Isn't it amazing that OT is a profession where 13 to 14 years in the business 
defines you as old (no offense Mary Alice - coming from another old OT).
   
  Jimmie

Mary Alice Cafiero <[EMAIL PROTECTED]> wrote:
  
This discussion brings to mind a recent experience I had. I have 
recently moved from working full time in a pediatric hospital to 
working on my own in a variety of PRN contract positions in home 
health, SNF, and high end independent wheelchair evaluations for 
Medicare and Medicaid. Interesting stuff. I have been out of OT 
school since 1993 (scary that I am an OLD OT!!) and have pretty much 
practiced in all areas.

I did a couple of days in a well-respected upscale nursing home with 
a high capacity rehab unit attached. They have a large full time 
therapy staff and a big patient population that actually goes home. 
It was a deal where I was just filling in for a few days so didn't 
really get to know the staff at all.....just came in, quickly got 
oriented to the paperwork and where to find things, and was turned 
loose with a patient list. I was horrified to see all the OTs and 
COTAs sitting in the gym watching their patients sit in little 
clusters doing arm bikes, pinching clothespins, etc. I didn't see any 
cones, but I'm sure they were lurking in a corner somewhere. With so 
little time and preparation coming in, it was very difficult not to 
get sucked in to just plopping my patients right down with the rest 
of them and letting the patients do their time and count their minutes.

Instead, I spent a little time figuring out what each patient was 
planning on doing after d/c and what they actually liked to do with 
their time (how novel!). I actually incorporated that into treatment 
(again, such a rebel!) With one guy, who was returning to live alone, 
we did actually work on him showering by himself. I was chastised 
severely by one of the other OTs and by the rehab director (a PTA) 
because the said now nursing would expect for OT to help with all the 
showers for the rehab patients.

It is just sad and frustrating that we seemed to be damned if we do 
and damned if we don't. How hard is it to incorporate function and a 
person's individual needs and goals into a treatment plan? It isn't 
that hard! AND it quickly shows how unique and wonderful OT can be.

Now, I've had my little moment on the soap box. I will let someone 
else have a turn!
Mary Alice, Texas

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