Interview with Travel Physical Therapist: Kristen Schwenk PT, DPT

Image Credit: Jaunted.com

Interview Post! I recently ran in to Kristen Schwenk PT, DPT in Philadelphia and we got to talking about PT (naturally). Kristen was the person who got me into PT and literally introduced the field to me. For reference, I was in San Diego, we met up on the advise from a mutual friend, and I first heard the words “physical therapist.” I was in my late 20’s at the time and had never even heard of PT. She described her job with such passion and enthusiasm… well, flash forward about 6 years and here we are.

Besides being a totally cool person, Kristen is a Travel Physical Therapist and had some really nice insights into the setting, some tips/advise, some perspective and really what it’s all about. So let’s see what she has to say:

Give me some background: What made you want to go to PT school?

I decided to become a PT because I knew I wanted to go into the medical field and help people, but I didn’t want to be an MD, I felt that they spent so little time actually getting to know the pt and their problems. I had been to PT in high school for the first time when I had undiagnosed stress fractures in B tibias. Eventually, with some run around, the PT urged the MD to get me a bone scan which showed the fractures. How cool was it that the PT had a good understanding of what was going on with me! Then later (still in high school) with a quad injury I returned to PT so I could get back to Cross Country ASAP. They did gait analysis of my running on a treadmill (again just awesome the things they could do). I had no idea PT did so much for people. So, I went to VA Wesleyan and did the bio major thing to get into grad school and PT just clicked for me. I, like most people, thought I would get into the sports aspect of PT.

Where did you go – what did you do right out of school?

I graduated from Thomas Jefferson in Philly, the first Doctorate program for the school, in 2007. I went on my last clinical to Rancho for 10 weeks and knew that I was going to move back to CA as soon as I got some money and passed my boards! I moved to San Diego in ’08 and pretty quickly got a job with Sharp Rees Stealy outpatient PT where I stayed for 4 years doing ortho, vestibular, neuro and workers comp. I also worked in rehab and an acute hospital on the weekends.

What got you interested in Travel PT (tPT)?

I always wanted to do tPT. I am a Navy brat and it is in my genes to want to travel. I had been advised by a couple therapists during the time I was a student that it was a good idea to get some experience first. Along with that urging I didn’t feel confident going out into the world of PT as a traveler to begin with. I knew that I wanted to eventually become a traveler just to see what it was like traveling the country to help people. Also I heard the money was good and who doesn’t want to make more money coming out of school with massive debt!?

Do you think a new grad is ready for tPT?

I have now been a traveler for 3 years and I would say then, and now, that I don’t think that a travel position is the best option for a new grad. I have met a couple travel PTs and OTs that were new grads and they were excellent, but extremely nervous and needed a good deal of mentorship. Mentorship is key to the first year out. Now, it doesn’t mean that you’re asking your mentor about every patient, but there are undeniably things that happen to you that you didn’t learn in school. It’s a relief to know you have a therapist that you trust and has a solid knowledge base to get opinions from. The amount of knowledge that comes from the first year or two out of school in the same setting, developing relationships with patients and coworkers, having a mentor or other staff members that can help to impart knowledge and experience is priceless. Not only are you coming off one of the most stressful experiences being in grad school and attempting to stay afloat mentally and physically but to then throw yourself into a position where you move every three months, don’t know the staff, situation, environment that you will be walking into, etc…it isn’t something I was ready to take on immediately after grad school.

So, the first year out is quite formative…

I believe that in the first couple years as a therapist you really start to understand your voice as a therapist. You develop how to speak to patients, speak to their families, get what you need from your coworkers; as in how to manage any PTA in the clinic and develop their POC, direct your aides if you have them and if not how to maintain your attention in multiple directions and also impart information to the MD in a clear, concise manner and vice versa. And on top of all that knowing what you think is going to work best for your patient scenario presented to you. Since becoming a traveler I have been placed in every setting imaginable including home health in rural settings where in addition to the aforementioned things to concern yourself with there are also social issues such as hoarding, cleanliness, etc that have to be addressed to the correct people. There are so many things that you can’t possibly learn in school and those first couple years as a therapist are crucial. Taking time to develop skills in a stable setting is optimal, a far different scenario than the life of a travel therapist.

Do you find it difficult to fill-in at different clinic cultures, or for varying organizations, etc?

Not really! Part of being a traveler is adaptability so you mold to get things done in a new setting and get to work! I have heard stories from other travelers about some hostility between the regular staff and travelers due to pay differences, hours, etc but I have been extremely lucky and welcomed with open arms for the most part. My first travel job I walked into I was really nervous. I didn’t know what to expect. I actually got sent to orientation all day and didn’t see a single patient. Now that doesn’t usually happen because the clinics are often so busy and they need help! Generally I’m given a whole day’s worth of patients and a finger pointed in the direction of the rooms. Occasionally I even get a tour, haha! It can be stressful the first week and I end up working longer hours most times just to get acquainted with where I’m going, how the documentation is set up (paper vs. electronic), any new online documentation program that I haven’t seen before and who the heck the patients are. I tend to fall right into the flow after a couple days and I get used to what the therapists are doing in that particular setting.

Can you give us some of the positives of that changing environment?

One benefit of traveling is if there is any work drama going on, I generally get to avoid it. Also I love being in new place because it’s impossible to not learn something. I get to learn a new setting or exercise or a new hands on technique and a million other things that occur working with new people with a different POV. Since I started being a traveler I have worked in SNF (skilled nursing facility), LTAC (long term acute care) which happened to be for ventilator and trach dependent patients, home health, outpatient, large acute hospitals and rehab! It’s been awesome learning all the things that come with it.

