yeah. Yeah. Well, that's cool. That's very good. Yeah.
Openness to New Ideas in Mentorship
00:03:39
Speaker
Miranda and I kind of had the same mentor. Cindy Ivy is a friend of ours and she kind of helped train both of us on a lot of hand therapy stuff. And one of the things I learned from her as I had switched from pediatrics to hand therapy and was kind of just
00:03:55
Speaker
jumping in with both feet and said here i'm just gonna try to figure it out and i would suggest things to her and she was always open to new ideas and she had done it for such issues so good at it and you so much but she was always open to someone who had no experience how about if we do this is okay if i try this and she's a great idea and i love
00:04:13
Speaker
you can totally call that exercise that thing. And so she kind of instilled in me this idea that there's lots of ways to solve all these different problems. And we have to get stuck in a rut. And a lot of times in hand therapy, we feel like there's one way to do each individual thing. And there's so much variety that still gets good outcomes.
00:04:29
Speaker
Yeah. And what I really liked about working with her too was that she would always be like, do you have any ideas for this? And you knew she probably had hundreds of ideas, but she made you really feel like you had some novel ideas. Yeah. Yeah. And, and that's what I think I try at least to get out of our students and our new grads and say like,
00:04:48
Speaker
I may have been doing this a while, but you come in with fresh eyes. And so if you have something you want to try, let's make sure it's safe for the patient and give it a shot. Why not? And if a lot of times the patient will surprise everybody and be able to do something that I may not have even tried with them because it was completely outside my realm. So yeah, it's great ideas from Cindy for sure. Yes, definitely. Yeah.
Importance of Patient Data
00:05:11
Speaker
Um, one other thing that I learned, this was actually, um, from my time working at Mayo, we would always have the hand surgeon that would like pop over. Um, and he would be like, red, I need you to have all this information off the top of your head. I need you to know the date of the surgery for the patient, what surgery was done. And then.
00:05:29
Speaker
I need to know, has their range of motion improved? Has their sensation changed? So just based on whatever the injury might be. And that really helped me organize how I thought about patients in a way because now I always know their date of surgery. So when I know their date of surgery, I know kind of where they should be at with their healing timeframes, kind of how they should be progressing. So I think that was
00:05:51
Speaker
A really key thing that he actually taught me was always knowing some of that basic data stuff that, you know, sometimes we forget about data surgery, right? But when you're doing these post-op flexor tendons and extensor tendons, the date of surgery really does matter.
00:06:06
Speaker
Yeah. Yeah. And even distal radius fractures, like when should I be pushing aggressive range of motion? And when we see them a couple of times a week, we sometimes lose concept and some patients will come to us week one, some week four, and we have to have that. So that's a great way of getting that organized in your mind, not just for the doctor's report, but for your own plan of care creation. Yeah. And then you're always thinking, it's always in the back of your mind where they were, how far out there and where they should be.
00:06:32
Speaker
Yeah, yeah.
Techniques for Responsive Therapy
00:06:34
Speaker
Another thing I got from my pediatric days was I worked with a therapist who was phenomenal at handling skills. And when you're working with kiddos, you're doing a lot of like, NDT stuff and PNF and you're doing a lot of like hands on stuff. And she helped me learn how to have what we call listening hands. And so when I'm hands on a patient, I'm not
00:06:55
Speaker
doing things to the patient. I'm also trying to listen with my hands to what that patient's response is. So if I'm doing like range of motion on the shoulder and they're guarding and protecting, I need to be listening to that tactically to say like, I need to back off because they've got either apprehension or they've got pain or they've got something. So with my hands, I need to not just be thinking about what am I trying to do, but what's their response to that so I can adjust my load or my angle
00:07:24
Speaker
or just back off entirely. So having that responsiveness to the patient's sometimes involuntary guarding or apprehension, having that responsiveness is important. Yeah, I've actually never heard that before. So that's interesting. Listening hands. Yeah.
