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Both NGPT founders share why acute care makes sense for new grad PTs.

5 Reasons to Work in Acute Care as a New Graduate

Meredith and I are both new grads, but we sit on both ends of the timeline; I graduated in 2014 and she graduated in 2010. We met working in an acute care facility together, and we both agree that working in acute care physical therapy when you’re a new grad is a fantastic idea, regardless of whether you jump in fresh out of school or try another setting first.

Brett’s Perspective

Throughout physical therapy school, I always thought I wanted to work in orthopedics; sometimes I still have those thoughts. During my last rotation in school at Scripps Mercy Hospital, my mentor, Mike Shaw MPT, asked me something that stuck with me and influenced my decision to work in acute care. He asked, “Do you think you will lose your ability to learn once you graduate?” He had an excellent point. If I want to go into orthopedics, I can very well do so. I passed my exams, practicals, clinicals and boards, so I’m a competent PT. Sure, I may be a little rusty once I get into ortho (if I do so), but starting in acute care physical therapy offers a brand new graduate so many opportunities!

5 reasons to work in acute care physical therapy as a brand new grad:

1. Preparation for worst case scenario

I’m glad I’ve worked in acute care, because I’ve kind of seen it all. I’ve seen patients go hypotensive and pass out. I’ve witnessed near-falls and monitored for hyperglycemia. I understand the signs and symptoms of a medical emergency. Had I started out in outpatient, I may have missed critical signs of these potential disasters. Medical emergencies sadly do occur in outpatient clinics, and if I should work there, I will definitely feel confident in my ability to handle the situation.  With direct access becoming more prevalent, understanding a medical emergency and need to refer is more important than ever.

2. Exposure to multiple settings

The beauty of acute care physical therapy is that you have an entire hospital at your fingertips. Unlike a therapist in a strictly outpatient setting, I am able to try out the ICU, behavioral health unit, outpatient neuro and outpatient ortho, just by talking to my boss and expressing my desire to gain experience in multiple settings.

3. High pay

PT school is expensive, and I am making it a priority to recoup my gains as soon as possible. By working in acute care as a brand new graduate, I’m able to really make a dent in my losses by working at a high per diem rate.

4. Perspective

If I wind up in ortho and I feel like a patient is being a little whiny about pain, I have a better understanding of just why their knee/shoulder/hip is aching so badly. Now that I have witnessed the gory details of post-op pain and immobility, I have much more compassion for a patient having a bad day with pain.

5. Mentorship

In my hospital facility, I have met some of the most talented, compassionate, capable and brilliant physical therapists of my life. I work alongside wound care specialists, professors and pediatric gurus. With these resources, I feel that the vast majority of my new grad questions can be answered. I can also find a true mentor in acute care.

Meredith’s Perspective:

Like Brett, I spent my entire physical therapy school tenure dreaming of a life in outpatient ortho. I was lucky to land an outpatient job right out of PT school, but I found that I was frustrated by many aspects of that job. The employers, patients and coworkers were fantastic, but the flexibility was lacking and I wanted to learn more than I could in a 5 visit HMO capitation clinic. I decided to try out some other outpatient jobs, and nothing felt quite right, so I followed a PT school classmate’s advice and tried out acute.  It was the best decision I made!

I’d like to say that I would have picked all 5 reasons above that Brett mentioned. Here are some more reasons I loved acute care as a new-ish grad 🙂

5 reasons to work in acute care physical therapy:

1. Putting the pieces together

It’s a little embarrassing for me to say how little understanding I had for patients’ frustration when I worked in outpatient. They often felt rushed (understandably, as I spent most of my time in fast-paced clinics) and irritated by their experience in outpatient. Once I moved to acute care, I realized that patients often had much longer treatment sessions.  Furthermore, I got a better picture of the entire process involved in some major orthopedic surgeries. Sadly, they often didn’t realize that one of the therapists was either a tech or an occupational therapist, but I digress 🙂

2. Camaraderie

I love teamwork and collaboration. I work best and learn best when I work alongside other therapists and soak up their techniques and methods of explaining their treatments. Acute care is such a wonderful place to learn alongside skilled therapists and nurses. In many ways, I felt that my two years in outpatient were spent learning how to manage time. When I moved to acute care, I learned how to manage people, meaning their fears, their pain tolerance, and their personalities. I learned those “soft skills” by working alongside some of the best.

3. Constant Change

I really enjoy when my days are always a little different. Monotony sometimes frustrates and bores me, when it comes to patient care. Acute care physical therapy provides a constant buzz of new patients, new diagnoses, and new challenges, all of which help me thrive as a therapist.

4. Immediate Fulfillment

I am a person who likes immediate results. I had to do my time in outpatient for almost two years, before I realized that I was getting inpatient with the slow pace of progress inherent to the majority of outpatient cases. Once I helped enough patients take their first steps after falls and strokes, I realized that I thrived on the immediate impact that a PT makes on acute care patients.

5. Flexibility

By the time I went to acute care, I’ll confess that I was feeling a little burned out.  I realized something about myself: I require frequent breaks from patient care to keep my sanity. It can be hard to take a three day weekend to decompress when you’re in orthopedics (unless you have a coveted four 10 hour day schedule).  When you’re in acute care, full-time schedules are often available in 6, 8, and 10 hour shifts.  It could wind up that you have a three day weekend every week, and if not, it’s quite easy to find someone to swap shifts, which is rarely an option in outpatient. Per diem is the route I took; it was pretty great to be able to work whatever days I wanted and explore other opportunities at the same time.

Do you want to know what hiring managers in acute care look for? Read this Article by Vonnie Coms – Hiring Manager at Scripps Mercy Hospital.


About Brett Kestenbaum

NSU grad 2014. I took my first job at Scripps Mercy Hospital in San Diego shortly after graduating, and since then built and for all the new grad PT's out there :).

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