In this new blog series, our lovely Nikki is taking over to tell us about her experience as a newly qualified physio and to describe the joys, fears and challenges she meets along the way. She'll also share her tips which might be useful to some of you too!
I have now embarked on my journey as a newly qualified Band 5 Physiotherapist. After three years of undergraduate training I have finally earned my blue stripes and have been awarded the all-important HCPC registration. In all honesty, stepping into this new role has been daunting and overwhelming. Having played the ‘student game’ for 6 placements, I am now trying to get my head around who I am as a Band 5 Physio. Where do I fit into the team? And more worryingly, who am I to have a say on clinical decisions?!
After attending three days of induction, I nervously donned my blue trousers and white polo shirt with ‘Chartered Physiotherapist’ embroidered across my chest.
My first job is on the surgical wards. My caseload typically consists of any patient who has received any type of surgery. “Great”, I thought as I sat in my first Whiteboard meeting, glancing down over my handover sheet, trying desperately to access my mental medical dictionary… Laparoscopic cholecystectomy, Latarjet Procedure, Laminectomy. Sitting there, I felt a bit of a fraud.
For me, the student/qualified physiotherapist transition has been confusing and frustrating at times. I am not ashamed to admit that, as a student, I felt as though I had my educator there as a comfort blanket. Someone to run clinical decisions by and to clinically reason ideas through with. Having struggled throughout my placements with my own confidence, I actually finished university on a high, feeling self-assured and excited to take on the next step as an autonomous practitioner. Therefore, it came as a bit of a surprise to me that some of the same fears and anxieties I had experienced at the beginning of my first placement were back to haunt me.
Integrating into a new team is daunting. Prior to starting my job I worried about fitting in – whether or not my colleagues would like me or if I would like them! This has been a huge skill that we have had to perfect as students (it is even on the marking criteria)! I've learned to use this experience to your advantage. I surprised myself a few weeks ago by approaching one of the Orthopaedic Consultants, introducing myself and shaking his hand. We then talked at length about one of our patients and he proceeded to draw me a diagram of the surgery he had performed. Personally, I have found that I have been able to relax more and be myself without an educator breathing down my neck!
I was anxious that, as an autonomous practitioner, I would be expected to be in charge of a large caseload immediately. However, I found the level of support similar to that I received on placements. Over the first two days, I was able to complete joint initial assessments and see a variety of surgical patients with the band 6. This helped to boost my confidence and over my first week, I slowly begun to find my feet.
In addition, I worried that senior members of staff might find my questions silly and irritating. However, since spending a treatment session with a patient who had their abduction brace on upside down and having my suspicions that something was not quite right, I have since learned that no question is a silly one! Understand your scope of practice and use the tools available to you. Seek advice, looks things up in your pocketbook, nip to the toilet to Google medical conditions if you have to. It is important to remember that safety (both yours and the patient’s) is vital. I soon learned that as a band 5 you are not expected to know everything, and that is ok.
"I was anxious that I would be expected to be in charge of a large caseload immediately. However, I found the level of support similar to that I received on placements."
I think my biggest challenge has been finding my feet as a newly qualified band 5. With the label change from Student to Physiotherapist came a feeling of immense responsibility which I found overwhelming. On reflection, I don’t think I truly knew exactly what was expected of me. I imagined that I would walk straight into my job and be expected to get on with it as though I had been there for years. When the opposite happened, I admit that I felt a bit deflated and frustrated with myself. In the future, I would perhaps ensure that I sit down with my supervisor and understand what they expect of me.
As usual, I have struggled slightly with my confidence in my own ability. I remember my educator highlighting this to me on my ITU placement, which may have been intended as a backhanded compliment, but it definitely did not improve my self-efficacy! However, having taken the time to reflect on the clinical decisions I am now making, I have realised that I am not second-guessing myself as much as I did as a student. Perhaps I am becoming more comfortable with my new Band 5 label.
The next terrifying challenge I will face is surviving a night on-call. My name recently appeared on the rota for 6 weeks time and I am already dreading that phone call in the middle of the night. As the day approaches I anticipate that the same doubts and fears I have discussed will re-visit me. I plan to attend the mandatory training day, shadow other members of staff and do my own revision to ensure I feel slightly competent.
"The next terrifying challenge I will face is surviving a night on-call."
Tips so far
Following what I have learned over my first two months as a Band 5 Physiotherapist, my recommendations would be…
- Ask questions. No question is a silly one; it is better to ask for help than get it wrong.
- Get to know your team. I am a big believer that your team can make life at work a million times more enjoyable. Bond over a shared lunch or take the time to go to the pub!
- Carry a note pad. I relied on mine as a student and I still do as a qualified practitioner. There is no way I can memorise my ‘to do’ list.
- Use a diary. You will have umpteen training sessions, meetings and supervisions to co-ordinate.
- Be friendly to ALL members of staff! A simple hello to nurses, therapists, housekeeping staff and the wider MDT will make your life on the ward so much easier.
A few months down the line, I have accepted that progressing as a Band 5 is all about experiential learning. If I make a mistake, I won’t get marked down, I learn from my experience. Consequently, I am finding it exciting to work without an educator observing me. I can now put the skills I have learned at university into my own clinical practice and it is actually pretty cool when you start to see the benefits you are making to patients. I have also realised that other professionals actually trust my decision making (!) and my voice is starting to grow within the MDT.
Despite the pre-conceptions and challenges I have shared with you, I thoroughly enjoy my job. I have discovered that we are not alone as Band 5s and in the NHS we have an abundance of resources available to us! It still baffles me that I sign my notes with ‘Chartered Physiotherapist’ but I have earned it, so why not enjoy it!
About the author
Nikki is a newly-qualified physiotherapist with a previous degree in Human Communication Sciences, currently working in a busy university hospital in East London. She was the first ever to sign up to one of our seminars when we started back in 2015; now a year down the line, she's our first ever resident blogger! Expect to see (and read) more of her very soon!