As trainers, our clients expect a lot from us. Sometimes what we’re legally certified to do isn’t in line with something that a client needs. A lot of us aren’t legally allowed to give recommendations on certain things, and the types of clients we’re allowed to work with are often limited by our certifications. I’m not an advocate of stepping outside of scope of practice, however I do recognize the demands placed on trainers. I also recognize that in certain situations, those who have the ability to help another person also have the responsibility to their fellow man/woman to do what is necessary, to do what others will not do or what others are afraid to do, and to do what is right regardless of what is acceptable.
One of my clients is an older woman who also happens to be a dear friend of mine. She is also a patient at the Mayo Clinic. Her doctors had advised her to hire a personal trainer, but because of her numerous medical conditions no one wanted to work with her; they felt like it was a lawsuit waiting to happen. This woman reached out to me in desperation. She was going to be kicked out of her medical program if she didn't lose 30 pounds by a deadline that was fast approaching (she had two months from the moment she contacted me about this problem.
Because of my lifetime connection with this woman and having over the years acquired intimate knowledge about her specific conditions, I stepped up to the challenge with what experience I have. She offered to pay me, but I politely let her know that her success and her determination would be payment enough. Initially, I had the same concerns that other trainers would have had/did have, but I put those fears aside, because I believed with my whole heart that I had both the ability and the responsibility to help this woman reach her goal.
When I started working with her, she provided documentation of her physicians' consent for exercise and limitations to exercise, her physical therapy program, and the information given to her by her nutritionist. I stepped outside of my scope of practice for this client, because she needed someone to help her. We've often discussed scope of practice on this site before, and my official position on scope of practice is that a trainer should never step outside of what he/she is legally certified to do. However, I made an exception for this client because I was confident that having known her for so long, and being intimately acquainted with the issues in her life, I could help her better than anyone else might be able to. I was also 100% certain that if I didn’t help her, no one else ever would.
There we were. She had 2 months to lose 30 pounds. This isn't considered a safe amount to lose in 60 days, but she had to get it done.
I took on the role of a life coach, more or less. She had been given a lot of information, and she didn't know how to put it all together. Her diet is a very strict, special diet. She had been given the knowledge, but not the means to adhere to her diet. I sat down with her and went through everything that her Allied Healthcare Team provided her with; we reviewed all of the "doctors' orders." I helped her to make sense of it all, and I created a food log for her that helped her to track everything she needed to be tracking (sodium intake, for example). I reviewed her physical therapy schedule, and created an exercise plan for her based on both this schedule and the limitations set forth by her physicians.
We have been working together for 3 months now. She went back to Mayo about a month ago. She had lost 28 pounds by the day before her scheduled appointments. I also wrote a very extensive report for her Allied Healthcare Team, which she carried with her to the Mayo Clinic. She called me from Jacksonville after she had met with her Allied Healthcare Team, and she said that they were absolutely blown away by the progress that she had made, and they commended both of us on a job well done. They actually filed my report in her medical records folder, which took me by surprise. Her Physical Therapist reviewed our workout plan, and he said that we were right on the money with our activity routine. He even sent her home with some information specifically for me to use while progressing her program. How cool! We meet once a week and we spend 2-4 hours every session, mostly talking about behavior change and the stresses of life. She now has the tools to succeed and reach her goals, because I took a chance and stepped up where another trainer would not. I’ve earned a lot of respect with her Allied Healthcare Team, as well.
She has come SO far, and she still has plenty of strength and determination to continue making progress. God willing, she will continue to make strides and I'll be right there with her!
So you see, sometimes there is a higher calling. It’s not always acceptable to go outside of scope of practice and many trainers may go their entire careers without ever doing so, but sometimes, when every option has been exhausted, going outside your scope of practice might be essential in order to fulfill the needs of the client because you, the trainer, may be the only “go to” source. The key is to be absolutely sure of yourself and always work in conjunction with physicians or Allied Healthcare Professionals whenever you can!
I was only able to share this story with you with the written consent of my client.
I am truly grateful that she has allowed me to share this story. I hope her story inspires you and others to never underestimate the impossible, and to never lose hope that there are still good people in this world who truly want to make a difference!
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