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The First Year Shift: Building Confidence in Acute Care Practice

Show Notes:

What changes when you are no longer the student with a clinical instructor in the room? In this episode of Acute Conversations, hosts Dr. Leo Arguelles and Dr. Daniel Young welcome back Fiona Kearns and Mika Mendoza one year after their first appearance as students. Now practicing in acute care, they offer an honest look at the difference between being prepared and feeling prepared.

Fiona and Mika discuss taking ownership of full caseloads, managing time and priorities, navigating complex discharge needs, and finding their voices within interdisciplinary teams. They also share the hands-on experiences that shaped their growth, from line management, ICU mobility and safe patient handling equipment to vestibular assessment, emergency care and cardiovascular practice.

Throughout the conversation, both clinicians return to the same foundations: protect patient and clinician safety, know the basics, ask questions and keep learning. Their reflections also highlight the value of mentors and colleagues who create room for early-career clinicians to build confidence without pretending to have every answer.

This episode offers practical perspective for students, new graduates, clinical instructors and experienced clinicians supporting the next generation of acute care physical therapists. Listen now on Apple or Spotify.

Today’s Guests:

Mikhaela Mendoza PT, DPT

mikaimendoza21@gmail.com

Fiona Kearns, PT, DPT

fkkearns2000@gmail.com

Guest Quotes:

3:49 Mikhaela “ I just told myself that, I trust in what I know, and if you don’t know, you just ask the questions, that the goal is to never feel like you’re the expert right away. That’s not necessarily the most realistic. It’s to just know when to ask the right questions.”

6:59 Fiona “ When you become your own clinician, you have had all of this feedback, and then you can develop your own treating style based on what you’ve learned from being a student and just feel like you can relax into that a little bit more.”

Rapid Responses:

What’s the most challenging sort of patient that you get to work with in the hospital that pushes your limits the most?

Fiona: “ In terms of my brain limits, it’s definitely our intubated patients. Our… They just, you have to do… There’s so much monitoring, so much stuff that you’re thinking about beyond just them being intubated. Whatever, especially intubated strokes, I feel like those are the patients that they can be so unpredictable.

They can be so impulsive. Sometimes they’re going to pull their lines. You j- just, I feel like I come out of those rooms and I’m sweaty and my head hurts and I have to just stand and stare at the wall for a minute and, like- … pull myself together.”

If you’re on a nursing floor, what’s your go-to snack that you can find in the nurses station?

Mikhaela: “ Usually some sort of donut that they always bring ’cause- … I feel like people are always celebrating something. Or the graham crackers in the drawer. Those are always a staple.”

You know you’re working in acute care when…

Mikhaela: “ You’re outside of work and you hear a random beep and your heart drops.”

Fiona: “ I was gonna say, I feel like I walk into a room and I think about how I can 📍 rearrange it. And then I’m like, “Why would I need to rearrange this room?”

🎧 Connect with Our Hosts

Leo Arguelles (pronounced LEE-O R-GWELL-IS)

📧 largue2@uic.edu

🐦 Twitter: @LeoArguellesPT

Nicole Neveau, PT, DPT, NCS

📧 ngunder1@gmail.com

🔗 LinkedIn: Nicole Neveau

Danny Young, PT, DPT, PhD

📧 daniel.young@unlv.edu

🐦 X: @DLYoungDPTPhD

🌐 Bluesky: @dlyoungdptphd.bsky.social

🎧 Listen now on Spotify | Apple Podcasts