We congratulate Avenlea Gamble and Kellye McKee, our new scholarship winners for this quarter! Read their awesome essays below:

Avenlea Gamble, SLP Student at University of the Pacific, Stockton, CA, Grad Date: December, 2017

The opportunity I was afforded as a student clinician at the Pacific Speech, Hearing and Language Center was a formative experience to my education and cemented my interest in serving the adult population in the field of speech/language pathology. University of the Pacific has provided me the ability to work across a lifetime of demographics during the short time I’ve been here, but my favored clinical experience was within the adult clinic. There I was able to work with individuals who truly inspired me as a clinician. I believe the most rewarding aspect of working with an adult demographic is that you are returning a voice or supporting the ability to communicate with a group of individuals who could freely communicate prior to the incident or diagnosis that changed their lives.

Reading a textbook provides a limited academic view into the disorders and the individuals in which we will see these disorders realized. Actually working in the clinic brought a humanity to our field that a classroom can’t provide, and challenged me as a developing clinician to take static information and apply it to the improvement of my clients’ lives. I was working with individuals who were struggling or lost their jobs because of their communication problems; clients who had given up on past times or lifelong interests because of the deficits they now faced; or even people who couldn’t tell their family that they loved them.

I was raised in skilled nursing facilities, visiting one when I was three days old and returning regularly since then. My mother began working in the local skilled nursing facility in our rural hometown of Willits, California, when she was 17, and I started working there when I was 16. I worked under the social services department as a Care Partner, a position in which I was tasked with providing psychosocial support to the residents. One aspect of my job was attending residents’ appointments with them, and I began regularly taking one resident to his speech-language pathology appointments at the local hospital. Watching the clinician work with my resident lead to the realization that I could see myself in that position, fulfilling that role of returning and supporting the communicative abilities of my community members, and seven years later, here I am at University of the Pacific, in my final year of schooling to do just that.

I was also employed in the social services, dietary, human resources, compliance, and administrative departments at the nursing facility. My experience in the adult clinic at Pacific, as well as the different departments of the skilled nursing facility, have given me a unique and collaborative insight into the needs of the adult and geriatric populations that speech-language pathologists often serve. I want to improve the quality of life of individuals with dysphagia using the dietary and speech-language pathology experience I have gained, as well as bolster the cognitive-linguistic support for individuals with different neurological disorders or disorders secondary to brain injury or cardiovascular injuries. My personal goals lie in dementia capable care, aphasia therapy with couples or in the group setting, and stronger collaboration between the dietary staff, registered dietician, and SLP to provide a better quality of life for individuals on specialized or thickened diets. The adult and geriatric population are a precious resource to us because of their life experience and wisdom, and they must be respected and provided the highest quality of life they may receive during the golden years towards the end of their lives.

I supported clients who presented with different aphasias, voice disorders, dysarthria, apraxia, and a laryngectomy. A chart review gives the clinician a very limited view into the client – every client is incredibly unique, and no two people with aphasia present the same. It’s a continuous challenge which allows clinicians to continue growing and learning throughout their careers.

My combined experience at the skilled nursing facility and adult clinic at Pacific have fostered an empathy and compassion in me for the adult population that I will carry with me throughout my career and life. As long as I have the ability to serve, I have a duty to support the communication needs of this population and my community as a whole using my education and clinical experiences.

I come from a small community, a town of about 4800 individuals, so when a patient passes through my door, they are not a stranger. They are a community member, a friend, a member of the family. My wonderful education, clinical experience, and lifelong growth within skilled nursing facilities will allow me to be that spark for my patients, because serving this population has been what has defined my life thus far, and what gives me the deepest satisfaction that I have known.

Kellye McKee, PT Student at Rocky Mountain University of Health Professions, Provo, UT, Grad Date: December 2017

Go across the floor leading with your bones. Come back by moving your muscles. The words of my college dance professor resonated through my head as I attempted to move my body forward, leading with my pelvis and allowing the rest of my body to follow. Unbeknownst to me, that class and its concentration on dance anatomy would determine the focus of my college education. Ultimately, it sparked my passion for the human body and how it moves and works, leading me to pursue a career in physical therapy.

Dance allows me to comprehensively explore my body and the intricacies of its movements. Performing as a professional dancer from 2007 until 2015 gave me the opportunity to express my love and knowledge of dance. As a performer, I love envisioning and understanding the muscles, ligaments, and tendons that allow me to twist, bend, and leap across the stage. That connection to, and awareness of, my own body has facilitated a passion for kinesiology and anatomy, as well as a deeper understanding of how the body heals and recovers from injuries. After thoroughly enjoying a human anatomy course, I began exploring career paths centered on the human body and health care. This is when I discovered physical therapy.

