Working at the Top of Your License: A Method Worth Keeping
Patty Scheets, Vice President of Quality and Compliance
Let’s start with a bit of history:
John Wesley, an English cleric and theologian, led what became known in the Colonies as the “Methodist movement” because of Wesley’s habit of building a method, or process, for nearly everything. He was an early knowledge translator, taking what the learned knew and putting it in a form ordinary people could use. In 1761, he gave his congregations a short set of instructions for singing together.1 I have drawn on it for years because its principles apply well beyond singing. They describe how to do good work in community, including the work we do in rehabilitation. Here is my adaptation,
Learn all you can. Engage heartily and with good courage. Beware of working as if you were half-dead or half-asleep. Do not put yourself forward to be heard above the rest, but strive to unite your voices together. Keep up. And above all, work in a way that feeds the human soul, having an eye toward the vision. So then shall your work buoy your spirit and manifest your love for others.
And now, for some contemporary application:
Learn all you can. Your license is a floor, not a ceiling. Current evidence, new assessment tools and the clinical reasoning behind a plan of care are all there to be learned. The clinician who keeps learning is the one who sees what others miss.
Engage heartily and with good courage. Practice at the top of your license using the full scope of your training. Make the clinical judgment call. Advocate for the patient who needs a different plan. Speak up when something doesn’t look right. Courage in this sense is professional confidence, backed by preparation.
Beware of working half dead or half asleep. Everyone knows what going through the motions looks like. It means a note copied forward, a session run on autopilot, a patient treated as a task. Older adults notice. They respond to a clinician who is present and curious about who they are and what matters to them.
Do not put yourself forward to be heard above the rest, but strive to unite your voices. Excellent care is a chorus. PT, OT, and ST, assistants, nursing, and the patient and family all have parts. Working at the top of your license means trusting your teammates to work at the top of theirs. Delegate well and communicate clearly, so the whole team sounds better than any one voice.
Keep up. Stay on tempo with documentation, with your team, and with the changing needs of your patients, the external evidence, and the healthcare environment. Our patients deserve care based on the best science delivered artfully.
And above all, work in a way that feeds the human soul, having an eye toward the vision. This is the center of it. Behind every goal, minute, and outcome score is a person who wants to get back to something: a garden, a grandchild, their own front door. When we keep that in view, the work stops being a list of tasks and becomes a calling.
A closing thought:
Wesley’s method was never about rigid rules. It was about giving people a way to do something meaningful good, consistently, and together. My hope for you is that your work for Infinity is a means to lift your own spirit and show your love for the people you serve.
