Choosing a Placement

1. Choosing a Placement A few tips to make the process easier

2. Please note � the explanations given are what typically happens at most hospitals in a given service. You are not guaranteed to see/care for everything that is mentioned. This is merely a guide of what you could come across.

3. What to choose?? Can be a very stressful time for some students. Should really be an exciting time. How best can you meet your requirements and get the best clinical experiences possible to stand you in good stead for the PNE and your future practice

4. The Process Consider your outstanding requirements Think about your areas of interest and see if you can fit that into your requirements Review the offers available in the areas you have requirements Read the placement profiles on the Clin Ed website to see what is involved in each placement Make your choices and then revisit the database closer to the run RELAX

5. Database When making your choices, out of your 10 you may only choose two offers at any given site; this will hopefully allow for a more fair run. You may only complete two placements per site and they must be different services/areas of practice. You will leave Edmonton for at least one placement but most students end up completing 2 or more placements outside the greater Edmonton area.

6. Requirements Acute Care Community Private Practice/ Out Patient Ortho / Occupational Rehab (Millard) Alberta Adventure CardioResp � 40% Neurology � 40%

7. Acute Care Typically involves: A large urban hospital Acutely ill / emergent patients Surgical Medical Critical Care Rehab Ambulatory clinic follow ups for Med/Surg patients with Internist/Surgeon ++Interdisciplinary team

8. Many diverse fields of practice in which PT is involved Many other health care providers striving for a common goal of patient well being, healing, compassion, and or palliation

9. Acute Care Services - Medicine General Internal Medicine Typically adults and older persons, occasionally younger adults with complex medical problems COPD exac, Pneumonia, Acopia and Falls, CVA�s, generalised problems relating to DM, Malnutrition, Poor compliance with meds, and some people that just need a �tune up�. Also may see people following discharge from ICU. Typically Assessment, Treatment (strengthening, balance training, functional activities, mobilisation, discharge planning for home, equipment (Mobility aids etc) ordering. Typically you will have opportunity to use your CardioResp and possibly Neurological skills. Lots for InterD team work with SW, OT, Dietician, Pharmacists, SLP, RN�s and MD. A very rewarding service, you enable people to return to their own homes with INDEPENDENCE

10. Acute Care Services - Medicine Nephrology/Renal Adults and some older adults. Occasionally younger adults. Patients with kidney disease. On one form of dialysis (IHD, Peritoneal etc). Typically sequelae of DM. Renal disease is quite debilitating and draining. Patients don�t usually have a lot of energy following dialysis. Really benefit from exercise and strengthening. Can lead productive lives and are able to live independently. Are prone to infection. Will involve, assessment, treatment (strengthening, exercise prescription, maintenance programs), D/C planning, equipment ordering. You will be using CardioResp skills ++ InterD teamwork, SW, OT, RN, MD. You are enabling independence and improved function

11. Acute Care Services - Medicine Pulmonary/ Respirology All ages across the adult spectrum Typically patients with COPD exac, post ICU, patients with long term ventilator requirements or straightforward weaning. Patients with traches, CF, pneumonia, interesting/obscure lung conditions. Lots of chest assessment, auscultation, treatment (vibes, percs, breathing ex�s, resp muscle training, general strengthening, suctioning), equipment ordering and D/C planning ++ InterD work, OT, SW, SLP, RN, Pharmacist, MD. You will really be able to hone your cardioresp skills

12. Acute Care Services - Surgery General All ages across the adult spectrum Variety of conditions � cancer, bowel obstructions, internal bleeding, elective and emergent surgery. General surgery typically involves the abdomen Will involve assessment, treatment (typically cardio resp skills, strengthening, mobilisation, perhaps equipment ordering, and D/C planning. Involves chest care and lots of mobilisation to prevent complications. Patients typically will have lines, tubes and drains Will involve InterD teamwork and D/C planning

13. Acute Care Services - Surgery Specialised surgery All ages across the adult spectrum Will involve specialised surgery on specific areas of the body ENT, Head and Neck, Plastics, Urology, Thoracic etc. Will involve cancer, malformations, obstructions and repairs. Will include assessment, treatment (cardio resp skills, education, mobilisation, strengthening) and D/C planning InterD teamwork OT, SLP, SW, RN, MD

14. Acute Care Services - Surgery Orthopaedic Surgery/Trauma Ages across the adult spectrum, typically older adults for cold fractures, younger in traumatic injuries Will involve ++ joint replacements, mainly hips and knees. May involve �cold trauma� a fall resulting in a fracture that requires fixation and hardware. May also involve a trauma service which would deal with patients post MVA, workplace injuries Will involve assessment (should involve some form of cardio resp assessment in addition to ortho assessment), treatment (strengthening, ROM, mobilisation). Often includes best practice care paths. Crutch walking, equipment prescription and ordering, D/C planning InterD teamwork