My strongest draw to the profession of physical therapy was the opportunity to use my education and training to spark a passion in my patients and to empower each one. When patients gain insight into their diagnoses and deficits, they can use that education to help themselves improve and heal. Knowledge is power, and knowledge concerning one’s own body sparks a lifelong motivation to continue working toward a healthy body. Another passion of mine that is rooted in body awareness is working as an instructor for The Dailey Method barre exercise class. Being a TDM instructor has given me the opportunity to help people build strength and flexibility through education, encouragement, and hands-on adjustments.

The Dailey Method approach is centered around proper body alignment and controlled, non-impact movement that engages the body deeply. It has been rewarding to help people reach their physical and mental goals. That lifelong love of learning has contributed to each client’s well being. Of course, people coming on their own to The Dailey Method classes are motivated in a different way than some physical therapy patients, including patients in a skilled nursing facility. Sparking a patient’s desire to improve requires flexibility and a positive attitude, as well as knowledge and training in the importance of physical activity.

My appreciation for the human body has grown during my eight-year career as a professional white water raft guide. Being a raft guide provides me with extensive experience working with a diverse group of customers, each with his or her own individual needs, thoughts, and personalities. Rafting gives me the opportunity to accept and appreciate diversity as well as provide an environment for my interpersonal skills to flourish. These skills are essential for working as a physical therapist. My ability to communicate with a wide range of people, combined with my desire to facilitate healing, allows me to work collaboratively and effectively with patients and other health professionals. Being a raft guide has to do with safety first, and providing a safe trip often has much to do with the guide’s ability to motivate customers to dig in, work hard, and paddle together as a team. These skills are certainly transferable to the world of physical therapy. Creating a safe run down rapids require setting goals and planning how to achieve that success.

Creating success for a patient involves their help in setting their own goals and their involvement in planning for their own long-term and lasting success. Freedom to spend more time with each patient, beyond corporate limitations, would create a more patient-centered approach. Having that freedom was would allow the flexibility and time to try different evidence-based approaches. My physical therapy career choice was further affirmed at the beginning of the 2014 rafting season. I had begun the season with back pain that was not responsive to my usual stretching and strengthening regimen. I had also begun seeing a chiropractor and acupuncturist but had little relief. One of the guests on my first rafting trip of the season happened to be a physical therapist and was more than happy to help me. She explained what she believed was causing the pain and recommended several daily exercises. She also listed motions and movements that I should try to avoid, as these motions would have a negative impact on my back. I followed her advice and in just a few weeks I was feeling better than I had in months. It was inspiring to discover that a few physical therapy exercises and stretches could make such an impact. I strive to pass along that same knowledge: understanding and respect for the human body. I also want to be able to help others with their physical ailments the way this therapist had helped me.

As a student of physical therapy, I learned so much about the human body, what it is made up of, how it works and why, and what can go wrong. I found this education fascinating, and I am inspired to learn more everyday. Now that I am an intern and able to spend time with patients, I love to pass on my knowledge and hope to inspire everyone I encounter. I have worked with many patients who were unmotivated to participate in physical therapy. One that stands out was a male in his 30s who had been in a bad car accident ten years prior and had been living with severe back pain ever since. He was prepared to spend the rest of his life with limited activity and in severe and constant pain, but he decided to give physical therapy a chance. He did not particularly enjoy the first few treatments, but he was compliant with the home exercise program I prescribed, and he continued to come in for his appointments. After three treatment sessions, he reported a decrease in back pain, and by the fifth visit claimed to feel the best he had felt in ten years. By the end of our visits, the patient was able to participate in every activity that his pain levels had kept him from enjoying. He was so thankful for the help and education that he had received. I was inspired by the improvements he was able to make, and his profound appreciation for the successful treatment resonated deeply with me. This gratitude will serve well as a reminder throughout my career as a physical therapist that even the most unmotivated patients can be helped.

Witnessing firsthand the interactions between Ensign physical therapists and their patients, I am continually inspired by the communications I witness, the improvements the patients make through therapy, and the compassion shown by the physical therapists. Using my background as a professional dancer, raft guide, and as an instructor at The Dailey Method, it is my goal is to inspire each and every physical therapy patient I have the privilege to treat.

Did you know we have an exciting new opportunity with Ensign? We are starting our very own internal travel program! What? Yes, we’ll have our own internal team of travelers who will go and serve in any of our communities. We have been asked by several DORs and EDs for the past several years when we could start something like this … well, here we go!

It’s a brand-new program, and we’re starting it from the ground up. Holy smokes! Sounds crazy and overwhelming, right? It definitely is, but it is much-needed and well worth the efforts. We are spending millions of dollars each year on outside contractors, registry, travelers or whatever you want to call them. It’s a huge financial and cultural burden. With a typical contractor, we invite strangers into our communities and expect them to act like family, without much training on our core values. They are not invested in our people and often don’t understand our culture.

