1. You took Pelvic Function Level 1 and you left with more questions than answers when it comes to consent, vulnerability, chaperones, safety, and clinical decision-making about how to deal with tough client situations.
2. Your state requires you to take an ethics class and you're looking for a new class that actually applies to your area of expertise. (The thought of taking another ethics class honestly makes you feel like you'll immediately fall asleep).
3. You'd love to be in a conversation with a small group of like-minded professionals in pelvic health with varying levels of experience about common challenging ethical scenarios for pelvic health providers.
4. You have a burning ethical concern that you would love help with and the ability to anonymously offer it up to a think tank of other pelvic health providers sounds like a dream. You feel icky about something and need to get it off your chest and find solutions.
5. You're looking to learn about what ethics is, why it matters, and how to apply these concepts to your clinical practice, whether you're a newbie or veteran to the therapist life.

In all seriousness, Ethical Concerns for the Pelvic Health Professional is an ethics class created to fulfill your state requirements, answer your clinical practice questions on this topic, and help soothe any situations that may be causing you stress (maybe just a little, maybe a whole lot). Every time it runs, it's slightly different because although there is a structured curriculum, there is also a lot of dedicated time for applicable case study situations and group discussion of real concerns of the providers attending. Join Mora on April 20th in her next course!

PARTICIPANT TESTIMONIALS:

Mora Pluchino, PT, DPT, PRPC is a Stockton University graduate with a BS in Biology (2007), and a Doctorate in Physical Therapy (2009). Mora's toolkit involves experience in a variety of areas and settings, including working with children and adults, including orthopedics, bracing, neuromuscular issues, vestibular issues, robotics training, and in 2016 she began treating Pelvic Health patients. Mora is active with Herman & Wallace as a Lead TA, faculty, member of the content team, and has written and instructs 3 of her own courses with HW including Pediatric Pelvic Floor Play Skills which is intervention-focused, and does not delve into specific pediatric diagnoses.

“I’m an expert at children’s behavior” said no experienced therapist (or parent or teacher) EVER. Working with kids is one of the most gratifying and frustrating, not to mention mystifying experiences I have ever had. What works for one child sends another into a temper tantrum. What one kid thinks is fun has another whining about how they may die of boredom. Ask the pelvic organ stuffies in my treatment what I’m talking about, they could tell you some stories!

Herman & Wallace has two amazing pediatric courses by Dawn Sandalcidi (Dawn Sandalcidi’s course Pediatric Incontinence and Pelvic Floor Dysfunction) that give such a great foundation to diving intro treating pediatric clients. I’ve taken them both myself and would not have been the clinician, teaching assistant or instructor I am without them. In these classes you can learn all of the diagnoses, latest research and treatment protocols from someone who has been a leader in pediatric pelvic floor therapy for years.

It's been four years since my pelvic floor bestie (fellow Lead TA Carly Gossard) convinced my introverted self to try my hand at teaching assistant. I was hesitant, to say the least. I had taught small lab groups at Stockton University and mentored many of my colleagues in different areas, including pelvic health, but a class of 50 people relying on me to guide them through their first pelvic exam experience…I was terrified. It was the weekend before the world shut down for COVID, so there was this underlying current of “What does the future hold” and “Should we steal the gloves and hand sanitizer?” 

Flash forward to the present day. I consider myself so lucky to wear many hats for Herman & Wallace. That first TA experience sparked this love of being with the Level 1 students as they embark on their pelvic health provider journeys. When HW needed to shift to the satellite model, I was one of the first TAs to jump into that role. When Megan Chamberlain (herder of the TAs) asked for help building a Lead TA program, I gave her my list of suggestions (I may consider Leslie Knope from Parks & Rec a role model). One of my favorite things about HW is that they take feedback seriously. At one point, they realized they needed someone to track the patterns of that feedback and guess who got that job….ME!

