I got more involved with my career as a physical therapist when I started my practice in 2013. I began to realize that helping surfer's stay in the water longer in life was having profound affects on their overall mental and physical health... way above and beyond the injury they were coming to see me for.
I powered through, and went back to work within about 2 weeks from the first surgery... perhaps too soon, but I didn't really have the time or finances to rest.
I was back on my shortboard within the year surfing at Pavones, and for the most part I was doing alright.
One day while working an extra shift at a skilled nursing facility,I was transferring a patient from his bed to chair. My patient lost continence, I slipped in poo, re-injuring the a disc in my back I'd had surgery on 4 years prior. Before I knew it, I was out of work, unable to do the activities I loved, having trouble with my marriage, and realizing that without surfing or the ability to work, I didn't even know who I was anymore.
To make things more challenging, I found myself battling an ugly work- comp case, trying to get my medical care and a second back surgery covered. When neither my insurance or the work comp would pay for care, I made the choice to seek out a doctor in Panama. Even though I had to pay out of pocket for injections and a surgery, and leave the country for a while, it was worth it just to get back on track, get the care that I needed, close the work comp case, and move on.
Within 5 months of the surgery in Panama, the very disc I had repaired re-herniated whilst sneezing, and I found myself unable to walk without excruciating pain. The end result was going through with a lumbar fusion in the United States.
My Moral Pain
Almost daily I tried to juggle managing my job’s 90-93% productivity requirement, with my need to earn enough money to pay my bills. If I decided to take the moral ‘high-road’ and not see a patient who was scheduled for therapy minutes that I didn’t feel were within integrity with the patient, then my personal paycheck and ability to provide for my family would suffer the consequences. My work-demands were juxtaposed with my moral conscious that I was unable to provide the therapy services for patients in need due to limited resources, or, conversely, asked to provide services for my employer’s financial gain that felt out of alignment with my values.
My cynicism grew due to seeing the fallout from staffing shortages and budget cuts in multiple healthcare facilities, all while being asked to increase documentation, coding and billing at ‘point of service’ with patients who required hands-on treatment.
Understanding of Moral Injury
In March 2019, I came across the following YouTube video: https://youtu.be/L_1PNZdHq6Q . The message in this video hit home, loud and clear, and articulated in very strong language exactly how I was feeling about my 10-year experience as a physical therapist in our healthcare system experiencing moral injury, moral dilemmas and how that ultimately was a contributing part of my injury.
A Plan For Change
I began to connect some dots between my existing small business which provides physical therapy for surfers (www.surfersedgetherapy.com), with current Surf Therapy research (https://intlsurftherapy.org/) and Dr. Wallace Nichols research regarding Blue Mind health. I realized that I had a great foundation in mind to help other healthcare professionals experiencing burnout.
Whether naming it by the symptom, burnout, or the cause, moral injury, it is an issue amongst healthcare providers that is a global health issue. Some studies cite up to 50% or more of healthcare workers are experiencing burnout, leading to exhaustion, cynicism, decreased sense of self efficacy, and suicide.
This symptom of burnout, which I believe is actually a result of moral injury affects the ability for healthcare providers to provide compassionate care, and ultimately affects not just our institutional healthcare outcomes, but the quality of life for the provider him/herself.
My intention is to create Surf and Standup Paddle Therapy Programs for health care providers, using evidence-based literature and research, in efforts to ameliorate some of the symptoms that go along with burnout, create awareness of the severity of the issue, and work to community, support, and structure to healthcare providers worldwide facing this issue.
Here's a few things I'd like to share based on this whole crazy experience:
As a healthcare provider, I am committed to helping people stay active in their sport of choice throughout one’s lifespan. Realizing that activities around the water and outdoors provides tremendous physiological and psychological health benefits is what drove me to start my practice Surfer’s Edge Physical Therapy in 2013, later expanding to Surf Body Connection to include online surf wellness courses and coaching in 2016.
Physical Therapy Licenses:
California: 35208 | Maine: 4589 | Hawaii: 3388| Wyoming 1829| Idaho 5978
Doctorate of Physical Therapy (DPT) – Chapman University
B.A. Psychobiology- University California Santa Cruz
Certificate in Massage Therapy- Mueller College of Holistic Studies
Certified Life Coach-Life Purpose Institute
Certified: Selective Functional Movement Systems, Functional Movement Systems, Y-Balance Test, Titleist Performance Institute.