*by Whitney*
Timeline: April-August 2017
This is a continuation of my previous post Travel PT: Moving Struggles… Moving from Eastern NC to West Virginia (April 2017)
The Location
I’m just going to give a brief overview here, because this post is going to be a lengthy one as is. I’ll write a separate one on our adventures during this assignment. We were living in a campground in WV and working in VA, so every morning we’d drive into VA and every evening drive back into WV (see pics below). The town where we were working in VA was small, quaint and rural. We really liked it. But there wasn’t necessarily a ton “to do” there, or in the town where we were living in WV. But the really cool thing was that we were within driving distance to a TON of cool places where we had never been. I love this about traveling. Even though we were only about 3 hours from home, there was so much about this area and the areas within driving distance that we had never seen. Stay tuned for my separate post on our adventures.
Our Jobs: The Day to Day
So as I said before, our jobs were at a Skilled Nursing Facility (SNF) where we also did home health visits outside the facility. This was Jared’s first SNF job and my third. Long story short: we hate working at SNFs. This one seemed like it was going to be a “good one” at first, and some days it wasn’t so bad. We liked our coworkers, but the management was not great. There are always issues with the “productivity standard” at SNFs, and while our boss seemed pretty understanding, it inevitably comes up. We both want to be ethical in our billing and not work off the clock. So when you bill correctly and stay on the clock for all documentation, it makes it very difficult to look “productive” on paper. Even with two PTs, we still felt overwhelmed with the amount of documentation for this building (evals, progress reports, discharges, etc), plus the added responsibility of doing home health visits as well. We were left to manage how we wanted our schedules organized between doing our SNF responsibilities and our home health visits. It was chaotic. We were working all kinds of overtime because what was put on our schedules for an “8 hour day” was unrealistic. We were lucky in that our boss would allow us overtime when needed. Most jobs, especially travel assignments, don’t allow overtime. But I think they were more concerned with getting the patients seen, even if that meant overtime. I will say too, this was one of those places that has had a stream of travelers and no permanent PT in years. That usually tells you something about either the location or the job.
Our Jobs: An Unexpected Spin
So this job took an interesting turn, because our boss was also taking on some regional management type responsibilities and was helping at another facility about 4 hours away from our contract facility. This other facility was a home health company that they had just taken over the rehab portion of. She asked me and Jared if we would be willing to go “help out” with this new company for “a week or two,” and she offered to put “us” up in a hotel, pay for our travel time, gas, etc. This sounded a bit crazy and certainly was not part of our contract. However, the only reason I considered doing it was that the location of the other facility happened to be in the same area where I went to physical therapy school. I had actually been planning a weekend trip there during this contract anyway to see my friends since it was within driving distance. So I figured if I went there for work, I’d basically get a paid trip to go there.
This whole situation was a mess and overall a huge, huge mistake. First major mistake: I emailed my recruiter about this and asked what she thought. She didn’t get back to me, but I just went ahead and did it anyway. This was dumb on my part, because I should not have been doing something outside of my contract at a different facility, even though the facility manager asked me to. As a traveler, I need to make sure to communicate with my travel/contract agency about any major contract changes. Next, it turned out what our manager meant by “us” going was one of us at a time, because she still needed one of us at the main facility. So the plan was I would go first for a week, then Jared would go for a week. Meaning we’d also be apart for 2 weeks. Again, it was a little crazy, but for some reason, we went for it.
So I get there, and this new contract they were taking over was an absolute mess. Nobody was on the same page. They were drowning in referrals and trying to get the rehab caseload up and going under the new company name. Nobody was managing me well, and I really didn’t know who to answer to: the local manager? My original manager? My recruiter- who had no idea I was even doing this? After a week of me struggling through this, spending hours doing paperwork, having almost no home health experience anyway, driving hundreds of miles per day (way too big of a radius for home health), my week finally came to an end. After all this, Jared and I figured that it really wouldn’t make sense for Jared to try to learn this new system and go do this for a week, when I had already struggled through it for a week and had a little bit of my own system figured out. And we realized it probably didn’t make sense for me to drive the car back 4 hrs, then him to turn around and drive the same car back there, putting hundreds more miles on my car (because we were definitely not going to take the truck). So I ended up just doing 2 back to back weeks there. Fortunately: I did get to see some of my friends and professors; the manager did put me up in a hotel; it was nice to be back in my old stomping grounds; and it was a unique contract experience. Fortunately as well, I remained on the clock for absolutely everything (and got paid for it), including the drive from original to facility to new facility & back, the visits, the phone calls, the paperwork until 10pm in my hotel room, etc.
