The blog is approaching its 2nd anniversary (November 13th) and what a wonderful journey it has been. I particularly want to thank the readers who contact me with requests, sharing their stories, and asking for advice on conditions they are struggling with. Rayner & Smale is a blog written for those who are maybe just graduating, have embarked on further studies, or simply love to continue learning.

When I graduated I thought I had a pretty good handle on what I would do with my career and what my profession involved…. but in hindsight I think I was grossly underprepared. At the time I lacked a mentor or even senior Physiotherapist who could help me understand a little better what working could be like.

I’ve learnt a lot about my profession over the past six years and to the graduate physiotherapists around the world - these are my lessons that I want to share with you. So, in no particular order….. things I wish I knew about when I graduated.

Be committed to your career but never abandon your personal life

Working with people in pain is exhausting so take steps to look after yourself.

Burn out is inevitable unless you find your balance. That balance is completely unique to you so don’t compare yourself to others. To avoid burnout you will need to set goals professionally and also personally that you can work towards.

Stay fit and be involved in activities outside of work.

As soon as I started full time work I felt I had no time for sport or activities. This is not true - make it work. Join a running group. Organise once a week to go to yoga with friends. Play sport on the weekends. This way you can continue to stay strong and fit and keep your energy levels up. Remember that you can't help others well until you first help yourself.

Be committed to your hobbies.

I’m sure all of you had hobbies growing up and during school. For me piano helps me decompress from a days work. Playing works on my hand dexterity, memory, creative brain and there is nothing more relaxing and meditating than getting lost in the music and devoting my concentration to something so active and removed from being a physiotherapist. I often play for just 10 minutes before leaving for work or when coming home and for me, it’s a wonderful way to leave things at work and make home about being home. What ever your hobbies might be - make time for them - it’s important for nurturing your soul.

When choosing a workplace - go for a cultural fit, not just a learning opportunity.

The first step in achieving this is to visit the workplace you want to be apart of.

My first job was at the hospital I worked at as a Physio Aid for 2 years while I completed my bachelor degree. I knew the staff really well and felt so comfortable there. It was an amazing place to start my career as adjusting to a new role was the only thing that needed to happen.

Then I transitioned to private practice. I visited the practice first as a patient before I decided to apply for a job there and I knew how the practice operated, the culture of their staff, the character of their front of house staff and the way physiotherapists worked. I had an urge to be apart of that culture and that is how I knew it was somewhere I wanted to work. The reception staff were one of the biggest deciding factors for me - they are the face of the clinic and they represent the beliefs and morals of the company. I felt so welcomed by the reception staff at Physica from the moment I walked through the doors, and while I worked there, I was so proud to have them represent our clinic.

Some physios have emailed me asking about whether to go into a public or private practice job. It is a decision everyone faces. You’ll get a great perspective of public health from your University placements but that is harder to achieve in the private setting. Go to various private practices and pick a place you want to work in - where the culture fits you, where you feel you can envision growth and development. Don’t follow the recommendations of others without seeing it first hand for yourself.

Wear comfortable shoes.

Seems like a silly point but it is not. It’s hard for girls to find comfortable work shoes and we often go into ballet flats which are awful to walk around in all day. I bought my first pair of full black Nike free runs when they first came onto the market. Best decision I ever made. This is not a plug for Nike, in fact, there are many black sneakers now available that you are able to wear to work. It’s not the most designer or fashionable decision but think about your body and invest in comfortable shoes.

Practice your spinal mobs as much as you can (PAIVMS and PPIVMS)

I was always told this but never did it. During my masters I had to practice over and over again and I was often practicing my manual handling on the weekends with my friends or if they were busy, my poor husband. The more you practice and get used to feeling necks and backs and getting feedback from those people, the better your handling becomes. If you only treat for money, without practicing, you loose the ability to be creative and work on techniques you’re not as strong at.

Be open to being observed by others.

Prior to beginning my masters I was never watched and had developed all these habits and beliefs and ways of saying things. It’s not all bad but it’s an amazing thing for someone to ask “where did you learn that? Why do you do it that way? What do you mean by that?” After overcoming the nerves of others watching and being involved in the feedback of colleagues I started to love being watched and checked if I was doing the best thing and explaining all my crazy thoughts to others well.

Allocate time for professional development because you will never stop learning.

