Clinical specialty area: Cardiorespiratory
Years in specialty practice area: 33
Practice setting: Acute care and outpatient consultation practice for complex respiratory patients
Why did you choose to become a clinical specialist?
Living in Newfoundland and Labrador, where there is not a physiotherapy program at Memorial University of Newfoundland (MUN), I regularly seek ways to keep reviewing practice options and connections. This program enhanced my network, allowing me to connect with highly skilled practicing therapists across the country, which is always an asset to move your practice forward.
In addition to my clinical practice leadership position at work, I have also developed and presented courses on cardiorespiratory assessment and management courses. I felt that it was important for ongoing credibility to be able to complete the specialization designation. It helps set a high bar for professional achievement.
How do you feel the clinical specialization role will change the field of cardiorespiratory physiotherapy?
I hope by CR being one of the inaugural areas of specialty, it will raise the awareness surrounding this area of practice and broaden its consideration in the total physiotherapy care of a patient. This certification program is yet another element that highlights our strengths as physiotherapists and raises the profile of how and what PT can contribute to teams and integrated patient care. Taking the ICU setting as an example, the growth in technology and the number of disciplines involved in a patient’s care is evident. Being able to substantiate our role for both high level respiratory management, as well as guiding progressive mobilization, helps us not only work well with our colleagues in other disciplines but also provide leadership in developing goals of care. It is also important to cross boundaries and find ways to link MSK, neuro-rehab and other PT specialists to collaborate in new ways that will benefit our patients.
This program enhanced my network, allowing me to connect with highly skilled practicing therapists across the country, which is always an asset to move your practice forward.
What are important things to consider for those who are interested in pursuing their clinical specialist?
The expression “we are only as strong as the weakest link” could apply here. To bring a strong credible performance to a specialty area requires a solid base. I would suggest all PTs aim for a broad base of practice initially; to consolidate knowledge and skills before branching into a specialist area. My previous experience across multiple areas of practice, including acute neurology and outpatients prior to my move to CR, has enriched the lens I bring to the CR field. Keep a practice that is patient-led; based on a balance of evidence and a push to innovation and a new take on the science underlying our work. You will then discover a passion that will drive your practice and the CPA specialization program is one vehicle to help you achieve your clinical specialist goal. I would recommend PTs review this program -you may be closer than you realize to meeting the requirements.
I graduated with a BScPT from Queen’s University and returned home to St John’s, NL to work at the Health Sciences Center in fulfillment of a bursary program commitment. When I began my physiotherapy career I thought acute neurology was going to be my primary field, as it was my first senior position. Two years later, I agreed to temporarily fill in the vacancy in the senior role for ICU and coordinate the cardiorespiratory (CR) services for a short period. I was in a PT department setting and agreed to do this as a favor to my first manager until she could recruit someone to be a CR Clinical Lead. My only stipulation was that I be supported in researching new evidence ( this was prior to the common use of the phrase “evidence based practice”) and incorporate it into practice, as CR treatments seemed a little routine at the time. What I thought would be a 3 month hiatus from neurology turned into a lifelong passion for cardiorespiratory practice. Once I was full time in the ICU, I was able to explore the pathophysiology of patient presentations and their moment- to moment response to our intervention. I was immediately attracted to the possibilities a constant feedback setting could provide! You could challenge a patient and make subtle adjustments to input based on the physical and technological feedback from the patient. The ICU setting allowed for safe experimentation and innovation; therefore new advances in patient care could be extrapolated, from patient findings, courses and evidence, and introduced into practice.
Currently, I am the Clinical Practice Leader in Physiotherapy at Eastern Health. My position is split between clinical time in the ICU and resource coordination and administration for inpatient physiotherapy services at St. Clare’s. In 2012, I received the Allied Health Clinician of the Year award for Eastern Health – an honour that I am thrilled to receive.