On the other hand, what if we could save our Ensign facilities just a little of that burden — what would that do for our employees and patients, let alone our bottom lines? Think about it. What would it mean to have our own Ensign family members go into facilities and serve where they are needed most? What would it do for us to enlist someone who already has CAPLICO ingrained in them, can lead in clinical excellence, and who is passionate and team-oriented? The implications are huge!

We are calling these elite therapists Thera-Troopers. They will be part of a team of special forces (OT, PT and SLP) who will be called to serve our new builds, our most staffing-challenged or newly acquired facilities. We understand this is not a typical travel job, where therapists get to call recruiters and say, “Hey! I want to go to Sacramento for three months!” and the recruiters say, “Hey! OK!” Instead, it’s more like, “Hey! We need you to go to Reno for three weeks until our new therapist starts! Then Sonoma for two to cover a vacation!”

We realize that this opportunity to serve our company is challenging and is not for everyone. For others of you reading this, you may be getting excited with possibilities of leadership opportunities, exploring our great countryside, networking and building lifelong relationships, and learning new settings and environments in which to hone your therapy skills.

As a full time Thera-Trooper with Ensign, you are considered family and are treated accordingly. We are looking for those special therapists who feel compelled to serve wherever the greater need. It is not an easy task at hand, but with lots of love and support, and a few extra goodies gently placed in a care package, it is an opportunity worth exploring!

Contact Tara Brown if interested: tarabrown@ensignservices.net, 816-516-0985.

As a director of rehab, you’re familiar with the challenges of finding therapists. Filling a critical opening can’t happen fast enough! Yes, you can hire a contractor or traveler, but filling a job this way often comes at a cost. The traveler may have the credentials, but culture-fit is often overlooked by therapy contracting companies, and this can be a problem. After all, the Ensign culture and core values are what makes an Ensign-affiliated facility more than a building with people. And because culture is critical, an idea was floated. Why not create a new traveling therapist position in the Ensign family? Place therapists who are not only qualified with credentials, but who also know and support the unique culture that is Ensign. These elite therapists would be available for temporary placement whenever and wherever they’re needed by an Ensign-affiliated facility.

And that’s how the TheraTrooper position came to life. TheraTroopers represent all disciplines–OT, PT, and SLP–and are called to serve our new builds, our most staffing-challenged, or newly acquired facilities.

This isn’t a typical travel job where therapists get to call recruiters and say: “Hey! I want to go to Sacramento for three months,” and the recruiters say, “Hey! OK!” Instead, it’s more like: “Hey! We need you to go to Reno for three weeks until our new therapist starts! Then Sonoma for two to cover a vacation!”

If you’re a therapist looking to explore new cities, expand your professional network, and build lifelong relationships, then becoming a TheraTrooper is a great opportunity. As a full time TheraTrooper with Ensign Services, you are considered family, are treated like family. We are building a team of Special Forces therapists who thrive in a fast-paced, ever-changing therapy work environment. It won’t be easy, and we realize this opportunity to serve our Ensign-affiliated facilities will be challenging, but with lots of love and support, and a few extra goodies gently placed in a care package, it is an opportunity worth exploring!

Check out the Therapy Jobs page and look for TheraTrooper positions to read job descriptions and apply online.

First TheraTrooper Deployment

July 2017 – Mountain bike, check. Gas tank, full. Nav system set. Our first TheraTrooper is an adventurous empty-nester. She is traveling to Reno, Nevada, and then on to Santa Rosa, California. What a great opportunity to get out and see the country!

Have questions about the TheraTrooper program?

Call or send an email to Scott Hollander.

(207) 952-4268
CHollander@ensignservices.net

Job Description & Online Application

Current Open TheraTrooper Jobs

It Only Takes a Spark

By Leandra Stuckey, PTA Student

Metropolitan Community College – Penn Valley, Kansas City, MO

Grad Date: May 2017

Italian poet and moral philosopher Dante penned the following words in his magnum opus,The Divine Comedy, “A mighty flame followeth a tiny spark.” Today this quote can be translated as, “from the little spark bursts a mighty flame.” Though there are many ways to create a fire, there always needs to be a spark to ignite a flame. As a Girl Scout, I learned that a conventional fire requires three elements to ignite: oxygen, a heat source and fuel. If any of these three elements are missing, you will not be able to start a fire. Through my clinical and work experiences, I have learned there are three ingredients needed to create a spark and eventually a mighty flame in my patients’ lives. They are empathy, passion and a commitment to excellence and on-going professional development.