00:07:40
Speaker
And when new students or new grads or whatever are learning handling skills, especially on shoulders and elbows, because fingers are a little bit more obvious, but it's, they jump in, they think, oh, I have to do range of motion to think about big movers. And we lose, we lose awareness of that patient is, they're in, they're close to pain or they're in pain. And so having that responsiveness to say, I need to listen to what their body is telling me. And you can feel the difference through your hands if you're paying attention to it.
00:08:07
Speaker
Yeah, and I think that's especially key when we have these patients that sometimes won't tell us, right? So a lot of times people think, well, I guess it's supposed to hurt, so I'm not going to tell them it's hurting. Or, you know, something like that where we may not even be aware that they're in pain and tell, like you said, you're feeling what they're guarding or what type of response they're having.
00:08:27
Speaker
Yeah. And you can see those responses in their facial expressions, in their body tension. You can see it in their breathing patterns. You can see all different kinds of ways, but also through the actual body part when my hands are on that PIP joint and suddenly they're stiffening up out of nowhere. Okay. Maybe they're responding negatively to what I just did. And so I need to adjust or back off or give them a moment or yeah. Yeah. Or they get really sweaty.
00:08:52
Speaker
Yeah. Yeah. Especially when you're stretching the PIP sometimes they get super sweaty, you know, and you're like, Oh gosh, they're getting diaphoretic. Yeah. You know, is this a pain response? Is this an anxious response? Yeah. Yeah. Or it's just Arizona at 115 degrees outside.
00:09:08
Speaker
And we just took them out of a hot pack. Yeah, yeah, yeah. That could be it too. Yeah, yeah.
Effective Communication with Surgeons
00:09:14
Speaker
And then talking about your time working with surgeons, and we both had the opportunity, I think you've been fortunate to have even more direct one-on-one time with surgeons. You talked a little bit about the communication necessary there. Tell us more about that.
00:09:27
Speaker
I think a big thing was the surgeon telling me like, hey, I know like sometimes I might not be like the most approachable person, but I want to know if something's not going right. So now just from I guess that working relationship, I've learned like, yeah, it's a, you know, sometimes you feel like you're bothering the surgeon or you're like going to complete more of a problem for them.
00:09:50
Speaker
But now I don't hesitate. I reach out, I call, I just know I have a job to do. I have to, you know, support this patient. And if I think something's going wrong, I'm going to call the surgeon and let him know about it so he can choose how he wants to handle it. If he wants to see him in three weeks, you know, that's on them. But I know that I've done my part in communicating what I needed to do. And I feel much better about that than waiting like, is this an infection or not? You know, now I just know I'm just going to call.
00:10:19
Speaker
Yeah, communicate that. And if you have a doctor that gets annoyed with communication, that's on the doctor. That's their issue. The vast majority of doctors that I've ever interacted with all appreciate us reaching out and asking appropriate questions. I'm not going to ask things that are obvious or that we should take care of. But those appropriate questions, hey, is this an infection, or this wound looks a little open, or is it OK to advance them to this level because it's a little questionable? They always appreciate that.
00:10:48
Speaker
Yeah, and I think one other tip is going back to when you call the surgeon, you know, they take care of hundreds of people, so they may not remember that particular patient. So I always make sure I have the patient's data down, right? Like I know how many, how far out there at what type of surgery they had. So that way, you know, you have all the information that the surgeon needs as opposed to saying, well, I don't remember, let me go look. Yeah, yeah. Make that conversation efficient for them. Yes. Yeah, yeah.
Encouraging Mentorship in Therapy
00:11:16
Speaker
All right, hopefully what we learn from our mentors helps you out a little bit too. And we always encourage people to take students, be around new grads, because it gives you a chance to learn more when you're teaching other people. So we all learn from our mentors, be that mentor for someone else. Yes. All right, for more information, you can email us at info at handtherapyacademy.com or check out our website, handtherapyacademy.com.