You are currently viewing Caroline Morris: A Physical Therapist’s Perspective on Healthcare

Caroline Morris: A Physical Therapist’s Perspective on Healthcare

We get a physical therapist’s perspective on healthcare from Caroline Morris in this episode of the Perspectives on Healthcare Podcast with Rob Oliver. Caroline is from Alexandria, Virginia (just outside of Washington DC.) She is a member of the millennial generation and has worked in the fields of geriatrics and women’s health. Additionally, Caroline Morris is a health coach and staff development specialist.

Here are 3 things that stood out as Caroline Morris gave us a physical therapist’s perspective on healthcare:

· Caroline was looking for ways to help her patients that went beyond the physical therapy role that she was playing in their lives. She was looking for a way to treat her patients holistically.
· Medical professionals need to ask themselves if this is the right treatment plan for this particular patient. The more involvement the patient has in developing their home program, the more successful it will be. Collaboration is the key!
· Collaboration between members of the healthcare community is essential as well. For patients with an acute stroke, there needs to be coordination between EMS, the Emergency Department, Cardiology, Neurology and Pharmacy (from the very first moment.)

You can learn more about Caroline Morris and her work through the links below:

Website https://carolinemorris.com
Twitter http://www.twitter.com/carolinehmorr
Facebook http://www.facebook.com/carolinehmorr
LinkedIn http://www.linkedin.com/in/carolinehmorr

Here is the transcript of this podcast episode as Caroline Morris presented a physical therapist’s perspective on healthcare:

Rob Oliver: Thank you and welcome to another episode of Perspectives on Healthcare. Today, my guest is Caroline Morris. She is a physical therapist, a health coach, a staff development specialist located just outside of D. C. In Alexandria, Virginia. She has a specialty in geriatrics and in women’s health. She is a member of the Millennial Generation. Caroline, welcome to the podcast.

Caroline Morris: Thank you, Rob, and thank you for having me on. I’m excited to have this conversation with you.

Rob Oliver: You bet. It’s my pleasure. So let’s start right from the beginning. Tell me a little bit about yourself and your role in health care, please.

Caroline Morris: All right. So as we said, I’m in Alexandria, Virginia. I grew up in this area. I actually grew up next door to my grandparents, which I think put me on the path towards geriatric care. I always enjoyed spending time with them, oftentimes more than my own peers. I like being around older people when I was younger, and that’s still true in terms of my roles in healthcare. There are many and overlapping, which works for me. Physical therapy was my start, and I got interested in that actually, as a high school and college athlete, being injured and interacting with my athletic trainers and seeing how they could diagnose and treat me with nothing more than their hands and critical thinking. And that was very appealing to me to not to have an avenue of health care that wasn’t reliant on imaging or complex procedures or lab work to be one on one interacting with people. The majority of my career has been hospitalized therapy. So I started out in acute care, treating patients at the bedside during their hospitalization for four years. And then I switched to outpatient hospital based physical therapy, doing mainly neuro rehabilitation and geriatric balance and fall prevention. My staff development specialist role is at that same hospital, which is a lot of clinical education for the rehabilitation department, as well as collaborating with the nurse educators to bring about some quality improvement projects. The health coaching came about as my pandemic project. I think with a lot of us having some more space to think or triggers to think about where we want our career to go, I was really looking for a way to help people transform their health and really change it for good and not have this cycle of illness and relative recovery, but to actually encourage people to find ways to transform their own health so things didn’t keep coming back as problem.

Rob Oliver: It’s interesting. This is a theme that I’ve heard before. It’s the difference between not being sick and being well. And it sounds to me like that’s kind of what you’re looking at. Am I properly understanding that it is?

Caroline Morris: Yes. And it’s something I think I’ve been chasing for a long time. It was part of my impetus to switch from acute care physical therapy to outpatient where I thought I could work with patients for longer, help them become stronger and better and not need me anymore. But some of my patients would come back every six months. The gains they’ve made in therapy weren’t lasting. They weren’t carrying out the home program that we had established. And also I was realizing a lot of them needed help with nutrition or sleep or stress management, things we could hint at during physical therapy but couldn’t address fully.

Rob Oliver: Yeah. And again, what you’re talking about is a theme that I’ve heard before, and that is the holistic approach in which you’re looking at them, and it’s more than just strengthening. It’s more than just balance and fall prevention. It is a holistic approach of your sleep patterns, your nutrition, all of those things together that create your life and create your I don’t know if this is a proper word or not, but your health portfolio, right? It’s all of it wrapped up together into who you are and how you live and your wellness, so to speak. What does quality health care mean to you?

