Hey there fellow pelvic floor PT! Whether you just took pelvic 1 or have been working in this specialty for a while now, we all have the same fears. How can I help people the most? If you've already taken a pelvic floor course or two then you also know that just taking the coursework is not enough to make you a great clinician.
Other than the knowledge and technical skills, great clinicians also have amazing "soft skills." Thankfully these skills can also be developed!
From being mentored, to now mentoring others, here are my best tips:
1. Be an active listener
The #1 thing you HAVE to do is hear what the client in front of you is trying to tell you. We allow healing to start simply by listening to their story. And trust me, you will hear stories which make you downright angry, some which bring you to tears.
Do you need to get certain information from this person so that you can conduct a thorough exam? Absolutely. But the average time for a patient to be cut off by a medical provider is 17 seconds. It's easy to think of the next question and I understand you want to be sure you get all the specifics and details. However, I assure you that you are doing them and yourself a favor by letting them talk.
I have found that most of the time, the client gives me a good chunk of the info I would be asking about - they just do it in a different order. So I make the effort to not interrupt them. I sit with each of my patients so that I can maintain good eye contact. And plenty of times I will just forget the typing all together and be present with them 100% because I can sense they need it.
2. Get comfortable with being uncomfortable
I get the sense from non-pelvic health providers that they think we’re just wired differently. That somehow I came out of my mother’s womb, already preaching pelvic health to everyone. But the truth is, while I was comfortable talking about pee, talking about sex was something I actively work on being comfortable with. I’m still learning the best way to phrase questions without assuming heterosexual relationships. And constantly learning what other questions I should be asking about sex.
The expectation is not for your to be a rockstar at this right out of the gate. What’s more important is that you are willing to get comfortable with it. And that you fake it till you make it!
3. Set boundaries
Personally I think that pelvic health therapists are usually some of the worst at setting boundaries with clients. Why? Because we are deeply empathic, know there are few other ways for this person to get relief, and we genuinely want to help. What's that look like in real life?
Working into a lunch break because the client showed up late. Feeling emotionally drained at the end of the day. Working so hard that you have no time for your own self care. Taking on this person's problems.
I've been there. And I promise that you are not doing them any good. We need to be compassionate motivating coaches, empowering our clients to take a stand and supporting them where they need it. We do not need to bear their cross. If you want them to get better more than they want it... that is a problem.
If they show up late then do the absolute best you can with the time you have left. A few mins into lunch isn't the end of the world. But you do need to eat and have time to replenish your own fuel (physically and mentally). Please, please, do not make it a habit to skip your own meals to document or treat. It's not sustainable. It will catch up with you.
The hardest realization here is that you cannot be the healer for everyone. Sometimes it comes down to personality matches. Sometimes that person simply isn't ready to start the journey. Sure, they took the step and came in for an appointment, maybe many appointments. But are they following through at home? Are they making the changes?
It's okay to tell these people that at this time, there is nothing more PT can do. You are not giving up on them. You are simply acknowledging that until they can show up 100%, you cannot offer them anything else at this time.
This is often a relief for them. I used to be so fearful of this conversation - until I realized that they knew it and kept coming because they wanted me to feel successful. What?! It's similar to when clients apologize for not doing a home program... it's not about us and clearly communication has gotten murky somewhere if these are the beliefs they have.
I found that when I had those conversations, I was actually giving them the permission to return when they are ready. Now I do not fear the conversation. It'll help them to take their time or it can spur them into action. Either way, the outcome is best for everyone involved.
4. Continue to learn
So I get a bit salty here... but it’s so important I gotta say it again for the people in the back. You will NOT learn “everything” in one course. You will NOT become an expert provider overnight. We are all constantly learning. There is still so much research to be done in this area! This is the key to success in any field, but I feel so strongly about it, I had to say it.
The absolute best thing to do for yourself and your clients is to keep an open and curious mind. Once you get the basics down, it's time to identify what you don’t know you don’t know. Not a typo: it means becoming aware of the areas you don't know about! My best recommendations to do this are to:
Work with a more experienced provider in your own field
Work with a different pelvic health provider (i.e. PT and chiro shadow each other, etc)
Build bridges with different providers. Learn about what they do, discuss patient cases. The point is to see what's outside of your bubble, not to become a PT/chiro/nurse/mental health provider. Although I think all of us have felt like a therapist during a few sessions at least!
5. Take care of yourself
This is by far the most important. I touched on it in #3 with boundaries, and that's part of it. You have got to take care of your spirit, mind, and body. Otherwise you'll burn out and have health problems. It's not a "maybe" - that's for sure. I don't wish this on anyone... but as medical providers we know that's how the story goes.
You have to show up for yourself before you can be the best at showing up for others. If you don't take the time to do it now, you will be paying for that time later on.
Finally, I want to say thank you.
Thank you for joining this specialty. Women, men, and children all over the world are going to benefit from you bringing your own special take on pelvic health. We need more providers like you to work alongside clients, educate the public, and create change in our communities! If you know someone just starting out in pelvic health, then please share this article with them.