Hello All,
Thanks to all that responded about OT and acute care. I also do
outpatients in my hospital which is my prime area. The hospital that my town
is in is a summer coastal town. I joke with my PT friends about some of the
diagnosis's we get orders on. Example: small bowel obstruction, vomiting,
diarrhea. I drool at the thought of working on a burn unit, nuero unit and
so on... (But I wont give up my summers and winters in Maine for anything!)
I guess that was why I was getting my feelings of uselessness. We do have
two orthopeadic MD's on staff, so I see a lot of THR, TKA, and I treat and
lot of hands/elbows for splinting in day surgery. I really enjoy working
with people who have a THA because there is a lot of fun ADL retraining
involved. It is is a nice feel to also help an acute CVA stand pivot into
the commode for the first time. The real rehab patients they come in our
hospital are a small percentage. It seems like he once the rest get
medically stabilized, hydrated, blood straightened out they regain any lost
function. I do love working with the elderly who have chronic LBP and OA/RA
and are hospitalized because of a flare up and I get an OT order. A lot of
these patients are amazed at how easier there daily routines are after we a
have a few adaptive technology/equipment sessions. I think that is one of
the most rewarding exp's.
Just another question, how many other OT's do sponge baths as a
part of their regular ADL tx. in acute care. And do you do that type of tx
in early AM or do find that you pt's don't mind that type of tx in PM time?
I usual have a busy schedule with outpt's in am, and I find that some pts
are resistive to sponge bath/self care tx/eval in PM time.
Mike Butterfield
----- Original Message -----
From: Ron Carson <[EMAIL PROTECTED]>
To: The Butterfields <[EMAIL PROTECTED]>
Sent: Sunday, November 11, 2001 5:54 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
>
>
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