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Practicing Physical Therapy With Confidence

Physical Therapy means fun and life long learning!

FEATURE STORY

Author: Aimee Bealer
“I could never have a desk job,” confesses Rebecca Austerer, PT, DPT. Currently practicing physical therapy at the New England Rehabilitation Hospital of Portland (NERHP) in Portland, Maine, Austerer says she feels like she won the career lottery. “It’s the most fun job ever—I really have fun working with people. There’s nothing better than watching people get functional again,” she proclaims with an unaffected joie de vivre.
Although she has been in her current position for just six months, Austerer says she feels at home at NERHP. “This is a pretty amazing place,” she enthuses, “it has 90 beds and is the only free-standing acute rehabilitation hospital of its kind in Maine. We have several different specialty programs, including amputee, arthritis, brain injury, cardiac, neuro-rehabilitation, orthopedics, pulmonary, spinal cord injury, and stroke rehabilitation programs. We also have the following clinics: amputee, brace/orthotics, driving evaluations, stroke and wheelchair clinic. Outpatient clinics include: balance and vestibular, lymphedema, pediatric, pre-driving evaluations, pulmonary, speech-language, swallowing disorders, and pre-op programs. The facility has a relationship with University of New England, which is also in Portland, as well as has clinical affiliations with several universities. NERHP offers in-services, community outreach, and is very supportive of continuing education.”

Austerer is excited about the resources NERHP has to offer their patients and seems determined to come up with creative ways to use them. “We have cranes,” she announces with delight. “They really work and it is scientifically sound. We had a guy who’d been in bed for three months; he was really sick and had been intubated most of that time. When he got to NERHP we had to think; how can we get him moving again? So I said to him, ‘I’m going to tie you in a harness and hoist you up,’ and that’s how we started him weight bearing. I sit around and think about how to get people back on their feet no matter what. We use PVC piping, and whatever we have, to build what we need to help a patient. Part of my job involves inventing things. When you have a patient with a unique problem you have to figure it out.”

Figuring out her career path was not easy for Austerer, who claims she was intimidated by the idea of studying for a specific profession despite an affinity for physical challenges. “I have always been very athletic,’ she explains. “I ran high school track and cross country, swam in college, competed in triathlons, even competed in Europe when I was 17. During those years, fortunately or unfortunately, I met a lot of PTs through my injuries. It seemed like a great profession; fun, sports oriented, and important. It definitely made an impression on me, but I never thought of becoming one. I lacked the confidence to pursue a career such as physical therapy. While I was a good athlete, I was not such a good student. I applied to college with a major in physical education. I thought I wanted to teach.”

However, she soon switched to exercise science after realizing she wanted to work within the health professions. “I enjoyed the lab work and the biology aspect, although I wasn’t doing so well at it. Learning biology, exercise physiology and chemistry seemed so difficult for me,” she recalls. “In the fall of my senior year I went to an American College of Sports Medicine conference at State College, Pennsylvania and felt lost. We were urged to go to this conference to network for exercise physiology internships. I was nervous and barely talked to anyone. I remember speaking to my mother about changing my major back to physical education during that conference. The very next day I was offered and accepted a position for an internship as an exercise physiologist at a large orthopedic group near my mother’s house. That internship led me to my first full-time job.” She graduated from East Stroudsburg University in Pennsylvania with a BS in Exercise Physiology in 1998.

After a job as a ‘step down’ trainer, helping people who were finished with physical therapy to continue exercising, Austerer moved on to a position with a chiropractor incorporating exercise programs for patients. “This job was great,” she recalls, “I made the programs and I was really helping people feel better. I became enamored with the idea of helping people and went to a sports medicine conference at a big hospital near New York City to learn more. I didn’t learn a lot of sports medicine at that conference. What I learned was how little I knew, how much of the language I couldn’t speak. Once again, I felt like an outsider. I had a conversation about this with a good friend of mine who was a dentist. After much confidence building and Internet surfing, we decided physical therapy school would be a good fit for me. I was so intimidated, but I got in and I went! I even learned how to study and did much better as a graduate student. My major motivators were to learn, to help people, and to feel as if I could make a difference. When I began physical therapy school I didn’t know there were PTs in hospitals, SNFs, homecare or even pediatrics. I didn’t know what OT or SLP were. When I look back now, I have a good laugh.”

Upon earning her DPT in 2005 from Drexel University in Philadelphia, Austerer began her first job in physical therapy at the New York University Medical Center Hospital for Joint Diseases. “It was primarily an orthopedic hospital with a small neurological unit, about 20 beds,” she remembers. “I had the experience of practicing on rehab floors, acute floors and intensive care. Occasionally I floated to the neuro unit. My co-workers were great; I loved the job, but didn’t like the lifestyle in NYC. Three and a half years were enough. I wanted a place where I could be outdoors and have some space.”

