Nakita Grinie

April 21 On my real job

Did you know that blogging is not my actual job or calling in life? Shocking, I know.

Kristal asked me to post about my career as a Physical Therapist in the home care setting, which is something I've discussed but never in much detail.


"I’m also curious about your job and Nate’s. This might be more info than you want to share, so maybe not a good topic. I know you are both PTs, but you do different things. You work with people at home…because they are sick? Or they have an injury they are recovering from? Or is it just general maintenance for the older crowd? You work part time…does that mean you have to take on a certain number of patients but you can schedule them in your own time? And Nate, what type of clients does he work with? And I know he teaches some, right? As in, PT students? Writing that all out sounds super nosey, haha. But I’m just curious about what y’all do!"

I obviously don't mention my job too often for patient privacy reasons but also it doesn't seem like it's especially interesting to describe. But then again maybe it's a fair topic (especially when grasping at straws daily blogging) since not everybody knows what a PT entails and some people might be curious. I mean, it *is* a huge part of my life and I don't mind describing my job minus specific patient details.

So yes, both Nate and I are Physical Therapists. He has his Doctorate in Physical Therapy (DPT, not a PhD) and graduated four years ago. I have my Masters in Physical Therapy (MPT) and graduated ten years ago, before the profession upgraded to a doctoral degree. Lucky me got out of school with 'just' my masters and I don't ever have to go back to get a doctorate, since we don't get paid differently based on our degrees. I suppose someday employers might really push for DPTs versus MPTs but so far that hasn't been the case for me. I mean, Nate's dad is a Physical Therapist and he practices with 'just' his bachelors degree--I cannot even tell you how long ago he graduated but I'm guessing 35 years ago? So you could work with a PT who has their bachelors degree, a masters degree, or a doctoral degree all based on how long ago we graduated. Anyone who wants to go to PT school now will have to do four years for a bachelors and then three years of graduate school. It's a lot of schooling (ahem, and loans) for sure and I'm lucky I graduated just a few years before the DPT was mandatory! But everyone has to sit for the boards to obtain their license and then we all do continuing education courses to stay up to date with our licensure.

Hahahaha, this was 'only' ten years ago?! December 2004, Masters graduation with my family. Geez we have all changed just a bit.


And 2011, Nate's Doctoral graduation with his family (his brother couldn't make it). Aw, Sammy dog!!


Once you graduate you can 'specialize' in many different areas and work in all sorts of settings, changing it up if you get bored or want to try something new. I have worked in an outpatient clinic, a nursing home, a hospital (on the floors, called acute care) and now home care. Nate has always done Sports Medicine at an outpatient clinic and both of us really love our particular settings. We like to make fun of each other to our respective patients about how the other person has it made as a PT. Nate tells his patients that I have bankers hours and work from 10-2 three days a week (not totally true, but pretty freaking close!). I tell my patients that Nate has froufrou patients with minimal pain in their knees after golfing 72 holes WAH WAH (also not true, but it's fun to elaborate) while I have the patients struggling to stand up off their bed at home.

Let's talk about Nate first: Nate mostly treats athletes who are injured or who just had surgery, but he can also see a variety of other people who aren't athletes, too. All sorts of pain issues (knee pain, back pain, hip pain, shoulder pain, etc), and all sorts of surgeries (ACL reconstruction, rotator cuff repairs, total hip replacements, etc), plus he does running gait analysis, dry needling and lots of corrections to *how* people move their body. Actually, he would probably love to write all about what he does as a PT and he'll totally roll his eyes at my description for you here today;) His clinic is affiliated with one of the local universities so they see their student athletes, he works with our professional hockey team, and also adjunct teaches at a PT school twice per week. He's a super PT and a dedicated employee. So very glad he decided to go to PT school after wavering about his options for a solid few years after his bachelors!

As for me: I work part-time which is based on the number of visits I make per week, not the number of hours I put in. Averaging five patients each day is my ideal so that I can meet my FTE requirement but of course it fluctuates quite a bit. There are never two days that are exactly the same in my job and truly never a dull moment!

