Interesting question. I just had a student last week who asked pretty much the same question. Currently, my rotation is on the Trauma unit, Neuro ICU, Surgical ICU, Cardiac Care Unit, and Medical ICU. In that type of setting, I feel like we are laying the foundation to recovery. OT does a lot of splinting and positioning to preserve both skin integrity and joint mobility. We cotreat quite a bit with PT, but it is extremely appropriate, I feel in this setting. We are the people who sit these very sick individuals up. We educate their family, we are a sign of hope. When families see that their loved on is receiving rehab services, somehow that makes it a little bit better.
On the regular floors, I see OT as having a very important role. We are a very important source of information. For most of these patients, the residents come in for five minutes, talk around the patients and then leave without ever saying a word. The nurses are understaffed and very often don't take the time to discuss what is going on with the patient. That leaves the therapist. Along the way, I've learned a little bit about everything. Education is very important at this stage of the game, b/c the patient's want to know what's coming next, what is to be expected, is what they are feeling normal.. We also have the very important role of where does this patient go next. In acute care, as soon as someone is stable they are out of there. Can they go home? Do they need rehab? What type of rehab do they need inpatient? SNF? outpatient? Insurance companies will only pay for what we document and recommend. Which makes our job very difficult b/c insurance companies and case managers only seem to look at PT notes. Okay, fine this person may be able to walk, but they have no short term memory, no problem solving skills and would not be able to take care of themselves at home. It's our job to make sure this patient goes where it would be most benificial and appropriate for them. And some people just need the confidence boost to see that yes, they can get themselves dressed and walk to the bathroom, and that they will be fine to go home once they are discharged. I view my role in the hospital as a multiple one. The patients we see are going through the roughest time in their lives. They and their family are scared, confused, angry, and most likely full of questions. I become a resource person for them, and can also bring in much of my psych training to assist them through this trying time. That's how I see my role in the hospital. I think it is a very important one. Jo Eates ----- Original Message ----- From: "Ron Carson" <[EMAIL PROTECTED]> To: "The Butterfields" <[EMAIL PROTECTED]> Sent: Sunday, November 11, 2001 8:54 PM Subject: Re: OT and Acute Care > Hello Mike: > > This is an interesting debate, one that I have often wondered about. > Personally, I've never worked in acute care hospitals but have always > wondered what role OT might play. Can you give an example of where you feel > OT has a good and positive role in an acute setting? > > Thanks, > > Ron > > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ > On 11/10/2001, The Butterfields <[EMAIL PROTECTED]> wrote: > > TB> Hello All, > > TB> I am writting this post to get some feed back from other OT's that treat > TB> acute status post total knee and hip replacements. I think I actually will > TB> talk just about total knee arthroplasty since this seems to be my area of > TB> confusion. > TB> In my hospital there is a five day pathway for TKR. OT's go in on > TB> day 3 of the pathway. Each day there are certain goals that we are suppose > TB> to do with the patient and then "check" them off in the pathway. For > TB> example, on day three contact gaurd with commode transfer and independence > TB> with lower extremity bathing after set up are some of the goals we have to > TB> work on. By day five patients are suppose to be independent with lower > TB> extremity dressing with adaptive equipment and be independent with personal > TB> self care. > TB> I guess feel that there is not really a need for OT with TKR. I > TB> feel that once pt gets enough knee rom and hip flexion strength they will > TB> not need any adaptive equipment. In my experience I have found if a pt can > TB> get to 85-90 degress they dont need any AE. A majority of the time the knee > TB> patients by day 3 have already gone to the bathroom with cna's. I guess I am > TB> rambling so I will cut to the chase. I really feel dislike treating TKR > TB> because I feel there outcome would not change if they did or did not recieve > TB> OT in the acute care setting. Maybe a part of my dislike is because I am > TB> going by the pathway (groan) to determine my goals, not very > TB> person-centered. Yes there are exceptions, the older patients some times do > TB> need AE and ADL/transfer training but they seem to be the exception. > TB> I would love to here from other OT's who work in acute care and treat > TB> TKR. Feel free to email me personaly or you can keep it on the list. I have > TB> other questions, gripes, comments about OT in acute care that I would love > TB> to talk about. > > TB> Take care, > > TB> Mike Butterfield > > > TB> *********��*********** > > TB> Unsubscribe? Send a message to [EMAIL PROTECTED] > > TB> In the message's *body*, put the following text: > > TB> unsubscribe OTlist > > TB> List messages are archived at: > > TB> http://www.mail-archive.com/[email protected] > > TB> *********��*********** > > *********��*********** > > Unsubscribe? Send a message to [EMAIL PROTECTED] > > In the message's *body*, put the following text: > > unsubscribe OTlist > > List messages are archived at: > > http://www.mail-archive.com/[email protected] > > *********��*********** > > *********��*********** Unsubscribe? Send a message to [EMAIL PROTECTED] In the message's *body*, put the following text: unsubscribe OTlist List messages are archived at: http://www.mail-archive.com/[email protected] *********��***********
