Ron,

Regarding the recent case assignments that you put forth, in which you question 
the need for OT to be on the case and your conviction that OT's should not be 
UE experts but rather focus on occupation if the patient's goal is to focus on 
occupation:

You appear frustrated and I wonder if communication between you and whomever is 
assigning the cases to you could be improved so that they understand that you 
are not going to go out there to "rehab the UE."  

How much communication do you have with the PT's at your agency?  Do you and 
the PT's agree that you are not going to focus on the ROM and pain and strength 
issues and that you expect PT to do that?  What types of conversations have you 
had with the PT's?

I am wondering if you've given an in-service to the intake dept., your 
supervisor(s) and the PT's to illustrate what you do as an OT in home health.
If you have, what was the result?

I know you recently spoke with your supervisor when you were moved to PRN due 
to low caseloads; what is your supervisor's expectation of your services?  Does 
it include rehab of the UE?  

Would improving communication with the physicians who refer patients to your 
agency assist in modifying the types of referrals you receive?  

How many OT's are in your agency?  Do you have OT meetings?  Do you all agree 
on "how you do OT in your agency" or is there a difference in 
the interpretation of how you perform your job?


Thanks,

Sue






 


----- Original Message ----
From: Ron Carson <[EMAIL PROTECTED]>
To: [email protected]
Sent: Tuesday, October 21, 2008 8:19:02 AM
Subject: [OTlist] UE Evauation Yesterday...

Hello Everyone:

Yesterday,  I  received  a  home  health  referral  for  a  humeral
fracture/tricpes  tendon  reattachement. By now, I'm sure most regular
readers  are  aware  of  my  stance  on  OT's  NOT  being  UE experts.
Interestingly,  PT  had  already  evaled  the  patient  and  said they
couldn't do anything.

So, as I'm sitting there talking with the patient, I'm encouraging her
to  use  her  affected UE for daily activity such as eating, dressing,
toileting.  During  this time, I'm thinking there just isn't much role
for  OT.  The  patient's  concern is ROM and pain, not occupation. For
sure,  improving  her  elbow  function  will  improve  occupational
performance, but the patient's concern is NOT occupation.

As  I'm sitting there pondering doing ROM, exercises and strengthening
the  patient  tells  me  that  her doctor ordered outpatient PT. Since
patients  can not be on home health while going to outpatient therapy,
I discharged the patient.

It  was  an  awkward  situation.  The  family  and  I  discussed  the
differences  between  OT  and  PT and how some OT's treat UE injuries.



Ron
-- 
Ron Carson MHS, OT


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