I work Monday, Wednesday, and Fridays and usually schedule my patients beginning at 9:00, I try to squeeze in a lunch break at some point, and I prefer to be completely done with patient care by 3:00 and done with paperwork by 4:00 so I can pick up Porter and Cecelia from Lori's. That doesn't always happen and sometimes I have to do my paperwork at night after the kids go to bed--I dislike cutting into my 'me time' of the day so so much but oh well. There is a LOT of paperwork in home care but if you are organized and Type A like myself, it doesn't pile up on top of you and it's always a goal to get it done the same day.

I schedule my own visits with my patients and I adore this part of my job because it's so incredibly flexible. But this can be both a wonderful and a challenging part of the gig. Let's say one of the kids is sick: instead of 'taking a sick day' and staying home with them, I am responsible for calling each patient I have scheduled, explaining the situation to them, and then attempting to reschedule our visit for a different day that week if possible. Almost always, my patients are more than accommodating as soon as I explain that my children need their mom;) It does create added stress for me to rearrange my schedule but I'm lucky I have that option for sure, and usually I can usually stick to a solid schedule with each patient because we all know how much I love routine.

One part of being a PT in the home care setting that is very different from other settings? The autonomy that is required. There are no co-workers, no doctors, no other staff present during my treatments so the responsibility that rests on my shoulders can be enormous. I make a lot of phone calls to doctors, updating them about patients. I have had to call 911 for several patients over the years and it's still really scary to wait for an ambulance to arrive. There are so many things that can go wrong and a home care PT has to be assertive enough to make decisions constantly. That being said, home care PT is not for everyone (Nate would HATE it!) for a variety of reasons, but I really do love my job.

I go into patient's homes all day long (well, from about 9-2:30ish) and there is a never a dull moment being introduced to how other people live within their own houses. That's all I'm going to say about that, but I really haven't seen anything TOO horrible in my years in home care.

I adore being in and out of the van, driving a bit, getting to know my way around the city, and getting some sunshine/fresh air on non-blizzard days.  I'll sometimes have a cancellation or a lighter case load that allows a quick Target stop, allows me to fill up for gas, run to the grocery store, etc. I do a lot of my end-of-day paperwork at Starbucks, too, so that makes my job extra rough;)

A majority of my patients are elderly and it's very rare that I treat anyone who is younger than age fifty. One big stipulation to medical insurance covering home care services is that the patient has to be 'home bound.' So if they are healthy enough to be out and about in the community, they probably don't need me to come to their home for therapy---they could go to an outpatient clinic. This means a lot of my patients are fairly sick, or recovering from being sick. I can see people with all sorts of diagnoses: stroke, fall, orthopedic or any surgery, pneumonia, general weakness, cancer...really anything that would make a person less than 100% of their previous selves with a need to regain their strength.  Most have recently been to the hospital or just came out of a rehab stay/nursing home.

Big picture is that most of my patients are older, frail, have some health problems, and tend to be very appreciative for the help I give them. Some are lonely and their PT sessions with me might be the only thing on their calendar all week. Sometimes it's difficult to get out the door after a session is over, turning down coffee and cookies and candy. Sometimes people I see are really struggling with some very heavy issues, like a terminal diagnosis, the decision to sell their home and move to an assisted living, or the loss of their independence. My job can be emotionally draining as you can imagine. But it can also be incredibly rewarding.

I am constantly blown away by caring families who will do anything and everything for their loved one, to keep them at home. I'm also constantly blown away by how much priorities can change and what I take for granted---like my ability to just stand up, walk out the door, down some steps, hop into my van, and drive away. We might work on those individual tasks for weeks if not months in physical therapy. My job constantly reminds me to be grateful for this busy, fun, exhausting time in my life because things can change in an instant.

Whew. That got deep. But now you know a little bit more about my 'real' job;)

Hope that answers all of the burning questions you never knew you had about my 'real' job.