In 2023, the HW team decided it was time to take that feedback and update the main series to be more…more inclusive, more advanced, more hands-on, more to take home immediately to clinical practice. I was quick to chime in as I had a lot of subjective data from years of review synthesis. We have been organizing, researching, considering, consulting, and revamping the main series, and the first two classes of the series launched in January 2024! As the series rolled out, I decided I needed to TA each class to feel and experience the changes. 

Mora Pluchino is instructing her new course, Pediatric Pelvic Floor Play Skills, which is scheduled to debut on October 22, 2023. This short course is targeted to pelvic health providers looking for specific “child-oriented” treatment techniques for pediatric pelvic health patients. This class will cover some basic challenges and changes for a new or experienced pelvic health provider entering the realm of treating pediatric patients with pelvic floor diagnoses. Pediatric Pelvic Floor Play Skills is intervention focused and does not delve into specific pediatric diagnoses.

As an only child, I have lived my life working to be surrounded by children. From the age of 11 when I could take the Red Cross’s babysitter training, I worked as a mother’s helper, babysitter, and nanny. I never even had a “real” job until beginning my career as a physical therapist in 2009. Before I entered the world of treating pelvic floors, I was a physical therapist who spent the beginning years of my career caring for mostly pediatric and neurological patients. I was in charge of a pediatric program and helped with their specialty programs for kids including cardiopulmonary, feeding, and robotics.

Mora Pluchino is instructing her ethics course, Ethical Considerations from a Legal Lens, which is scheduled for June 3, 2023. This remote course covers ethical considerations from a legal lens for professionals working in the area of Pelvic Health. Health Care Professionals have many day-to-day ethical considerations to “do no harm” including basic decisions for billing, patient care, safety, and compliance. Pelvic Rehabilitation comes with additional layers of vulnerability and ethical challenges, and the legalities of pelvic health can add further complications for patient care, business, and clinical practice decisions.

The patient is a 70 cis-gender female:

• Primary complaints - Painful sitting, terrible tailbone pain x 2 years
• Secondary complaints - SUI, fecal urgency, mild POP
• Prior therapy - multiple, most recent Hospital Based OPPT 3 x per week x 8 weeks (24 visits)
• Progress - minimal to none, the patient actually thinks her symptoms are worsening, pain is unbearable
• Other diagnoses - Parkinson’s Disease, HTN, high cholesterol
• Primary Insurance - Medicare

SEPTEMBER
The patient presents to the provider for specialized pelvic floor therapy. The patient is seen 1 x per week for a total of 6 visits. The patient reports a 75% reduction in symptoms, adheres to her HEP, and attends all scheduled visits.

What is a TA? In the world of the Herman & Wallace Pelvic Rehabilitation Institute, a TA is an abbreviation for teaching assistant. Herman & Wallace has always had teaching assistants (TAs) at lab courses to guide hands-on lab time to be extra hands and helpers for the instructors. Having exemplary instructors and the addition of more people on the teaching team in the room to answer questions, guide, and give clinical pearls is what creates the optimal learning experience through Herman & Wallace.

During COVID, the demand for quality pelvic health education was still high, but COVID limited travel and group gatherings. The Institute was able to pivot and reformat some courses into fully remote offerings. This allowed continuing education to continue but did not answer the question of the core series of pelvic floor courses and all of the other course offerings. This required some creativity. Some labs could be taught virtually, but some educational topics and skills could not be covered without in-person, hands-on learning in which participants got to practice on real bodies..The next pivot was to create a hybrid model of learning, in which some didactic skills were reformatted into pre-recorded content, and the labs were offered in smaller satellites around the country. Herman & Wallace had always been a leader in education because of the hands-on skills provided and learned during in-person labs. The question arose, who would help guide them and be the “boots on the ground” for lab skills?

Mora Pluchino, PT, DPT, PRPC (Faculty member, and Sr. TA) is a graduate of Stockton University with a BS in Biology (2007) and a Doctorate of Physical Therapy (2009). Mora authored and instructs Ethical Concerns for Pelvic Health Professionals and Ethical Considerations from a Legal Lens.