In general, what is the ‘vibe’ given to a tPT in a new clinic?

I’ve been fortunate that the vibe is thankful. I usually get to be the superhero that comes in and relieves the pressure off the other therapists. They are generally swamped with patients which is why they needed me in the first place and I get to take the load off them. Every once in awhile I get the short end of the stick because my hours get cut before the regular employees. Also when it comes to vacation time the regular employees obviously get first dibs at holidays, as they should!

What setting have you liked the most? Why?

That’s a more difficult question that at first it would seem. If you would have asked me 4 years ago I would have said that I’m an outpatient therapist thru and thru. I love outpatient because I’m an athlete and I find that challenging people is so much fun and creative! However, since becoming a travel PT some of the things I’ve done and loved have surprised me. When I got to work in the LTAC, which was probably my most dreaded assignment before I got there, I absolutely soaked up every minute being there. I got to work with patients that had significant respiratory compromise and were mostly on ventilators which meant I worked closely with the whole team but specifically respiratory therapists, psychologists, speech therapists, occupational therapists. Seeing somebody on a ventilator that cannot even roll over in bed and after hard work and lots of therapy with a great team approach might take their first step a couple months later. Wow! How can you not love that part of the job. I definitely shed a lot of happy tears with patients there at their successes. I also thought I would not like working in SNF setting because of all the obvious negatives to the job, the worst one being changing peoples underpants. Yes as a PT sometimes you just have to get in there and do it. However, elderly people are so awesome and know so much more about life than most. Getting some life lessons and doing your job can’t be all that bad! Some of my best patients have been in their 90s and impress me with their skills! So because of that I have come to sit on the fence of what I love as a therapist.

Can you really make your own travel plans and go to locations that you want to?

Yes and no. The general rule that most recruiters will tell you is that you either choose location or setting. So if you want to live in Chicago you might not get the kind of setting that you really really want but you compromise because you get to live in Chicago. Or vice versa if you really want outpatient only then you might have to live in the middle of nowhere in Georgia. Sometimes the plan you have doesn’t always work out because all the jobs filled up in that state. Possibly there is nothing that you’re interested in so maybe you take a job in a different state altogether. I have been extremely fortunate and have pretty much ended up exactly where I wanted to. I usually have something I’m looking forward to also, whether it be a new state, a new area, somebody that I know that lives close by or a specific patient population I‘m going to get to work with. Since the contracts are usually 13 weeks I ask for any vacation I have planned prior to starting so that it goes in my contract and is approved before I ever start. They can also deny it before I start as well. Often times vacation is planned for between contracts when it doesn’t interfere with work contracts.

What is your treatment philosophy? Does it change from setting to setting (IPR, OutPt…)

Absolutely! Not only does it change setting to setting but person to person. I can have one patient with poor self esteem that needs to be encouraged, uplifted and urged to set small, obtainable self goals on a weekly basis and another person that wants to stay in the gym for 8 hours so they can get healthy as fast as they can! The treatment philosophy I use is just tailored to the patient. You have to look at the patient from a medical viewpoint, what’s wrong and what tools do I have to fix it. However, you also have to look at them from a human viewpoint. How can I get this person to be confident in their skills or reign them in so they don’t hurt themselves.

Are there any big names in tPT? Like, super-boss generalists who can do it all (like there are in Sports, or neuro, etc…)

I don’t know of any big names specific to travel PT, however there are very good therapists that travel around spreading their knowledge in CEU form and thankfully allow us to continue learning and progressing our knowledge base. As far as other influences, not specific to travel, there are the obvious choices like McKenzie, Maitland, Paris, Grimsby.

If you were to meet any of the PT players, who would it be?

I think the coolest people to meet would be some of the first Physical Therapists, the women that were sent into WWI to treat injured military soldiers. Wouldn’t it be interesting to talk to them about all the changes that have occurred as well as hear their stories of what it was like in the beginning. Just start with how they came up with ideas and implemented them for their patients and just being in the middle of a war in general? Also include Mary McMillan, what an impressive lady. I’d like to hear their stories and more about their lives. Along that same note I have had the pleasure of working along side Dr. Jacqueline Perry, she led a very interesting life and achieved some great things for polio and the field of PT especially how we look at gait. I can thank her for my vast knowledge of gait! One other person that I think has influenced the way I think about therapy is Gary Gray. I went to one of his CEU classes and he is a wealth of knowledge but the basis being to treat in all three planes of motion. What a simple concept but a very important one at that. The world is not lived in one plane of motion so why should we treat patients in that manner.

Advise for those looking to do tPT?

Stick to your guns no matter what. We all have a moral compass and sticking to it keeps you out of hot water. I have been urged to do unethical things in various settings and I can assure you that it is asked in such a manner sometimes that you wouldn’t even know it was unethical or illegal at times. Having the experience I did before going into a travel position was so helpful. I was able to understand and also advise fellow coworkers how to handle the situation and alert the correct people. And also – Be flexible! You can have life planned exactly and in an instant it will change. Now that is general life advise but it is definitely advise for a traveler. You can sign a contract for three months, have your housing paid for and all moved in and then get cancelled on the second day! Having a back up plan is helpful but as a traveler often times it’s difficult because the job market is unpredictable.

Thanks Kristen! There is a lot of good info here, for all PTs, #DPTstudents, and on. There are many paths in PT, but seemingly the one most rewarding is the one filled with new experiences.

I know we don’t usually do interviews but I know it got me thinking…

–Matt D