I enjoy the potential for creativity that is needed to individualize 
treatment. I am frustrated by the time constraints that do not allow me to 
design an individual therapeutic program. (but does provide time for pulling 
out the pegs and cones) There is a factory worker mentality to timing 
treatments, clocking in, clocking out, overtime, etc. FIM scores are 
narrowing the thought processes for goal setting. Insurance is leading us 
around telling us what to do and what not to do. It is not about what the 
patient needs anymore.

I have some difficulty with bathing programs that take place in an adapted 
bathroom down the hall but is nothing like the patients home setting. The OT 
is assisting with personal care such as what the lowliest staff members 
(CNA's) are being asked to do for patients. Do you suppose OT's begin to 
identify with the CNA's more than other staff? When I think about the 
bathing program, I  value my own privacy and do not think that I will enjoy 
being treated in a carwash atmosphere when I am a patient. I am really 
hoping for some spa treatments, typical of The Homestead in VA when I am a 
patient. Soaking, massage, skin treatments, podiatry, manicures, aroma 
therapy, calming music, what would you want?

I am not asked to participate in the administrative meetings therefore, am I 
to assume the value of my experience is not of important to them?

Pardon my meandering thought processes this evening, this has been a long 
day. 




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