When I used to hear the word “ethics requirement,” I would wrinkle my nose and find the cheapest, quickest course to fulfill my New Jersey requirement. I would sit through it and count down the hours. It was not out of a lack of respect for the continuing educator or the importance of the material. I just felt, no matter how the material was presented it was just dry and did not feel like it applied to my more niched areas of practice.

Faculty member, and Sr. TA, Mora Pluchino, PT, DPT, PRPC is a graduate of Stockton University with a BS in Biology (2007) and a Doctorate of Physical Therapy (2009). Mora authored and instructs Ethical Concerns for Pelvic Health Professionals and  Ethical Considerations from a Legal Lens.

• "I want to start my own practice but I'm not sure if I need to hire a lawyer to help!"
  
• "I have a problematic patient that I want to discontinue seeing, but don't want to be guilty of abandonment of care."
• "I am so confused by the types of clinical insurance that I am required to have!"
• "I want to hire an employee and include a non-compete clause in their employment contract!"
• "I want to start my own cash-based practice and need help with this process!"
• "I plan to market my practice for THIS population, is it legal to exclude THAT group of people?" 

With the end of 2022 approaching, now is the perfect time to take a pelvic health-focused ethics class. For many states, licensed professionals have to fulfill an ethics continuing education requirement, including physical therapists, occupational therapists, mental health, and many other healthcare providers. 

I started writing this series a year ago. I struggled to find a class to meet my biannual ethics requirement for New Jersey that was related to my practice in pelvic health. I soon realized that as a pelvic health provider and educator, the most popular questions that come up for practitioners, secondary only to specific treatment interventions, are ethical in nature. 

H&W is proud to be able to present a new remote course on ethics from new faculty member, and Sr. TA, Mora Pluchino, PT, DPT, PRPC. Mora is a graduate of Stockton University with a BS in Biology (2007) and Doctorate of Physical Therapy (2009). She has been working at Bacharach Institute for Rehabilitation ever since graduation and has experience in a variety of areas and settings, working with children and adults, including orthopedics, bracing, neuromuscular issues, vestibular issues, and robotics training.

Mora began treating Pelvic Health patients in 2016 and has experience treating women, men, and children with a variety of Pelvic Health dysfunction. In 2020, she opened her own "after hours" virtual practice called Practically Perfect Physical Therapy Consulting to help meet the needs of more clients and has been a guest lecturer for Rutgers University Blackwood Campus and Stockton University for their Pediatric and Pelvic Floor modules and has been a TA with Herman & Wallace since 2020 with over 150 hours of lab instruction experience. Mora authored and instructs Ethical Concerns for Pelvic Health Professionals. 

This week The Pelvic Rehab Report is featuring faculty member (and senior TA) Mora Pluchino, teaching assistant Amanda Moe, and faculty member Dawn Sandalcidi on the topic of pediatric issues from infancy through adolescence. Our first guest blogger, Mora Pluchino, PT, DPT, PRPC has published two books. The first of which is titled The Poop Train: Helping Your Child Understand Their Digestive System. This is a rhyming, kid-friendly book to help children understand how their poop is made. It has resources in the back to help parents and caregivers manage a child's digestive system for optimal function including proper voiding positions, ideas for activities to help voiding, fiber recommendations, fiber-filled food options, and belly massage instructions. Her second book, Practically Perfect Pelvic Health 101: A Visual Tour of the Pelvic Floor is a visual tour of the pelvic floor to help all genders and all ages understand general pelvic health. You can find Mora online at https://www.practicallyperfectpt.com/ and on Instagram @practicallyperfectpt.

As a pelvic health specialist, I treat the pelvic floors for all humans of all ages. I am frequently asked the question “Why would a child need pelvic floor therapy?” The response is “So many reasons!”