To create the initial spark needed to build a fire, it is important to build a rapport and have empathy for my patients. The role of a physical therapist assistant is multifaceted; I am what my patient needs me to be. One of my instructors described the role of a change agent as a chameleon wearing a referee’s shirt, a priest’s collar and a used car salesperson’s plaid jacket. I think his example provides a blueprint on how to be an exceptional therapist. The chameleon shows that even though my message may be the same to multiple patients I am able to change the appearance in order to reach each of my patients. As the referee, I am an honest broker between different groups, like family and the healthcare team. As the priest or counselor, I listen to my patient hearing problems and accepting suggestions. Finally, the salesperson’s plaid jacket is used to represent my ability to analyze a patient and give a sales pitch about my treatment plan and why it may work for them. Being a therapist that exemplifies this chameleon challenges me to consider my patient’s life before their illness. In order to provide a holistic treatment plan, I have to build a rapport and figure out what their physical and recreational goals are and come up with a way to help them attain those goals while working within the framework my supervising physical therapist provides.

My job as a rehab tech gives me the opportunity to work with a diverse group of patients and diagnoses. During a shift, I was assigned to passively range a patient who had recently suffered a spinal cord injury when he fell out of a tree during work. I went into the patient’s room cheery and excited to practice the skills I was learning in school. The patient looked at me and asked why I was there. When I told him I came to stretch his upper extremities, he gave me an obstinate look and said, “No.” Though I was taken aback by his response, I did not let my disappointment show. Instead, I asked if I could do anything for him while I was there. He asked for a drink of Pepsi and if I could fix his covers. As I proceeded to make him comfortable in bed, I talked with him about his family, life and work. I took note of the personal decorations he had hanging in his room and talked with him about those, not once mentioning therapy. When I was getting ready to leave, he asked if I still wanted to stretch his arms. I eagerly agreed and continued to talk with him while doing passive range of motion. If I had not taken the time to make him comfortable and assess his needs as a person, as well as the needs of the patient, I do not think I would have had the opportunity to work with him. He was going through a hard transition in his life, trying to get used to the idea of never being able to walk again and wanted someone to listen to his worries. I learned more about empathy with that patient than I have in any situation prior.

The spark that began with total patient care needs to be nourished and protected before it can be coaxed into a flame. Getting up at 5:30 am in the morning each day is not natural for me. However, while I was completing my clinical, it was easy for me to wake up each morning at that time because I was excited for the things I would learn and the new challenges I would face. I am passionate about physical therapy and the things it makes possible. This passion is the spark that gives me a drive to work hard, the energy to get through the day, and the ability to be more creative with my treatments. I will use my passion to meet and eventually overcome the intrinsic and extrinsic barriers my patients are dealing with. To protect the spark in my patient, I may need to deal with intrinsic barriers they may be facing like depression, self-limiting behaviors, and maintaining reasonable goals. To address these influences I will need to meet each area head on, listen to their concerns and search diligently for solutions. Sometimes, I may be able to find a therapeutic answer and other times I may have to consult my supervising therapist to help me find a way to break down the barrier. The extrinsic factors may affect self-esteem and ability to work with therapy. It is then that I need to figure out ways to bring therapy to them. This could mean starting therapy in their room until my patient is able to come to terms with a new amputation or bringing family on board to encourage and motivate my patient to keep pushing through their fatigue to reach their goals.

Even though I have not had a traumatic injury or needed physical therapy, I can still relate to my patients by sharing with them my stories of failure. Losing my high school student council election taught me to be transparent with my intentions, vision and goals when convincing others to follow me. Not getting into a doctorate of physical therapy program the first time I applied made me find another path to accomplish my goal. Failing a test and a practical on the same day showed me, that I must be prepared in order to be successful. My stories may be small in comparison to a traumatic injury, but losing something is a blow to the ego no matter what was lost. I believe this will help me coax a flame in my patients because each of my failures has set me on the path to be a better physical therapist assistant and leader, just as each of my patients’ failures in therapy will help them to improve their quality of movement and be one step closer to reaching their goals.

Finally, maintaining the flame I worked to create throughout the continuum of care requires me to be a life-long learner. Having empathy and passion will only get me so far if I am not willing to put in the effort to continue growing and raising the bar on the care I provide. I have a commitment to continue gathering more knowledge and sharing that with my team so that we can improve the level of care we are able to provide to our patients. When a patient presents with a challenge that seems too big or beyond my abilities, I search diligently for solutions consulting my mentors, classmates, textbooks and the Internet for ideas to get the desired outcome. I plan to continue taking CEU’s and would eventually like to become certified in neurologic physical therapy. I still have much to learn but each new patient I get relights the spark and passion that I have for this field, and I hope that I am able to initiate a spark in them.