15. Acute Care Services - ICU All ages across the adult spectrum, occasionally paeds if facility has no paediatric ICU A whole variety of conditions: acute medical patients, major surgical and transplant patients, lots of trauma, multiple organ failure 1:1 nursing, intense observation. Some very actutely ill patients Assessment, treatment ( +++ cardioresp � percs/vibes/positioning/ strengthening and mobilisation, possibly some neuro, ortho. Not much D/C planning as patients tend to go to ward. +++ InterD environment, MD, RN, OT, SLP, Pharmacist, Dietician, RT and many specialist techs Although daunting is the safest place to work, doctors around 24/7

16. Acute Care Services - Neurology Neurology All ages across the adult spectrum Patients with CVA�s, acute spinal cord injuries, MS, ALS, GBS, PD, ABI�s. Will involve assessment and reassessment, treatment (neuro skills, balance, coordination, function, strengthening, quality of movement, outcome measures) D/C planning, Equipment ordering, occasionally home visits. Rehab usually has big input about D/C, appropriateness for Rehab Hosp/LTC etc. You will be able to hone your neurological skills and possibly some cardioresp, perhaps some inpt ortho InterD work with SW, OT, SLP, RN, MD. PT�s. Really dynamic and exciting services. Big impact on function and quality of life -

17. Acute Care Services - Neurology Neuro-surgery Typically adults and younger adults, all ages in adult spectrum Usually traumatic injuries that require surgical intervention where the brain or spinal cord are involved. Following MVA or falls. May also be elective surgery for brain tumour or aneurism clipping. Could involve spinal surgery following trauma, which may or may not have resulted in quad/paraplegia Assessment (typically, neuro, cardioresp and ortho assessment), treatment (neuro skills, balance, strengthening, mobilisation, functional outcomes, cardioresp [esp in SCI] and ortho skills) D/C planning and equipment ordering. +++InterD teamwork OT, SW, SLP, RN, MD Big impacts on function and quality of life

18. Community Placements All ages across the adult spectrum Conditions you may see include: cerebral palsy, acquired brain injury (ABI), stroke, spinal cord injury, Parkinson's disease, COPD, muscular dystrophy, pneumonia, joint replacements Typically complex patients Will really test your skills and challenge you May be in a rehab facility (eg Glenrose, Dr Vernon Fanning) , could be in a school setting, long term care facility, home care, day programs Will involve lots of assessment, treatment ( will involve neuro skills, cardio resp skills and ortho skills, strengthening, balance training, mobilisation working on quality of movement and functional outcome measures. May involve suctioning traches. Will involve home programs, maintenance programs, individual treatment and class and group activities), equipment ordering, D/C planning and possibly home visits. Involves +++ InterD work with OT, SLP, SW Challenging placements that require integrated critical thinking skills

19. Community Placements Long term care Nursing home � residents with complex problems requiring assistance from nursing staff Require assistance with ADL�s, are unsafe to live on their own Often have multiple medical problems. May have some sort of dementia component. Perhaps will be on O2, may have traches that require suctioning May have mobility limitations Assessments and treatments, looking at maintenance programs as well as trying to improve function so patients could return home or to a facility requiring less direct care

20. Community Placements Home Care Bridges the gap after discharge � also frees up hospital beds for more acute patients Patients discharged home but still require rehab to return to previous level of function. Patient unable to attend out patient program Could be checking in on patients with chronic diseases that require on going assessment, treatment and home program prescription Aim is for independent function and managing condition in their community

21. Private Practice/OP MSK/ Occupational rehab Typically private clinics but some hospital based OP clinics All ages across the adult spectrum, typically younger adult General MSK conditions/injuries, necks and backs as well as peripheral joints, sports injuries, work place injuries, repetitive strain injuries. Some practices do some Cardioresp and Neuro treatment although this is rare Assessment, treatment (manual therapy, ther Ex, EPAs, home exercise programs), consultations Possibility of discussion with referring doctor Most Private Practices are not recommended for first placements

22. Alberta Adventure Your opportunity to get out of the big city and go on an adventure Think outside the box, see the province, wind down Community hospitals and small community programs offer a very different perspective on patient care All ages across the adult spectrum Typically a very mixed case load Most certainly some form of Cardioresp, possibly neuro, MSK May involve some LTC/HC Small facilities � everyone will know who you are Please read the �merits of rural practice� section in the clinical practice handbook or watch the student interview video-Who would have thought my first job would be in rural AB? on the Clin Ed website under Alberta Adventure.

23. Think about your requirements Consider your requirements when making placement choices. Besides that, strive for diversity. There are many settings and each offers both unique experiences and an opportunity to build your core PT skills VARIETY is the spice of life and makes for a well-rounded PT!! YOU and your attitude are key for a successful placement!! Have Fun and Good Luck