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A Day in the Life of an Emergency Department Physiotherapist

in All Physio Blogs, Clinical Physio, Physio News, A Day in the Life of
26 Jun 2019  |  0 Comments

Emergency Department Physiotherapist

Janelle Heine works as an Emergency Physiotherapy Practitioner in the Emergency and Trauma Centre at the Royal Brisbane and Women's Hospital (RBWH)

What is your current position?

Emergency Physiotherapy Practitioner, Royal Brisbane and Women’s Hospital (RBWH)

Where did you study and what year did you graduate?

I studied at La Trobe University in Melbourne and graduated in 1992.

Do you have any post-graduate qualifications/research/special committee roles?

  • Masters of Physiotherapy (Research), La Trobe University
  • Grad Dip in International Public Health, University Qld
  • Prescribing for Allied Health, QUT

Where was your new-graduate job?

I worked for a year in Bendigo in country Victoria at an inpatient rehabilitation centre.

What areas have you worked in during your career to date?

  • Graduate year in Rehabilitation Hospital; Victoria
  • Musculoskeletal outpatients/orthopaedic inpatients, 4 years; USA,
  • Musculoskeletal outpatients, acute hospital ward work, 6 months; UK
  • Inpatient Orthopaedics, 9 years; Victoria
  • Musculoskeletal outpatients and ward work, including women’s health, 4 years; Al Ahli Hospital, Qatar
  • Orthopaedic Physiotherapy Screening Clinic, 3 years; RBWH
  • Emergency Physiotherapy Practitioner, 2014 - current; RBWH

Who are the main patients you see in your current position and what is your role in their care?

I am a primary contact emergency department physiotherapist. I work in the Emergency and Trauma Centre at RBWH and see a variety of patients that present with musculoskeletal injuries. Conditions can include simple ankle sprains and acute LBP, as well as patients presenting post minor motor vehicle accidents and trauma. Sometimes weird and wonderful stories come through the door, including a patient who sustained a knee injury whilst hanging upside from a horse in a stunt show.

I commonly treat joint dislocations and upper and lower limb fractures. I am responsible for independently assessing the patient, requesting x-ray and other appropriate imaging, interpreting x-rays and providing ED management and ongoing follow up or referral for these patients.

I can reduce dislocated joints and fractures and apply plaster or splints as necessary. I can prescribe simple analgesia for these patients, and additional study and a research trial allows me to prescribe opioids to the patients that consent to be part of the trial. I work independently but also collaboratively with other medical staff in ED and make specialist referrals to orthopaedics or plastic surgeons as appropriate. 

What are the most rewarding parts of your current role?

  • The team environment in ED is amazingly supportive. The medical and nursing staff are always approachable and really value physiotherapy input, however big or small it might be. It’s nice to work somewhere where you feel appreciated and like you make a difference.
  • I learn something new every day and enjoy the challenge of assessing and diagnosing conditions – each patient is like a mini mental puzzle.
  • I love the diversity of patients and conditions that come through the door – every day is different.

What are the most challenging parts of your current role?

  • Dealing with patients in acute pain can be difficult at times. Being part of ED where people’s lives can change so drastically and dramatically can be confronting sometimes, and makes you value your own health. There are a lot of sad stories that happen in ED, and while I am not usually involved in the direct care of these patients, you still hear the stories and see the other staff dealing with these situations.
  • Sometimes the noise and chaos and sheer number of people coming and going can be stressful, but conversely that is also what I love about my job.
  • Learning to do 5 things at once, whilst being interrupted 3 times!

Do you have any advice for physiotherapists wanting to pursue a role in this area of work?

Having a strong musculoskeletal background is important, but it needs to be on a base of good broad-based hospital experience, which includes ward work. This gives you exposure to physiotherapy and medical knowledge in different areas, as patients that present initially as a musculoskeletal patient may not have a musculoskeletal condition after all. A musculoskeletal master’s degree is a desirable post graduate qualification to hold, but is not essential to becoming an emergency physiotherapy practitioner.

Experience in working in ED in a secondary contact role is great for becoming familiar with the environment and will give you exposure to physio management that is unique to ED settings, such as acute fracture management. Many hospitals will have a secondary contact physiotherapy service that if often used as a training role for upskilling to primary contact physiotherapy roles.

Work in inpatient orthopaedic settings, outpatient musculoskeletal settings, private practice, pain clinics are all helpful to expand your physiotherapy and musculoskeletal knowledge and experience.

Try to get involved in your state physiotherapy ED network. In Queensland we have a network that meets every two months by videoconference. We have case presentations each meeting which are a valuable learning experience for clinicians and then discuss other relevant issues.

Any other comments?

I love my job as an Emergency physiotherapy practitioner, and am excited to be part of this rapidly expanding area of physiotherapy.  

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