As a physical therapy student, pursuing an acute care affiliation can be a daunting task. Acute care is a fast-paced, high-pressure environment that requires quick thinking, exceptional clinical reasoning, and excellent communication skills. However, with proper preparation and guidance, you can succeed in an acute care affiliation and set yourself up for success as a future physical therapist. If you haven’t already, check out How To Prepare for Your Acute Care Affiliation to learn more on how to prepare before your first day!

Here are some tips on how to succeed in an acute care affiliation as a physical therapy student:

Learn From Your Clinical Instructor

Your clinical instructor (CI) is an invaluable resource during your acute care affiliation. They have years of experience working in the acute care setting and can provide you with valuable insights into the field. Take advantage of their knowledge and expertise by asking questions, observing their patient interactions, and seeking feedback on your own clinical skills.

Conduct a Thorough Chart Review

This is an essential part of the assessment process during your rotation. On your first day, your CI most likely will go over this with you, but for starters, you should carefully review the patient’s medical history, including any prior hospitalizations, surgeries, and diagnoses. If there is a trauma patient, ensure to clear the spine before mobilizing. You should also review the patient’s current medications, lab values, such as hematocrit and hemoglobin levels, diagnostic imaging results, if there are any lines or tubes, and oxygen requirements. Additionally, pay close attention to the patient’s current medical status, including their vital signs, symptoms, and any changes in their condition. By conducting a thorough chart review, you can develop a more comprehensive understanding of the patient’s medical history and current status, which can help inform your treatment plan and improve patient outcomes.

Plan Evaluation and Interventions Before Seeing the Patient

After doing a thorough chart review, think about what you currently know about the patient’s status, what questions you’d like to ask the patient, and what interventions you’d like the patient to perform. Talk to your CI if you have any questions, and offer your thoughts on what you’d like to do. There are some outcome measuares you may want to use, such as the 6MWT, 1 min sit <> stand, AMPAC 6 Clicks, etc. Most hospitals will have their preferred measures, so talk to your CI and see what tests they’d like for you to perform.

Patient Safety

The most important thing is to always ensure that the patient is safe. As stated in the first point, keep close attention to the patient’s vital signs and look out for any changes in symptoms. If a patient is a fall risk, ensure proper guarding techniques, and always ask the patient how they are feeling during their intervention.

Discharge Planning

As time goes on during your affiliation, you’ll learn more about how to make proper discharge recommendations based on the patients prognosis/recovery. Patients can be discharged home, SNF, outpatient rehab, etc. and may require equipment. Pay attention to your CI’s clinical reasoning behind their discharge planning, and ask questions to ensure you understand why.

Communicate and Build Strong Relationships with the Healthcare Team

In the acute care setting, physical therapists work as part of a multidisciplinary healthcare team, and you’ll find yourself being apart of that team. You’ll be the one communicating with nurses, social workers, occupational therapists, physicians, and other physical therapists, in which you may discuss things like patient status, whether the patient is appropriate for rehab, or discharge planning. Building these relationships can help you provide more comprehensive care for your patients.

Stay Organized and Manage Your Time Effectively

Acute care is a fast-paced and demanding environment, and you must be able to manage your time effectively. Prioritize your patient caseload and ensure you are providing the best possible care for each patient. Additionally, stay organized by keeping detailed notes and utilizing tools such as to-do lists and calendars to stay on top of your daily tasks.

Take Care of Yourself

MOST IMPORTANTLY! This setting can sometimes take a toll, so please make sure you are taking care of yourself. Talk to someone if you need help with processing any emotions, go to the gym, try to eat healthy, meditate; doing something that can help you de-stress is important in order for you to succeed in this affiliation.

Remember, you are here to learn. You won’t be expected to know every single thing your first day. Put in the work, and you’ll quickly learn what you need to know in order to succeed in this setting. There may be some difficult days, I’ve even had some of my own. The most important thing is to maintain good communication, and set boundaries if need be.