As a Girl Scout, I learned that I do not need a blowtorch to create a fire; from a tiny spark bursts a mighty flame. For me, I want to use empathy, passion and my willingness to learn throughout the continuum of care to create a spark in the lives of my patients. In order to optimize movement and improve each patient’s outcome, it will be important to use all of my experiences to shape the treatment plan as there is simply no “one size fits all” regimen. My passion dares me to be the spark that ignites a mighty flame to motivate my patient down the road to recovery. I can continue to bring a spark to my patients by being an innovative physical therapist assistant that is committed to using all of my skills to care for the whole person.

How my experiences will provide my future clients with a spark to their lives and bring hope to their futures

By Connie Wyatt, OT Student, University of Puget Sound, Grad Date 12/17

The word spark provides two types of definitions: a noun and a verb. The noun defines spark as “a small fiery particle thrown off from a fire, alight in ashes, or produced by striking together two hard surfaces such as stone or metal” while the verb defines spark as “to ignite.” Other definitions include: “a sense of liveliness and excitement,” “a small bright object or point,” and “a trace of a specified quality or intense feeling.” I love the simplicity of the verb, ‘to ignite.’ It is an action word which requires one to choose to do something. I like the implicit progression inherent in verbs. Verbs never stay in one place and as a future therapist, I want to constantly be moving towards a better, more glimmering (if you will) therapist. I have had many, many people ask me why I am always so smiley and happy all the time. I cannot help but realize that I have an incessant itch to ignite my life with kindness. I want to make others happy; I love the saying a ‘glimmer of hope’ because it implies that there is always a slight chance that something positive will happen. I rely on that saying each and every day of my life. I look for all the glimmers of hope from each day to provide me with a reason to wake up and give others with the glimmers they need to keep on progressing. My career as an occupational therapist relies on the notion that I will bring this spark into practice with each client; it is an energizing force and I feel eager simply writing about it. My future is bright and full of the kind of sparks that my future clients so desperately need from me. I am going to make a difference as an occupational therapist, but the difference I hope to make is one that each of my clients will believe they accomplished all on their own!

My focus on occupational therapy (OT) has been a constant in my ever-changing life. Although my life history is diverse, my attention always drew towards OT. In the last eight years, I spent my time doing many meaningful activities than some don’t get to do in a lifetime. Every job or opportunity I have taken is one that pushes me closer to my career. My eyes gravitate towards my co-workers, clients, or students who need this type of therapy in their lives.

Through the years, I have sought out many opportunities to grow and develop my skills as a compassionate mentor, friend and aide. Soon I will have the opportunity to use the skills I have been developing in my career as an occupational therapist. I have no doubt that lives will be changed and have been changed; if no one else’s, my own has been enriched. I hope my experiences in the following excerpts will help Ensign Therapy to understand the spark that will certainly transform the lives of those I work alongside with.

BRANDON

Is there anything that can bring more passion to an individual than personal experience with the person most dear to you? At the early age of 14, I developed the desire to become an OT. 11 years ago my older brother and best friend, Brandon, was hospitalized with a traumatic brain injury. It shattered my whole world. Initially, Brandon was only able to mutter `lil, lil, lil, lil’ when asked who I was. His brain function and actions were not collaborating. I had already witnessed a plethora of injuries, addictions, abuse and fights by this age with my older siblings, but this incident hit even closer to home (if that is possible). I couldn’t fathom the possibility of a best friend I couldn’t rely on like I did before. During those difficult weeks, I was given the time to relive memories with Brandon. I remembered a lot of good times and hoped that more were to come. Today, he is fully independent and has 95%+ brain function back. This experience gave me the ability to relate to the despair and grieving of family members, who are also our clients. It

also taught me the significance of time. Although, the rehab team was not in the forefront of my mind, I now realize that immediate intervention with OT is ideal and pertinent. OT clients will be much more likely to recover, the earlier they start working towards their goals. Brandon had to work with an OT, PT, speech pathologist, doctors, and nurses to successfully recuperate; teams are vital in rehabilitation and even my 14-year-old self realized that. I want to be a part of a team like the one that worked with my brother so I can change lives, every day, for the rest of my life.

