Lacking confidence as a physio - advice needed

[mckenzie]

Not sure if this is the right place to post this but the only way I could think of to contact lots of physios!!

After being out of practice for some time following graduation due to job crisis, I have finally got into a physio role. I've been working as a physio, initially in a very specialist area not using much of my hands on skills and now I have rotated to a medicine of elderly plus neuro rehab department. I am feeling a little out of my depth. When I've done an assessment I always think afterwards of everything I forgot to do and what I could have done better and sometimes feel I don't know enough and can't answer peoples questions. I just feel that I am not doing the job as well as I should be.

Basically I want to know if most new physios feel like that or is it just me and if anyone has felt like that how long did it take you to feel more confident in your knowledge and skills and to stop forgetting things in assessments etc plus feeling confident in tackling a range of conditions.

Thanks for reading and for any reassurance you can give.
Jen

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[gcoe]

Hi Jan

You may want to hear more from graduates than form educators however I'll give you my impression.

When going into a new area of practice it is normal to feel inadequate and this gets better the more you rotate through new areas over your first few years.

However with the delay in employment in your country and that we now are having similar problems with the job tightening a delay in taking up practice must surely exacerbate the situation and your feelings of inadequacy. I am sure this is not an ideal situation.

However I would advise you to front up to the feeling. It is good in a way that you do feel that way because at least that way you aren't "fooling yourself" about competence. "Known incompetence" is a way stronger position to be in than "unknown incompetence" even though it is uncomfortable.

Having a plan of how to improve your knowledge and skills in a practical way can help. For example it may be a case of making sure you have a really are systematically working through your theory from your course textbook and literature in the area of older adults and Neurorehab and applying it as your patients turn up; putting the work into reflecting on how to better assess and manage patients, clinically reason etc.

How do you find your supervisor(s)? Are you able to discuss this with them? Getting good support in your first job is very important in building up confidence and sometimes being forthright and open with them about your perceived difficulties can be beneficial for all. Rather than seeing you as less adequate a good supervisor may perceive you as reliable if a bit cautious and be able to know ones limits and ask for help. And you may feel less intimidated.

Another strategy that can help is joining your special interest group in gerontology/neurology. You might attract a mentor or two by doing this as well as finding other people in the same situation as you.

The question is how can you move from a position from this position of lacking confidence and competence to being the very best physio you can be in this area of practice? Remember your undergraduate course was only just a beginning. The work has really just started!

[rodzer]

Thanks for sharing. It is highly informative post.

[Gregde]

Personally I would suggest, having supervised students, that most feel out of their depth when beginning their career. And new physios who feel overly confident and don't feel their inexperience from time to time can be more of a concern.

Do not be afraid to ask for advice, yet choose the right mentors, those that will support you whilst not being critical of your lack of confidence. Remember also that studies have shown that confidence in itself does not necessarily parallel competence. Appearing assured to patients, however, is critical.

Ultimately you will also need to feel out your niche. All the wonderous and reputation strong physios who have specialised, I suggest, would to a certain degree lack confidence when taken out of their field.

Furthermore remember, 90% of the tasks you do whilst a physio. aren't going to harm a patient, much of it is repetition. Ask for advice when out of your depth, entrain the skill and reinforce the knowledge and concentrate on knowing first and foremost the safety issues and the critical points of difference that will haunt you if you get it wrong.

Most of all, don't be hard on yourself to the point of self destruction. Studies on doctors show that nearly everyone of them is going to make a mistake, quite often critical, in their first few years, even if God complexes and projectioning of blame deceives all of us to the blunt truth of it, physiotherapy is likely to be no different. You will have to deal with errors with objectivity and move on.

Which ultimately means being compassionate with yourself, as much as anything, honest with your patients, realising that ultimately you are only asking these questions because you are sensitive to the responsibility you feel for your profession and patients.

Lastly, the fact you are willing to openly ask these questions of yourself probably suggest, given your own self awareness, that you are a far better physiotherapist for patients already, given much of your results will come through your relationship and motivations with your patients (call it placebo if you like...who cares).

Perhaps a little soft on objectivity, for what it is worth, but hopefully makes sense all the same.

[mckenzie]

Gregde & Gcoe,
Thank you so much for your replies, I really wasn't expecting such in depth and helpful responses! Your reassurance that it is normal and will get better with time is exactly what I needed to hear and your advice is fantastic and I will certainly take it all on board. Thank you again for taking the time to respond
Jen