Dear Linda and the OTList,
I agree with your comments about therapist reluctance to work and consult with
nursing about adaptations for showers i.e. to make them more safe and
functionally independent. This kind of collaboration should occur and yes often
the OT's want to stick to the gym and get done what they can down in the rehab
area. So I feel your pain. When a patient is deemed too low level to take a
shower it should be followed with a plan to make that possible as soon as
possible and then put it into place...but don't avoid the matter all together
and just focus on "strengthening".
I admire all OT managers and teamates that actually concerned these quality of
care and functional outcomes and I know that it takes a lot of leadership and
energy to shape and mold the practices of the staff toward optimal
occupation-based tasks. I regret that, my experience, managers are often more
exclusively concerned about the number minutes your spent with the patient for
the optimal RUGS category, and whether you filled out all the required
paperwork for reinbursement.
So THANK YOU for focusing on these types of matters, this is the kind of
emphasis that we need to refocus our professional behavior.
P.S. As a male OT I sometimes have trouble with patient showers....people
prefer a female to be present...which sometimes means I ask a female colleague
to switch patients or I do work with the CNA so that they know to how to
structure the shower for optimal participation or sometimes I do delay
addressing showers with the patient until I know that they would only need
distant supervision and set-up to perform the task thus preserving their
privacy and modesty...this also requires a lot of rapport building with certain
patients. As I male I have a unique challenge in practice but I try not to use
it as an excuse for avoiding needed intervention.
Thanks again
Brnet Cheyne OTR/L
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