HOME EVALUATIONS

As an OT student, I had the opportunity to take a trip to the Methow Valley in Central Washington where many individuals enjoy retirement. A group of us were given the opportunity to practice our home assessment skills in the homes of some of these individuals. I fell in love with the opportunity to provide recommendations for a safer, more livable space and was surprised by the knowledge that I, a mere graduate student, had to offer our clients. I immediately fell in love with working in the home and having the opportunity to quickly connect with people. Following this incredible experience, my entrepreneurial spirit led me down a series of networking paths and I have had the opportunity to advocate for my profession. I have connected with a well-known Certified Aging In Place instructor, Steve Hoffacker, and I have had the opportunity to connect with a seasoned OT who decided to open an Occupational

Therapy consulting business. My research caused me to stumble upon a bill that has not yet been passed which would provide a $30,000 tax credit for anyone over 65 who wants to install home modifications to prepare for aging in place. This information led me to work with my AOTA representative for the state of Washington to bring this bill to the attention of AOTA. Our hope is that this bill will be revised to include OT services, so the home modifications are assisting the special needs of each client. As occupational therapists we have a special ability to connect the home environment inevitable life events, but I am particularly eager about the opportunity to be a part of something bigger than myself. Many of the baby boomers would like to age in place and preventing falls and other incidents early on will provide more healthy opportunities for them to age in place. Sometimes the initial spark of my many creative ideas eventually fade (I have many entrepreneurial ideas), but I am sure that the deep meaning that this project has in my life will give me the motivation I need to carry out each step. I am passionate about the happiness that a safe home can provide for people.

BOB

Bob is my life coach in understanding the ins and outs of the emotional and physical difficulties individuals with SCI’s deal with. How lucky was I to stumble upon an ad he posted for a trainer. He needed someone to ride with him on his tandem bicycle designed for and by him. He himself is the survivor of a fall, which resulted in an iSCI and has lived with this condition for 25 years. Bob is helping me to develop empathy, understanding and love for people I have yet to meet. He is developing in me a very real mindset of putting myself in his shoes. Bob offers me opportunities to feel what it feels like to be him; he is honest, he is open and he is blunt. Not only do I get to go grocery shopping and biking with Bob, but also, more importantly, I get the life knowledge that he has obtained and offered me. I often write down his words so I can remember them during future encounters with clients. His willingness to help me will surely have a ripple effect for the rest of my life. Bob has further added to my purpose as an OT and my desire to enlighten lives with understanding.

REHAB WITHOUT WALLS

When Carol Decker came to our program last spring, I was forever changed by her determination to live her life to the fullest. She is a beautiful mother of two young girls although she has never seen her youngest daughter before. During her second daughter’s birth she experienced ample complications, which resulted in blindness, neuropathy in one hand, two below the knee amputations and the amputation of her left hand. Her words inspired me and still do to this day. She began to talk about her rehabilitation when she got back home and she began to realize the obstacles she was going to have to overcome. She was discouraged and depressed (for good reason)! Rehab Without Walls came in and worked in her home and community and she talked about how the team collaborated with her to try anything that might aid in her independence. She admitted it was a long road, but attributed much of her success to her team at Rehab Without Walls. I was touched, so I obviously decided to call Rehab Without Walls the next day. After a few months, I was given the position as a rehab specialist. I get the opportunity to work one-on-one with individuals who are further along in their recovery and require less attention from licensed therapists. The opportunity to work independently has taught me incredible amounts about myself as a future therapist along with my ability to rely on team members when I need their advice and help. I have learned to jump right in and not be afraid of social stigmas in the community and I have learned from my mistakes. I have learned about how much I care about my clients and how much their happiness matters to me. This continued experience has solidified my desire to eventually work in the home as an OT.

UNIVERSITY OF PUGET SOUND

The OT professors at University of Puget Sound are some of the best. They have taught me many important skills, but mostly they have provided me with the skill set to find the answer to any question that might arise in my future career. They have taught me to trust my clinical reasoning, but have also helped provide me with the skills I need to find evidence-based research to back up my practice. They provide hands-on experiences daily and have collaborated with us since our first day; I have envied my professors ability to increase our competence while simultaneously trusting our ideas and thoughts; this has enlarged my confidence as a future therapist (something I greatly lacked prior to graduate school). If there is one thing I have learned, it is that in occupational therapy it always depends on the person, the day, the environment, or the context. There is no black and white answer to any challenge and we must treat our clients as individuals. I am thrilled to use my creativity and education from UPS to better the lives of my future clients.

I know all of the experiences that I have cited (and so many more) have helped prepare me for a successful career in occupational therapy. I could not have jumped into this profession without the plethora of experiences I have in my tool belt. Luckily, these experiences continue to build upon one another and I will continue to grow as a therapist for the rest of my career. I will never be fully prepared for every situation, but I can continue to learn and become the spark that someone needs to get over the hurdles that they face. I already love my career as an occupational therapist and I know that I will make a difference. I cannot wait!

