Family First

I typically avoid talking about my professional life online, simply because I'm not that interested in talking about work when I'm already putting 50+ hours a week into it.  But a recent comment to a colleague and friend on twitter (twitfriend?) sparked an, IMO, unhealthy discussion where I felt like I was chided for not devoting my personal time to evidence based practice.  So, I'm going to share my professional responsibilities and time requirements with you.  Since 140 characters on Twitter wasn't enough space, here we go!

First, I'd like to tell you a little about my professional life.  I work for a VA Medical Center as the only full time physical therapist.  We have another part time therapist that works three days a week and we've been in the process of hiring another full time PT for about a year now. I took the position of the only full time therapist on staff almost four years ago.  At the time, they had a contract PT and a tech.  The PT came in and did about 12 evals a day, two days a week and the tech 'treated' somewhere north of 40 patients every day.  I straightened that out in the first week. I put together an equipment list and had all of our outdated or nonexistant equipment replaced with things you would typically see in an outpatient setting. 

Now we roll 15 patients per day, 30 minute time slots, with 3 new patients every day, along with working in any 'priority' patients. We also cover inpatient evaluations and short term rehab evaluations, as well as issuing canes, walkers, TENS units, etc. I'm also the chair of an amputation prevention committee and host a tele-clinic to decrease driving strain on our amputees.

We serve an area basically the size of South Carolina, roughly 10,000 square miles if I measured correctly on the map.  Just the two of us. Time management is crucial in the office, as I alluded to in the twitter discussion with Jerry. Simply put, we do not have time in the clinic to devote to evidence.  As I suggested, someone/something that provided a synopsis of good evidence would be of great benefit to us, as well as many other rural PTs. 

I work 40 hours a week, plus 30 minutes for lunch and an hour drive each way.  So my work day is about 10.5 hours and busy with something to be done at all times.  I like it that way.  Sitting around makes for a long day. As you can see, I do not have large openings in my schedule to devote to literature.

All of the above information is why I suggested that access to evidence needs to be simpler and more readily available.   One person apparently took offense to my suggestion, telling me that such an idea would cut down my critical thinking skills and make me a lazy thinker.  I don't expect that I will agree with that person much.  Apparently we are from very different generations and different backgrounds.  I can break down and apply information quickly and easily, if I have the information.  Apparently, from her opinion, it takes her longer; that's okay, we're all different.  Just don't hold me to her standard as it may hold me back.

Now, dear person I do not know,  you know who you are judging when you start to have your little twitter chat with me as the central focus. As one of your responders said, I work to live, not the other way around. My career is not my life.  My life is my life and I wouldn't have it any other way.  You frequently stated, both on Saturday and in your discussion that I had identified family as a hindrance to EBP.  That is incorrect; you assumed that I felt they were a hindrance.  They are a priority. I'd hope that your family would be the same to you.  And while I'm addressing your asinine claims, I have no sense of guilt about time spent with family.  I feel like I have an excellent balance on family time and work time. I merely made a suggestion for making access to evidence better.

I put in my time, do a good job, and do my best to stay current.  That best includes staying in touch with courteous, respectful colleagues through various social media avenues to have access to their knowledge and taking on students, who bring in fresh knowledge from the academic relm.

Let me make this explicitly clear: I do not feel an obligation to give up any of the time that I have each day that is not already devoted to working, driving, sleeping, eating, changing diapers, or cooking. I'll be damned if I'm going to spend that 'free' time on work.

So, while you're sitting around, talking about #SolvePT on social media, I'll be happily enjoying my family and solving patient problems, one veteran at a time, while I'm at work. 

Oh, and there is a reason that I do not get involved in these silly, self-important twitter discussions:

To-morrow, and to-morrow, and to-morrow,
Creeps in this petty pace from day to day,
To the last syllable of recorded time;
And all our yesterdays have lighted fools
The way to dusty death. Out, out, brief candle!
Life's but a walking shadow, a poor player,
That struts and frets his hour upon the stage,
And then is heard no more. It is a tale
Told by an idiot, full of sound and fury,
Signifying nothing.