In April 2008 Austerer and her family moved to Maine and she used the American Physical Therapy Association (APTA) mentoring website to find contacts and ultimately track down job opportunities. In the end she narrowed her choices to an acute facility and NERHP. “I chose NERHP because the facility had every piece of equipment a PT could dream of,” she explains, “and I also decided I liked the idea of having my patients for a few weeks instead of a few days. I’ve been there for six months now and I love it.”

In addition to appreciating the equipment and staff, Austerer says she enjoys the flexibility of her position with NERHP. With a young daughter at home and extra-curricular activities like writing articles and studying for her CSCS, the ability to shift her schedule when the need arises is essential. “We all help each other out here,” she says of her colleagues, “and my day-to-day responsibilities are pretty typical; evaluate and treat patients, develop POC, delegate to aides and PT assistants, prescribe orthotics, prosthetic training, w/c prescription and training, gait training. The diagnoses I’ve seen in the last three months most frequently are amputees, CVA, BI, multi-trauma, Guillian-Barre Syndrome, respiratory failure, debility, and hip fractures. I’ve also seen a bunch that I never heard of before, like Hereditary Spastic Paresis. It’s an awesome place to learn!”

At NERHP, Austerer also gets to flex some creative muscle. “Sometimes I go to people’s homes and look at the house to try and figure out how to make a ladder to help them get into bed,” she elaborates. “Once, I went with a roll of duct tape to the house of a lady who had a broken hip and I taped all her rugs down. They were decorative rugs and she was attached to them but kept tripping on them. When I was done she was delighted and said, ‘I’m 85 and I’m not going to fall on them again!’ She just didn’t want to get rid of them and the duct tape solved the problem.”

Austerer points out that it is sometimes when the situation seems most hopeless that she feels most inspired to find a solution. “We had a guy with a stroke affecting one leg and the other leg was broken. We put him on a tilt table and elevated the broken leg and had him do squats with the stroke leg—it worked and we could see him just light up,” she reports with satisfaction.

“Probably the wackiest idea I’ve ever been involved with was when I was at NYU,” Austerer recounts. “We had a guy with a brain injury who had lost the ability to walk properly, and no amount of innovation was helping him. The primary therapist finally took giant rubber bands and tied him head to toe—basically made a web around him—and made him walk in it. It worked because it gave him some kind of feedback to make him realize where his limbs were.

“I don’t understand how people deal with things as well as they do,” says Austerer. “It’s very touching. There are a lot of patients I admire. For instance, we had a guy who fell off a radio tower and then the tower fell on him and he broke his pelvis and a couple of vertebrae. Now he’s back to climbing radio towers again. I find that inspirational to see so many people get back to themselves after devastating changes.”

Austerer adds that as much as she feels like she is doing something that people appreciate, maintaining a strong work ethic in an emotionally taxing job can be exhausting. “I take this job very seriously because I see how important physical therapy and PTs are in other people’s lives,” she asserts. “I strive for perfection and am excessively hard on myself if I feel I made a bad call, or if I’m not as knowledgeable about a condition or treatment as I think I should be. I think the job is very emotionally challenging, too. Seeing patients and family members crying or arguing because of the stress and loss they are facing eats at me. Trying to help them to the best of my ability and navigating our healthcare system today is very challenging. At the same time, I love seeing them go home healthier and more functional than when they came in. I love working and talking with so many people, and working with the team at the hospital. I dislike insurance constraints, paperwork, and terminal illness. Those are the three bummers of my job, but all inevitable,” she laments.

Over the last few years Austerer has made a habit of submitting abstracts to APTA’s Combined Sections Meeting (CSM). “A colleague of mine and I got a platform accepted at CSM last year on Superbugs, so that seems to have become a tradition,” she laughs. “We submitted one this year on c-Diff, so if this gets in it will be my third time presenting at CSM. We also have submitted a continuing education module for publication and are writing an article. I’m interested in teaching at a university later in my career so I am going to help at University of New England starting this month. I’m also a continuing education nut. Now that I know how to do it, I really love school!”

Austerer’s plan is to keep publishing papers, making presentations, and learning. Reiterating her plans to one day become a professor, she understands that staying current with the clinical side of the profession is crucial. “Part of me wants to keep one foot in a clinic because I don’t want to lose that groundedness—it would make me a better, more up-to-date physical therapy teacher. I want to give my students info that will help them on the job. Students want so much of the human piece, the real life stuff.” With her down-to-earth manner, professional creativity, and quest for knowledge, Austerer seems capable of doing just about anything she sets her mind to.

Rebecca Austerer, PT, DPT, received her BS in Exercise Physiology from East Stroudsburg University in East Stroudsburg, Pennsylvania. She earned her DPT in Physical Therapy at Drexel University in Philadelphia, Pennsylvania. Austerer is currently studying to become CSCS certified.

Aimee Bealer is a freelance writer from the Baltimore area. She is on the editorial staff of NEWS-Line for Physical Therapists and PT Assistants.