By Jack Rolfe, PT, MNA, CHC, RAC-CT

Lead Compliance Partner, Milestone & Endura

If your actions inspire others to dream more, learn more, do more and become more, you are a leader.” ~ John Quincy Adams

My first memory of the image of leadership was formed when I was eleven years old. I was with a group of my peers participating in a scouting activity at our church. My father was also in attendance as one of the scout group leaders. The individual in charge of the meeting was at the front of the room conducting the function. This person asked if everyone in the room would move closer to the front row. I remember looking at my buddies and we were all frozen with the thought “this would not be cool to do what the leader had asked us to do.” Then a sharp impulse came into my mind. I stood up promptly and stated “come on guys, let’s move up.” Everyone followed and the task was completed. Upon returning home that evening my father said to me “That was amazing what you did today.” I had no clue what he was talking about and stared at him like only an eleven year old could do. He repeated to me what he witnessed in the simple act of moving with my friends to the front of the class. He stated, “You are a leader.” His statement touched my soul deeply and has remained with me throughout my life.

In his book, “Executive Instinct,” Nigel Nicholson of the London Business School suggests that there may be a leadership gene — that some people are just driven to be in charge. But the University of Michigan’s Noel Tichy — in his book, “The Leadership Engine” — declares that leadership style and abilities emerge from experiences. I propose that leaders emerge from a combination of both these declarations. I add one additional idea for you to ponder. I believe that inside each one of us there is a leadership gene and it takes experiences to bring it out. Have you discovered your leadership gene?

In the movie “Facing the Giants” actor, Alex Kendrick, plays the role of high school football coach, Grant Taylor. In one scene Coach Taylor is instructing his team and specifically counsels his player, Brock, to remember he has been gifted with leadership so do not waste it! I have concluded through my life experiences that there is one sure way to develop leadership. This is accomplished by assisting others to become leaders in their own lives. When you facilitate someone finding and using their leadership gene then yours blossoms.

As we move into the year 2017, will you become a leader of your rehab team in attaining additional knowledge in regard to Compliance? Will your rehab team become the leader of Compliance in your facility? Will your facility become the leader of Compliance in your Market? Will your Market become the leader of Compliance for the Ensign organization? It can all begin with you!

As Compliance Partners go onsite when conducting the annual Medicare Systems Compliance Audit (MSCA) much of our focus on the therapy program is governed by two areas. First, is the Medicare Policies and Procedure for our organization. Second, is rule and regulation found in the Medicare Benefit Policy Manual, Chapter 8 – Coverage of Extended Care (SNF) Services. We find the successful buildings to be those who are most educated on what is expected by the Medicare Program and then they apply that education.

So, I extend to you an opportunity to express your leadership gene. Here is the challenge…Develop a creative way to present/discuss one item from the above mentioned Medicare resources each week in your rehab team meeting. Use specific policy/procedure and rule/regulation. Then create a way to spread that format to your building, your Market, and onto the Ensign organization. You can become a leader in attaining and sharing knowledge with your peers and beyond. I am eager to see the results. Will you accept the challenge?

“A leader is one who knows the way, goes the way, and shows the way.” ~ John C. Maxwell

Following is an essay written by our SPARC (Scholarship Program And Recognition Campaign) winner that garnered her $2,000 toward her education.

Julie Dunn, PT, Grad Date: May, 2016, Idaho State University

The making of sparks: A profession of excellent clinicians giving superior care to every patient

My lifelong passion for excellence has prepared me to be a unique agent of change, hope, and healing in the lives of the hurting and the underserved. I seek to continuously be improving inclusion, personal aspects of care, patient education, advocacy, and professional training for myself and for our profession. When my patients entrust me with the honor of helping guide them back to healing, I want to have full confidence knowing I have done everything possible to get them there.

My passion for excellence has been something that has driven me throughout my years of schooling, sometimes even becoming a point of resistance: While earning my bachelor’s degree, I was not content to simply obtain a common degree that would give me the most prerequisites for graduate-level education. Multiple advisors frowned on my unwillingness to major in health science, biology, kinesiology, or exercise physiology when applying for DPT and DO programs. In fact, I had to switch advisors multiple times to find someone that would work with my unique vision for my practice: I insisted on using my bachelor’s degree to obtain skills I wouldn’t learn otherwise so that I could reach the people most health care professionals can’t. Ultimately, I obtained a Bachelor of Arts in Spanish language on top of the normal prerequisites. I kept pressing onward, and by the time I started my DPT program, I was a qualified Spanish medical interpreter.

