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First-year physical therapist assistant student Jazmin Orozco takes a firm grip on the gait belt and stands close behind her petite patient.
“Don’t worry. I’m right here. I’m not going to let you go,” she says.
Her patient, Maria, an 82-year-old woman with a congenital spine curvature, steadies her sneakered feet more firmly on two “jelly pads” and grins. Maria holds up her paddles for Luis Rodriguez, Orozco's student therapist partner, to begin tossing her the ball.
Orozco, Rodriguez and Maria represent the healing work done in the Falls Risk Clinic at El Paso Community College’s (EPCC) Rio Grande Campus. It is the only community college clinic in Texas that offers free physical therapy to residents who are at risk of falling because of a disability, injury or disease. Patients also must have no active diagnosis of illness.
The Falls Risk Clinic opened in 2005 through a small start-up grant from Paso del Norte Health Foundation as part of its Initiative on Aging. The funding ended in 2006, but program director and physical therapist Debra Tomacelli-Brock says the clinic had proved its worth for students and patients. It is now integrated into the college’s physical therapist assistant curriculum as the students’ first practicum.
Unique learning opportunity
In addition to helping the general public, the clinic provides first-year students with the experience of working with different types of patients and also teaches them the “vital attitude of service, to profession and to community,” Tomacelli-Brock says.
All patient therapy is supervised by Tomacelli-Brock and her three instructors—Michele Biernacki, Derrick Delgado and Charles Fitzgerald, who are graduates of the program. Two students are assigned to a single patient each semester with supervision from a specific instructor.
“My first experience with a patient was a little bit daunting, and I thought ‘Gosh, I don’t know if I can do this,’” says student Terry Perez.
However, with reassurance from Tomacelli-Brock and Biernacki, Perez soon found her confidence and embraced the challenges of working with her patient, a stroke victim with little movement on her right side.
Perez’s partner, student Yvonne Garcia, agrees that “it is so different when you have direct interaction with a patient.” A former insurance biller for a doctor's office, Garcia says her initial nervousness was soon replaced with excitement when “you see how far Denice (Perez's patient) has come since we started working with her. It’s wonderful to be a part of that.”
A social aspect
There are many other benefits for patients at the center in addition to the therapy, Tomacelli-Brock notes.
“Patients tell me they love working with the students,” she says. “That they feel very welcomed here.”
“It’s not just the work that we are doing with them, but coming here is an outlet for them as well,” she says.
There is also a social aspect to the therapy. Maria walks to the clinic from her nearby home. It is an outing for her and an opportunity to talk.
“I’m very talkative,” Orozco says. “And Maria is, too. She is full of stories.”
Orozco uses their conversations to help Maria relax while she does her stretching exercises. This rapport with a patient—the intuition of how to motivate them and gain their trust—is not something textbooks can teach.
Boot camp before enrollment
Instructor Fitzgerald is a sort of “senior figure” for the students who encourages and also scolds them when he sees problems with their therapy or patient/student interaction. Physical therapy is a third career for this former policeman and investment advisor, and he is often tough, telling students to be more assertive with patients. Fitzgerald tells them, “this is serious,” and “don’t take any guff from patients. You need to be in control of the therapy; don’t let patients dominate or control you.”
Fitzgerald and the other instructors teach Introduction to Physical Therapy, which is like a therapists’ boot camp that students attend before they enter the 18-month program. As part of the class, students visit a long-term acute care hospital where Fitzgerald works as a therapist. Many of the students have never been exposed to such an environment or patients with such serious disabilities.
“It is an eye opener for them,” Fitzgerald says.
Garcia, who has a son in the autism spectrum, is familiar with physical and occupational therapy, but she remembers breaking down in tears when she visited the hospital. It reminded her of a nephew with degenerative brain disease who has since passed away.
“I never really understood the issues he was dealing with, how hard it was for him to get around,” she says. “Now my training is giving me a new understanding, a new empathy and a deep motivation to help.”
Garcia applies this understanding when she works with her patient, Denice. In spite of some speech communication problems because of a stroke, Denice patiently tries to do the hamstring stretches Perez and Garcia are applying, but stops and tries to relay that she needs her knee elevated slightly. The students are not sure what she is asking until instructor Biernacki, experienced with stroke patients, comes up and interprets what Denice’s partial words and gestures mean.
A family feeling
The program’s 15 student physical therapist assistants say that building this kind of trust and cooperation and applying the techniques they are learning under the watchful eye of their instructors is what they like best about the clinic. This deep and important feeling of “family” that develops over the semester, between students and patients, students and instructors, is celebrated in a unique way at the end of the semester.
“At the end of the semester, students are required to do a presentation that shows us the progress that their individual patient has made during the clinic,” Tomacelli-Brock says. “We have a potluck with patients, students and instructors. That’s our ‘thank you,’ and they get to see that they did make progress. Sometimes they are not aware of it. They forget how they were doing initially.”
Schroeder is a part-time English instructor at El Paso Community College (Texas).
Copyright ©2012 American Association of Community Colleges