Q&A with Stephanie King: Trust Your Instincts
March 13, 2015
All About Stephanie:
I grew up in Cincinnati, Ohio where the first 18 years of my life consisted of hours upon hours of dance classes and dance competitions. I also have a great passion for travel and learning new languages. My favorite place in the world is Israel; I‘ve traveled there seven times! While in high school I sought out Drexel University for its 3+3 BS/DPT program and locale in the middle of an east coast city. My three undergrad years at Drexel were great and flew by quickly. I was a dancer and choreographer in the Drexel Dance Ensemble, spending my free time exploring Philly and the surrounding big cities. PT school started a whole new chapter where my classmates became my family members. I left the east coast for my first two clinical experiences at a large trauma hospital in Albuquerque and an outpatient clinic in downtown Chicago. The three years of PT school at Drexel were so special thanks to the amazing faculty members. Each professor greatly inspired and motivated me to be a part of this profession.
What made you decide to pursue a degree in Physical Therapy?
With a passion for dance, I knew I wanted to pursue a kinesthetic career and one that would help people. Physical Therapy is exactly that. Initially I had hoped to become a therapist for a large dance company working closely with dancers, but after my undergraduate co-op experience as a therapy aide at Magee Rehab hospital my interests shifted to that of neurorehab. Specifically, stroke recovery.
Where are you working now?
I live in Los Angeles, California and work at Glendale Memorial Hospital. I have a unique opportunity at this hospital where I can treat patients in acute care and also in the acute rehab facility. In the acute care hospital I see patients in every unit including the ICU. This area of Southern California is very diverse, and in a normal day of work I speak 5-7 different languages!
What is your favorite part of being a Physical Therapist?
So many great aspects of this profession! How could I choose one? To start, I love having the opportunity to motivate my patients. Being a patient in the hospital is not easy; it is emotionally and physically draining. When I enter a patient’s room my goal is to get them out of bed and back to doing what they love, restoring a part of their dignity and independence. Therapists are some of the best listeners, teachers, friends, coaches, and shoulders/hips/thighs to lean on (literally).
You recently had a very interesting and ultimately rewarding experience. Tell us about it.
On Friday, January 16, I was evaluating a patient that was set to be discharged from our hospital. He had been admitted for about 48 hours with Atrial Fibrillation. He was completely independent prior to admission, though during my evaluation he presented with moderate gait ataxia. It was odd since he had (-) finger to nose and (-) heel to shin tests. His blood pressure was high, and when the nurse attempted to give him blood pressure medicine, he kept coughing on the water. I immediately called the code for rapid response team, though the nurse was at the bedside telling me I was overreacting. Once the team came, they assessed for strength deficits and didn't find any. When they asked the patient to smile he had no facial droop. Then when I said he was having difficulty swallowing they asked the patient if he ate breakfast. The patient answered yes, he had eaten breakfast. I kept trying to explain that if he had a cerebellar infarct he wouldn't have strength deficits or a facial droop but I wasn't being heard. The rapid response team eventually left the room feeling that the patient was stable, but I was still uncomfortable. I begged the nurse for a stat CT and as it turned out, he had a cerebellar bleed.
It took a lot to go against what the nurse and rapid response team were telling me. I could've begged for this stat CT and very well have been wrong. I would've delayed discharge and scared the patient and his family for no reason. But, somehow I had the confidence to follow my intuition. I thank all of the Drexel PT faculty and staff for giving that to me.
In your account, you say that both the nurse and the rapid response team felt that the patient was stable and that he needed no CT. What made you insist on the CT?
A common saying in healthcare is that strokes are like snowflakes; no two strokes are ever the same. Yet, the nurses and those on the rapid response team have been trained to look for hemiparesis (weakness on one side of the body) or a facial droop when detecting a stroke. Physical Therapists have a more in-depth ability to assess for other signs including deficits in balance, coordination, and sensation. Three red flags were present that made me insist on the CT scan. First, the patient exhibited significant coordination deficits affecting balance and his ability to walk. This was a drastic difference in his functional ability from just two days prior. Second, the patient’s blood pressure was dangerously high. Lastly, while attempting to take medication the patient exhibited signs of difficulty swallowing. I was resolute knowing that if a stroke had occurred in the cerebellum, the nurses wouldn’t see the signs they were looking for. With all three of these red flags, I felt our hospital would be doing a large disservice to the patient if we sent him home without further investigation.
Furthermore, I would be remiss if I didn’t mention my professors here. I can recall countless soapbox lectures (ahem, Dr. Ebaugh) where they drilled into us the idea that as DPT’s we do have the expertise to stand our ground for our patients.
What is your advice to students interested in a career in Physical Therapy?
If you want to be a motivator, someone that creates goals and then provides the tools to succeed, don’t let textbooks or hours of study deter you from choosing a career that will reward you every day. And if you do decide to pursue Physical Therapy, be open to learning about the many different patient populations that need your help.