Linda, I was very interested in your post as your comments I fully agree with. 
I work in the community with phys dis (NHS - England) and it is impossible to 
give one clear example of what I do with my patients. 
   
  I assess them holistically in their own homes with a view to support them to 
remain in their homes and often to avoid hospital admission.
   
   I work with them to problem solve any functional difficulties they have in 
their everyday life, with an aim to maximise their functional ability and 
reduce any burden on family/carers. 
   
  Many of my patients have long term conditions which can involve impairments 
of Upper limbs, lower limbs and cognition, and each requires a patient centred 
assessment.
   
  We usually work with a balance of rehab and home mods, and the key is we work 
towards goals we set WITH the patients not FOR them. 
   
  Therefore as you say, what we may work on with one MS patient e.g. how to 
access community effectively and safely may not be important to another MS 
patient, their priority may be how to maintain their garden..... 

  RE - why am I on this list...... this is my first posting as I joined whilst 
on mat. leave and not working so did not have much time or work experience to 
comment from, but found it a great way to keep my OT thinking ticking over. 
   
  I am now back in the swing of OT and hope to offer more to the list from now.
   
  Lucy
  
Ron Carson <[EMAIL PROTECTED]> wrote:
  Shoot, I was fired from a SNF because I was unwilling to meet their
productivity standards. What they wanted was a total joke, unethical and
probably illegal!!


Ron

----- Original Message -----
From: Jerome A Satorrre 
Sent: Saturday, August 18, 2007
To: [email protected] 
Subj: [OTlist] Marketing Results

JAS> Hi
JAS> I was really glad to read your email. You are right there are a lot of 
Dor's that really
JAS> force productivity on therapist. But we have to remember that at the end 
of the day it is our
JAS> clinical judgement to do what is appropriate or not. Productivity should 
be considered but
JAS> shouldn't be the only consideration. We have be able to judge wether its 
appropriate to do
JAS> group or concurrent treatments with certain patients or not. Most of the 
Dor's that I work
JAS> with know that I work this way so they never give me a case load that is 
more than what is
JAS> necessary. Thank you. 

JAS> Jerome

JAS> On Aug 17, 2007, at 9:55 AM, [EMAIL PROTECTED] wrote:

JAS> hi,

JAS> i am a new OT and spent the summer working in a snf. i loved the patients
JAS> and the staff i worked with were all caring and creative. While I agree 
that
JAS> OT is not just upper extremity work I think it's a shame to spend so much
JAS> time defending or trying to make people understand a philosophy and take 
that
JAS> time and put it toward real issues. I always tried to make treatment 
sessions
JAS> relevant, and what is important to one patient isn't to another. for
JAS> example, I would gladly spend time problem solving with a patient on being
JAS> independent in don/doff shoes and socks if that was important but some 
people say
JAS> right now that isn't a priority to me or someone will help me with that 
when I'm
JAS> home. but I'd really like to be able to make a cup of tea. all right then,
JAS> we'll focus on that. OT involves dynamic interaction with the environment,
JAS> which includes UE and LE. a patient said, well someone will give me a 
shower,
JAS> and my sister will cook for me, so I said, well are you going to sit up in
JAS> bed and get out of the bed. she laughed, but I explained that OT would help
JAS> her learn and practice these skills so she'd feel comfortable doing these
JAS> things at home. all this said, I see staff burn out when meeting minutes 
just
JAS> keep piling on and on - 600 minutes in a day - 120% productivity - !! - 
meet
JAS> that and more is added - working with 4 patients in one session, not in a
JAS> group session. caseloads are switched to meet more minutes so that it 
doesn't
JAS> matter what relationship you've developed over the course of a few weeks, 
you
JAS> may come in one day and find that patient off your caseload now. staff and
JAS> patient morale suffer. the mindset of the dor is getting the money - this
JAS> makes for terrible OT.

JAS> I joinged this list hoping to learn from experienced therapists and hear
JAS> about a wide range of experiences and opportunities.

JAS> Linda



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JAS> skills and credentials to propel your career.
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