Meet Lisa TenBarge PT, DPT. Dr. TenBarge has been practicing in Emergency Department Physical Therapy in Flagstaff AZ since 2004 and has presented on the subject dozens of times on the local, state, national and international level in the last 18 years. She continues to enjoy the challenge of work in this environment.
Describe how you became involved in Emergency Department Physical Therapist Practice.
I attended a presentation at a AzPTA state meeting in 2003 where this practice was described at a hospital in Tucson and thought that my hospital in Flagstaff should investigate the possibility of starting a program at FMC. I then presented to the ED physicians and administrators regarding why I believed it was a much-needed service and we started the program in March 2004.
Describe your practice setting and ED PT model.
We are a level one trauma center and see an average of close to 2000 patients a year for PT services in the ED. From the beginning, we felt it was important to offer the service 7 days a week and during the same hours of the day for continuity and acceptance in this area. Since 2004, we are 7 days a week from 11:00 am to 7:30 pm, staffed with one PT daily. We have had a rotating schedule over the years but currently have 4 different therapists working regular days in the ED every week as a part of an acute care rotation. We take an average of 1-2 students a year for full time ED rotations. We see primarily musculoskeletal diagnoses along with vestibular and wound care patients.
Why do you think this is a valuable practice area?
As physical therapists we offer a unique diagnostic skill set for evaluation and treatment of musculoskeletal injuries that does not exist in ED settings where PT is not included. We look at a patient with the end outcome in mind which is not the norm in that environment. This allows us to provide more holistic care for patients to include non-narcotic pain management, home management, more detailed return to work guidelines/recommendations, referrals for follow up interventions such as outpatient therapy, home health etc, or accurate placement recommendations.
What was the biggest adjustment for you in practicing in the ED?
The often chaotic environment was a challenge but I think learning to triage and treat higher acuity patients was so different from what I was used to that it was the biggest initial adjustment.
Do you have an area of specialty?
No, I am a jack of all trades but after 18 years feel like I can competently treat most any PT patient that walks through the door of the ED.
What barriers did you have to overcome personally and within your facility to practice successfully in this environment?
The biggest barrier to overcome was the constant education and reeducation of the ED staff on how to properly use PT in this setting and the constant marketing that is the norm in this setting where staffing is changing consistently. I knew that we were making gains when doctors started educating other doctors and nurses started education other nurses about use of PT in the ED. Personally, it was overcoming a more introverted personality to become comfortable in a setting that requires external confidence.
What is your philosophy about what makes an ideal ED PT?
The competency in differential diagnostics, the ability to communicate and connect with other professionals in a high stress environment, and the confidence to practice at the doctoring level with other professionals that are doing the same is I think what makes any PT able to work successfully in this environment.
What was your biggest win in the ED?
The first time someone asked me to speak on the subject for others ties with the time one of my students started an ED program in another state.
Want More?
Here Dr. TenBarge, Dr. Carleen Jogodka, & Dr. Griffith speak on current state of ED PT practice. Read more about Dr. TenBarge and her outstanding work here. Connect with Dr. TenBarge here. Watch our full podcast episode with the Legend here. Want to be featured on our podcast? Click here.