Okay so my two weeks of chaos was over. At this point, we had actually asked to extend our contracts for a few weeks extra because it was the most convenient thing for us at the time (not because it was a great assignment, clearly- HA), due to various factors (hadn’t found new jobs yet, saving for camper repairs, etc). But I had asked for a week off between the contract end date and extension to go home and see my mom. So I took my week off to go home immediately following the two week excursion in a different city. After my week off, I was ready to head back to the SNF (original facility) where Jared was and continue working there.
Then, things got REALLY interesting. Our manager said that she would need me to continue working at the other location for some or all of the remainder of my contract. I politely declined, citing many reasons why this was not okay (not in my original contract, wanting to be back in the same city with Jared {NOT in a different city 4 hours away?!}, not wanting to put all the miles on my car, etc). She then said that I would have to do this, or she would be ending my contract, because there was ‘not enough work for two of us at the SNF’. (Which was a complete fallacy, because Jared was working 55-60 hour weeks as the only PT there). This was just a ploy to make me do what she wanted me to do, because they were desperate and had ZERO physical therapists at the new facility. At this point, we had already been scouring for some new job options anyway, as we normally do as a contract is nearing its end date, and we decided to put in our two weeks notice and accept a new job in North Carolina. However, for some reason, mostly me feeling sorry for my manager and the local manager at the home health company, I agreed to finish out my two weeks at the other location, with some stipulations. The manager agreed to not only put me up in a hotel, but get me a rental car, and give me an extra stipend toward meals. So, there I was, going back and forth Mon-Fri and then Mon-Fri the next week to the new location, away from Jared for days on end, working crazy hours at a facility that was a huge mess. On the plus side, I did get to stay at some cool hotels and again enjoyed some time with old friends during my little bit of free time outside of working.
A Really Unexpected Spin
Then, things got REALLY, REALLY interesting. It was Monday night of my last week at this contract. I was out of town at this other facility, staying in a hotel. We were going to be starting our new jobs (in Western NC) the next week. I needed to go to the mall and buy some new work clothes, because none of my old khakis fit anymore! (I had gotten all-too-comfy in my scrubs at the SNF/home health; we had not been to the gym at all during our contract because we were working way too much overtime and I was traveling to this other facility (!!!??!); and needless to say we were stress eating.) So I went to the mall after I finished my home health visits for the day, and afterwards I was going to go to dinner by myself. Karma/foreshadowing: I distinctly remember ‘bragging’ to Jared that I was going to ‘treat myself’ to a nice meal that night with my meal stipend since I was out of town all alone on this crazy work trip/contract.
So, I got to the restaurant, ordered, walked to the bathroom to wash my hands. Came back out, walking casually back to my table, wearing my work scrubs and work clog-type shoes, and woosh! Wipe out! Feet flew from underneath me, all in one second landed on my outstretched right arm on the hard floor. I was in immediate excruciating pain in my right arm. I started checking my arm to see if I could feel if it was broken. I didn’t see any obvious deformity. The pain faded a little, and I thought to myself- it must just be a sprain. So, I decided to stay and eat my dinner. After a few minutes, my elbow started to swell, and I couldn’t really move it much. My waiter had to cut my meal for me, and I ate with my left hand (I’m right handed). The restaurant manager came to talk to me about the incident, offered me ice for my arm. At this point, I decided maybe I should look for an urgent care. They were all closed for the night. I thought- it’s not so bad that I need to go to the ER- I’ll go back to the hotel, and wait until the morning and decide. I emailed my original manager and the local manager to let them know I’d hurt myself, and I didn’t know if I’d be able to see my patients tomorrow.
By morning, my elbow was completely swollen and I couldn’t move it barely at all. I went first thing to the urgent care, got xrays (excruciatinggggg- because the xray tech was trying to put my arm in positions it wouldn’t go). The xrays are unremarkable, didn’t look like an obvious fracture. They gave me a sling and said to rest and ice it, and then gave me a referral to an orthopedist. So there I am, in a city by myself, with a rental car, with an injured arm in a sling. The lucky part was that I was in the city where I went to PT school. I messaged one of my professors who I had actually visited earlier, during my first week there, and I drove over to campus to see if she was there that day. Not only did I think she could be of assistance as an experienced PT and with local ties to the community, but she herself had actually fallen a couple years ago and fractured her elbow, so I knew she had personal experience too. Based on my physical presentation, she thought it was definitely more than a sprain. She was able to get me an appointment the same day with an orthopedist who was an upper extremity specialist, which was such a huge help.