Caroline Morris: I’ve been thinking about this question a lot, and I think for me, quality is health actually has to improve with the care. You know, just getting to the basics of isn’t working. And then, like we were just talking about, does that improvement last? So not only does it work in the short term, but do we have long term health benefits from the intervention as well?

Rob Oliver: Okay. When you find patients for whom the treatment doesn’t last, were you able to diagnose what is it about the treatment plan that was not working for them, and how did they fall off the wagon or how did that like, where were they falling between the cracks? Do you understand what I’m asking? I guess.

Caroline Morris: Yeah. I think there are a few different ways to approach it. Some is the treatment plan actually the right one for the patient? So we have a lot of as the research improves, we have a lot of general recommendations for patients, but it doesn’t mean for that individual patient that it’s the right recommendations. I think there’s some critical thinking piece on the clinicians part of, does this actually apply to the person in front of me? What I see often in patients who may have more chronic conditions, so in the case of someone with a balance issue, they may have multiple chronic conditions. Nothing is really changing with them, but it’s hard for them to maintain the program. And what I’ve found is, in that case, the less I can dictate the home program and the more I can get the patient to come up with it themselves with my guidance, the better. It goes. So there’s someone I’m working with now who was evaluated by a different therapist given a home program. She’s not doing it. I asked her why. She said she’s lazy and forgot. And I’m like, there’s got to be more to it than that. That was a couple of weeks of that. And so now I asked her to come up with her own program to help her meet her goals. And she immediately came up with, well, I can walk up and down the stairs in my apartment building every day, and there’s a neighbor that I want to go on walks with. And I said, great, that will help you get stronger and that will sustain more than doing some exercises with the therapy. And so I think the collaboration is key and really honing in on what are the barriers and what will get you to actually do it without me around.

Rob Oliver: Yeah. It’s amazing when you empower the patient to be part of the team, be part of the process, it makes a huge difference in their adherence to the plan because they’ve got some ownership in it and because they understand their lifestyle a whole lot better than any of the professionals do. And I think in some ways you just answered this question, but it’s on my list, so I’ll ask anyway. Can you give me an example of quality health care?

Caroline Morris: So I can give you another more broad example if that works. That’s great. Something I’ve been experiencing lately is evolutions and stroke care. So the hospital where I work is in the process of becoming a comprehensive stroke center of excellence. And it starts really with the EMS service. So the amount of coordination between EMS, the emergency department, radiology, pharmacy to help patients with an acute stroke get intervention as quickly as possible, I almost get emotional with the amount of collaboration and cooperation to get things done in a timely manner. And what can happen is if they have an ischemic stroke, the clot form, and can get the clot busting medication as quickly as possible, then their longterm disability is reduced greatly. So from the hospital side, I think that’s an enormous quality improvement project, and it’s trickling down now in our patient, where the patients I’m seeing with stroke now are often walking into therapy, whereas before they were coming in wheelchairs and the whole trajectory of their lives has changed because of this coordinated effort on the front end. So I think from a hospital perspective, that’s a great example of quality, timely intervention that has a long term impact. And then where my role comes in more on the back end is continuing the collaboration, the partnership and the support throughout the rest of the person’s life through some community groups to help them sustain the gains that they’ve made and continue to improve.

Rob Oliver: Yeah. And the concept of collaboration from the very beginning, it’s so powerful. Sometimes it feels like wherever you come into the system, there is a lapse before the collaboration can start. So if you come into the emergency department, then they see you and the whole thing doesn’t start. The collaboration process, I mean, doesn’t start until things have kind of gotten rolling a little bit and you’re in the system and then it starts from there. But you’re talking about almost immediate collaboration from the very initial call when you’ve got EMS there, the whole thing works where you’ve got pharmacy and everybody involved. A very different style of collaboration in a different timeline. What do you wish people understood about your role in healthcare?

Caroline Morris: If it’s all right with you, I’ll do one thing for each of my roles.

Rob Oliver: Sure.

Caroline Morris: So for physical therapy, I think from a healthcare provider perspective, I wish people understood the amount of time and quality interaction we spend with our patients and then that’s something perhaps a physician or another provider could leverage by collaborating with us more. When I’m seeing someone, one on 145 minutes twice a week, that’s a lot more information and picture about the patient that can be gathered and shared amongst the team. For the staff development piece, the biggest thing is that education doesn’t solve every problem. So it’s something I see in profrofessionally where we think we just need to educate staff more and more or even with patients, that we just need to re educate the patient. But just knowing better doesn’t mean we’re automatically going to do better. So that would be my big thing there. And with health coaching, I wish more people knew that coaches existed, that there are well, it’s not a regulated field right now, that there are certification programs that are pretty rigorous, that there is training involved and that it’s a really valuable member of the health team to bring about lasting change, particularly in people with chronic conditions.

