Monday, September 20, 2010

The Athletic Trainer vs. Club Sports

Here is my ethics issue that I would like to get some feedback on from the rest of the group...club sports. This seems to be more of an issue in secondary school settings where high school athletes are strongly encouraged to participate in club sports outside of their school. What do you do as an overworked, exhausted, often under-staffed athletic training program when day after day you are flooded with club sports injuries?

The major problem comes with kids who play a sport that is currently in season and also participate in a club sport. Let's take football players who participate in select soccer on the weekends for example. One of them comes in on Monday morning with a sprained ankle from their club game on Saturday or Sunday. This injury didn't actually happen during a school sponsored event, but if you send them away and tell them to go see a doctor and take care of it on their own, you are definitely going to hear it from that athlete's high school football coach for not getting the kid back out to practice with treatment and rehabilitation.

On the other hand, if you treat said athlete and the several other club sports injuries that will follow during the season, how do you avoid exhausting school district supplies on those kids? You are even donating school district employee time to that athlete with an outside injury.

Ethically, I have a hard time turning away any injury that walks through our athletic training room door; however, I have definitely been frustrated beyond wits end about the large amount of club sports injuries we have had to treat over the years. Does anyone else run into this problem? How do you handle these kids? As a knowledgeable professional, can you turn away an injured kid?

1 comment:

Anonymous said...

This is in response to Lindsay's "ethical question" from Friday. I think it's a great discussion topic Linds, and certainly, there can't be only one way to answer this. So what I offer, of course, is merely what I've found works best for me in my professional experience. I do realize each situation is different and every administration is different. I was extremely lucky to have supportive and encouraging administration in my former position as a high school Athletic Trainer.
I agree, first and foremost Lindsay, with the statement that we can't ethically allow an injured athlete to go without care or at least our minimal attention. We've worked hard to keep the student-athletes informed and trusting in our abilities and passion for their health. Injuries from non-school related sports, should therefore, be evaluated, treated as we the health care professional feels adequately staffed and comfortable with, however, we MUST include all parties of the care team: parents, coaches (club coaches included), athlete, administrators and the team physician in the communication about our evaluation and recommendations for treatment and the safest return to play options. These should include anything from rest, referral to team physician, request for formal PT in supplement to AT work, to specific home exercises. And then, the hard part....you let the cards fall where they may. If any one party chooses non-compliance with these requests, guidelines, or recommendations, you do the best you can with what you've got left and make sure you DOCUMENT! In my experience with non-compliant issues and non-compliant parents or coaches, it's best to refer them on to your team physician and request formal PT as necessary. Ultimately, we can't control for others' actions. If they choose to do other than as per your instructions and continue to drain resources, you again inform administration of the FACTS! If disctrict/school policy is just that you don't treat outside injury, then I think you can 1) petition coaches/administration to make club sport participation in conjunction with school season mututally exclusive, or 2) you evaluate, give self treatment recommendations and refer on to team ortho or appropriate physician regardless of severity....and then DOCUMENT!
This is a hard position for us to be in...we are conditioned, often hard-wired as individuals to be as helpful as possible in all situations. We are doers, supporters and problem solvers by nature...it's part of why the profession of Athletic Training is so appealing to us...there's an endless supply of challenge for us :) We do have to acknowledge the restraints put upon us by our respective working systems. We can't be afraid to admit there is a limitation to the amount of good we can do...using all of our resources and encouraging parents to do the same will only make us stronger professionals and more useful to more indviduals and teams. In my personal opinion, I see within all of us, not just a desire to help, but a self fulfillment in helping. Ethically, we have to be sure to offer assistance where it's needed, but we can not rely on fulfillment in being needed and helpful as judged by others. Sometimes, all that we can do is pass along an issue that is outside of our realm. I certainly hope there are others with comments and other ideas! I so appreciate the opportunity to offer an opinion and hope it is read as such.
Respectfully, Sara Kinsel MS, ATC, LAT
Physician Extender THC Bone & Joint Clinic FW, TX