Even though the quality of the xrays wasn’t good and you often can’t see an acute fracture immediately on xray, the orthopedist was able to tell it was a Type 1 radial head fracture at the elbow. Coincidentally, he said he had had the same injury before, and he was able to offer a lot of insight. I was very disappointed that I had a fracture, but the good news was that I wouldn’t need a cast or surgery. He said I would need to rest it for 4-6 weeks and be on lifting precautions.
I was glad to have some answers, but there were so many concerns from this point forward. What was I going to do about my current job? What was I going to do about my next job I was supposed to start Monday? How was I going to be able to do things like eat, get dressed, shower? How was I going to get from this location, back to where Jared was, and to the next location? And further down the line, was I going to get normal use of my dominant arm back? How was this going to affect my ability to perform my job as a physical therapist?
Self Pity and Moving Forward
Needless to say, I was really upset and depressed about this whole situation. Why me? Why did I have to fall at that restaurant? Why was I even at that restaurant in the first place? Why was I even at that job in the first place? Is this going to negatively affect me for the rest of my life? Is anyone going to take responsibility for this at the restaurant? I couldn’t help wanting to blame someone else. Blame my manager for sending me there. Blame the restaurant for their slick floor.
While I was having all these worries, I had to keep moving. I was already driving all around town with my one arm, so I didn’t think it would necessarily be that bad to drive 4 hours back to where Jared was. But, fortunately, I didn’t have to. Mom to the rescue. My mom took off work, drove 5 hours from home to where I was; we returned the rental car there instead of my pickup location; and she drove me back 4 hours to WV. But not before we got all my medical records from the Urgent Care and the Orthopedist, and we called around to some lawyers to find out if I had a case for the restaurant. (Spoiler: no case. As a condolence, I later received a $200 gift card from the restaurant, and that was all.)
I spoke with my manager and told her I wouldn’t be able to work the rest of the week, so we went ahead and ended my contract early. Unfortunately, I still had paperwork to finish from Monday that never got done (because I went to the mall, and the restaurant, right after my last patient visit). Also unfortunately, I was actually doing this facility’s documentation on paper, so I had to go back into the office one more time and try to write my last couple notes, with my broken right arm, while in a sling. I wrapped all that up and left the job. I spoke with the manager at our next job, and she wasn’t sure what to do. Since we already fully intended to move over the weekend and be there Monday morning, and since Jared could still start as planned, she agreed to go ahead and let us both start with orientation Monday. And then we would figure out the rest later. This was a huge relief because I thought I was going to lose the contract altogether, and that Jared may lose it too. More on the logistics of this later.
So my mom drove me back to WV. She stayed a couple days and helped me get everything ready to move, because I couldn’t do much with my arm in a sling. Jared and I moved from WV and went home to Roanoke, VA for a night. I did have to drive myself the 3 hours home with one arm. Then the next day, we went the rest of the way to our new assignment location in Western NC, and I did have to drive the 5 hours there as well.
What a life, right?
Stay tuned for a post on our time in Western NC, including how the saga played out with my broken arm!
But first, I’ll circle back and write an article about our adventures during our time living in WVA and working in VA!
Fifth Wheel Physical Therapist 
Wow, what an ordeal! I have never worked in a contract capacity as a PT (graduated in 2015), and I’ve only worked in an outpatient ortho setting where I can generally keep up with paperwork. If I were to try travel PT, do you think it would be best to initially only go for outpatient ortho? I’d imagine it could be very overwhelming trying to take in a new setting while in a contract, but it might just be that I have low tolerance for excess stress. 😛
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Hey, Adam! Yeah I’d recommend taking your first contract in the setting that you’re most comfortable with (OP ortho) so that you don’t have too many changes all at once. You can always try different settings once you feel more comfortable with travel in general but I think too many changes all at once can make things more difficult. If you decide to give it a shot, feel free to reach out for recruiter/company recommendations!
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