Now that I’m at the end of my formal education, my passions for excellence and inclusion still drive me to provide the best care to the underserved. My Spanish degree has proved particularly useful. One group I consider to be in underserved are non-English speaking patients: Patients with Limited English proficiency (LEP) are documented to receive not only less but also poorer-quality care, creating a disparity even greater than what exists based on ethnic and minority classifications alone.(1) Research is still being called for with regard to cost effective ways of reducing the negative effects of language barriers in health services.(2)

As an interpreter and a physical therapy student, I have personally witnessed LEP persons receiving less patient education, less examination, and overall less care during interactions with medical/therapy staff. I witnessed this despite working with outstanding physicians, nurses, and physical therapists who longed to surpass language barriers and eliminate the health disparity. Still, the quality of care remained inexorably constrained by language barriers, logistical issues with interpreter schedules, time lost during interpretation, and limited ability to communicate to build rapport. That is why, on my affiliations, I have taken on all the Spanish-speaking patients. I found myself staying multiple hours after my own shifts in order to help nurses communicate to deliver necessary medication, calm post-traumatic brain injury agitation, and figure out how to contact family members. It would make a long essay to describe all the times I have heard “I’m so glad you speak Spanish” coming from both English- and Spanish-speakers, and how many times my patients have confided in me feelings about their care, and questions they did not feel comfortable sharing with other providers. In my own practice, I will be able to communicate directly with patients without losing time or emphasis going through an interpreter. I will be able to provide more education, feedback, and understanding so that Spanish-speaking patients can confidently take charge of their own health and recovery.

Through my experience working in physical therapy from the office, technician, and now practitioner perspectives, I have added another group to my list of underserved populations: women with pelvic floor dysfunction. Disorders such as chronic pelvic pain, pelvic organ prolapse, and urinary incontinence are socially limiting and often privately debilitating problems. For example, I worked with someone who had excruciating tailbone pain so bad she could not sit, meaning she could not work, and was at risk for developing on opioid addiction. She had been to see two other PTs without success. However, thanks in large part to my post-doctorate training in pelvic floor assessment and treatment, she was able to return to full activities and sit a full day at work without symptoms.(3) This all happened after just one treatment session together! This is the kind of spark I want to be in my patients’ lives.

I am passionate about bringing high-quality, emotionally-sensitive care to these individuals who suffer privately because of shame, embarrassment, or simply not knowing what options exist for them. In school, I had the opportunity to perform qualitative and survey research with participants in one of our community health grants. I designed a survey to assess pelvic health/women’s health concerns and unmet needs in our population, who had already been involved in the grant for several years. We found that many of our participants suffered from quality-of-life-limiting pelvic floor dysfunction, and not one knew how treatable it often is! Even though each participant had biweekly interactions with a certified women’s health PT and at least yearly interactions with physicians, not one had addressed the uncomfortable subject. Neither had they received education on treatment for their other disorders within the women’s health physical therapy realm, such as osteoporosis or lymphedema. This research was presented internationally to help bring awareness of our responsibilities as PTs to at least connect these patients with the right resources. If we don’t start the conversation, it’s likely they will continue to miss valuable treatment. My passion for this excellence in PT and learning has already carried me to four continuing education courses in my last year of school. I also feel strongly about sharing that knowledge, so I sought opportunities to help make my peers better practitioners also: My school hosted me as a guest lecturer for underclassmen in the physical and occupational therapy programs on two occasions to discuss pelvic floor disorders and other physical therapy treatment options. I also got a significant piece of medical equipment donated to my school so that our students could learn about mechanical hip traction. I found it to be one more tool we can use to spark hope in those inappropriate for surgery, delay surgery, and best promote an active lifestyle until surgery best option.

To continue working for the benefit of more than just my own future patients, I have mentored numerous students in the program graduating after me. I was elected to serve multiple terms as the president for the Student Physical Therapy Association and the Director of Programming for the national Student Special Interest Group on Women’s Health. I want to find the best ways to help my patients, and share it with as many of my peers as possible. I believe when we all work together, we can increase the quality of care our patients receive.

Perhaps the best way to conclude my reflection on how I am going to be a spark in my patients’ lives would be with comments from my patients thus far. I was fortunate to work each semester to provide exercise testing and prescription to members of the community over age 55 with low socioeconomic status. I have had long conversations with several members, with them thanking me for what I helped give them: encouragement to begin taking walks again, confidence to play with grandchildren, better balance from practicing my recommended HEP while preparing dinner, and hope for a healthier and happier way of living. I want every one of my patients to leave my care with the same impression one patient described to me in a surprise thank-you note: “Thank you for being in my life. You are very special, caring, and you will be another bright star for everyone you help. You will always be a bright star in my journey.” (3) I want to continue being that “bright star,” that spark,”and I know that with this scholarship, I will be able to get even better training so that I can be.

1. Saha S, Fernandez A, Perez-Stable E. Reducing language barriers and racial/ethnic disparities in health care: an investment in our future. J Gen Internal Med. 2007;22(Suppl 2):371-372. doi:10.1007/s11606-007-0372-4.

2. Schwei RJ et al. Changes in research on language barriers in health care since 2003: A cross-sectional review study. Int J Nurs Studies. Feb 2016;54:36-44. doi:10.1016.injurstu.2015.03.001.

3. Shared with permission.