Rob Oliver: Yeah. I would imagine that when it comes to your staff development, that it’s similar to your work with patients in that staff needs to be involved. It’s not just a one way, like I’m going to dump all of this information onto you and now you are going to be smarter and you’re going to be able to implement things better. There’s got to be a didactic element to it in which they are contributing to the growth and they have buy in. And as such, the plan is more easy for them to assimilate because they’ve got ownership in it, but it also grows because they have a unique understanding of their work environment.

Caroline Morris: Exactly.

Rob Oliver: That’s going to have a major impact on what happens moving forward.

Caroline Morris: Yeah, absolutely. And sometimes it’s not a knowledge gap at all, it’s more a process issue and then we can problem solve that and it saves everyone a lot of headaches when you find the real problem.

Rob Oliver: Yeah. Again, this is something that I’ve heard in former guests, is you have wonderful people who have fantastic intentions and sometimes the biggest obstacle for them is working in a system that is just a little bit, shall we say, clunky. And it can be an issue that way. What excites you about the future of health care?

Caroline Morris: I think for me, some exciting things are that we’re learning a lot more about health in general and the amount of systematic reviews and meta analysis coming out is very exciting to me to learn some more general truths about health. But also there’s this parallel work of personalized care coming out where we learn how to work with the person in front of us in a way that’s going to most effectively and efficiently help their own health come about. So those kind of two parallel paths are very exciting to me. So I tend to read systematic reviews and meta analysis and case reports. I don’t read as much in the middle, but that’s what I find to be really helpful in actually bringing about positive change for the people I work with.

Rob Oliver: Yes, fantastic. I appreciate that. What is one thing medical professionals can start doing today to improve the quality of health care?

Caroline Morris: I think if they can focus on their own health, that will actually do a lot to improve the quality of care for a few reasons. So as I observe, a lot of health care professionals, many of them don’t look particularly healthy to me and myself included. I have had many health consequences related to the way I was conducting my work and my life. So if they can improve their health, like really improve it, focusing on this core tenants of exercise, nutrition, sleep, stress reduction, reducing use of alcohol, things like that, I bet their concentration will be better, they’ll have fewer errors, they’ll have more energy, they’ll be more present for their patients and they’ll also develop some more empathy for their patients because they’re asking their patients to become healthier, but they may not be doing it themselves. So both in figuring out what it really takes to become healthy so they can help advise their patients or understand their patients better, but also in becoming healthier, they’ll become better professionals.

Rob Oliver: Okay, let me just ask a quick follow up on that. Okay. When it comes to stress reduction, sometimes I feel like a lot of the stress is systemic in nature and it’s because of the environment in which they are working. Do you have any suggestions for how to reduce stress when some of the stress almost seems like it’s inherent to the system?

Caroline Morris: Yeah, that’s a great question and a very practical which I love. So one basic stressor that I found working in a hospital was I wasn’t getting exposed to daylight. So just not even like all the other stuff in health care we can talk about as stressors that my circadian rhythms were off and I’m working day shifts. I’m not working night shifts or rotating shifts like many providers. So some of it was just forcing myself to walk outside for lunch, or even if I’d rushed my lunch, just to walk outside for 30 seconds and come back in. So there are things like that that are just little pockets of relief in a day to improve or reduce stress. Some other things that I like to do, I monitor my own stress and other people’s stress via heart rate variability on some smartwatches, and then I can learn. And they can learn what is actually stressing their body and what isn’t, because it can be different for each of us. So I found for me that the stresses of being paged all day in acute care were a lot for my body and they aren’t for everyone. And so having a different piece of work was helpful for me, where I found that if I have alcohol at night, unwind after a hard day, my recovery is delayed significantly. So a lot of us might turn to a glass of wine or a drink, thinking it’ll help us unwind. But at the physiological level, it’s only inflaming us more. So that was a way to change my own behavior when I couldn’t change the broader system.

Rob Oliver: Got it. It’s interesting. I was just thinking about this. I know that one of the hospitals in our area has food truck Fridays where every Friday they’re bringing in a food truck. And in some ways it’s good because it gives a change of diet and a change of pace. But your circadian rhythm, it gets you outside and it gets you in the sunshine for a little bit. And that may even be some way to address that systemic need in a very creative way. Not just saying you have to go outside, but giving people an incentive to get outside and enjoy. What a great idea. Okay, great. Listen, Caroline, thank you so much for being with me. I appreciate you giving me your time, and I respect your perspective on healthcare.

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Disclaimer: All opinions expressed by guests on the Perspectives on Healthcare Podcast are solely the opinion of the guest. They are not to be misconstrued as medical diagnoses or medical advice. Please consult with a licensed medical professional before attempting any of the treatments suggested.

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