Seek out mentors within or outside the field of physiotherapy

Initially my mentors came internally from work and we scheduled weekly catch ups to debrief about tough cases, run through treatment techniques and learn new assessment tools. As my skills developed my mentors changed. It’s great when that happens. Now I love attending courses and meeting new people and learning about their career paths. You’ll be surprised how many role models and mentors are out there once you start networking.

It’s also a great learning experience to mentor others in your workplace and help develop the skills of those around you. So if the opportunity arises for you to nurture someone else's career - do it. Teach them everything you know and I can guarantee your knowledge will continue to expand too.

Set professional goals

Initially I set annual goals which were large development areas that needed time and focus. Now I love setting quarterly goals. Working towards developing a new skill for 12 weeks is a focussed time frame which I feel is more achievable. It might be as simple as maintaining contact with all active clients, aiming for inbox zero, practicing your letter writing, revamping old exercise programs, or reading a few articles on a particular topic.

Get involved with social media and online development courses.

Only after going back to University and getting a laptop and smart phone did I start to get involved in social media. I remember having breakfast on my honeymoon and my husband (who works in tech) saying I need a twitter account @siansmale and I was like "No… I don’t need one. No one is online anyway. Physios don’t do that".

Why not? We should! I love twitter and I have the access to follow some of the best physios around the world and stay in tune with their thoughts and work. So I would definitely encourage you to get a twitter account - decide on your identify, decide what work you are going to promote and who you are going to follow.

Don’t be a troll.

Encourage others. Be positive. Share what you’re learning.
I am so sick of people criticising others work on twitter and often it’s just to have a rant and it’s not a true reflection on the original piece. We don’t need to talk each other down. We need to support each other, advocate our profession and encourage others to learn and grow. The only way our profession moves forward is if we help each other get there.

Get a Twitter & Linked in account.
Follow blogs: There are many people already dedicating time to reading and disseminating the knowledge for you. Find a writer you relate to and enjoy reading from and follow their train of thought. I follow Body in Mind, Pain-ed, Real PT talks, Andy Franklin Miller, The sports physiotherapist, and Noi group.
There are online journals where you can access the original articles: PEDRO, Australian Physiotherapy Association journal portal and more...

Be apart of associations and attend lectures to meet others and network.

I am a MPA member for the Australian Physiotherapy Association and love going to lectures. Sometimes you don’t learn lots of new things but you get the opportunity to solidify what you know, be reassured that it’s still currently knowledge and network and meet others.

Be an advocate for our profession.

Having moved to a city where many people have never gone to a Physical Therapist (physio) before in their life, I find myself trying to explain what we do. We treat pain, we assess movement and biomechanics, we help set rehabilitation programs, we have the capacity to treat almost any body part or injury. It is just so broad that it’s almost hard to explain. But take it from me, some people really have no idea what we do. Often, once I've explained what I do, people mention injuries they've been struggling with and didn't know could be treated.

So this is what I say …. I’m a Musculoskeletal Physiotherapist which means I studied a degree in physiotherapy and then decided to learn more about one particular stream. It's a great stream because I feel I am a generalist and almost anyone can walk into my office and I am going to try work out what is wrong with them. Our profession is driven by what the evidence and science says. We are investigators that try work out why injuries aren’t getting better and once we understand the cause, we use a range of techniques to help people. This includes: exercise, massage, manipulation, dry needling, acupuncture, mobilisation, education and other treatment tools.

Everyone has a lesson to teach you.

Take the time, make the time, to truly listen to the stories of those around you and try to understand the journey that lead them to you, because you might be able to impact their trajectory in that moment in time.

Working in healthcare and being a Physiotherapist is a massive responsibility. A wonderful and unique opportunity. Everything you know has the power to change someone else's life. Share your knowledge and aim to make everyone around you stronger and more independent so you can continue to focus on your personal/professional growth.

Make time to read - it is good for your brain.

Share your thinking with others - this is what has changed me the most.

Go back to the basics over & over again

The mistakes we make teach us invaluable lessons.

Be humble & respectful towards others - it goes a long way.

Thank you again for the support and encouragement over the past two years. Writing this blog began as a hobby but now I'm so passionate about writing it and sharing my forever-changing knowledge. Thank you also to the special Physiotherapists who have contributed their thoughts to this blog. I'm grateful for the feedback, for the emails, requests and notes of motivation. Looking forward to what the next year holds and what I'll continue to learn and continue to share with you. Sian