Ron can you provide some examples of how you made it work in the in-patient rehab setting. You mentioned that you would see 2-3 people at a time, how did you work with each of them on their own occupations?
Also, why is a cooking group, folding towels, not good occupations to work on? Thanks, ~ Miranda ~ > Date: Thu, 23 Jul 2009 20:31:45 -0400 > From: rdcar...@otnow.com > To: OTlist@OTnow.com > Subject: Re: [OTlist] Vision ~vs~ Reality > > In all honesty, the problem of OT is not directly related to the work > setting. I've worked or have direct experience in acute care rehab, > academia, very briefly in-patient hospital, outpatient, private > practice, SNF and home health. ALL of these settings have a majority of > OT's focusing treatment on the UE. > > As far as being in the trenches, that's a choice. I said "no" to > inpatient, got fired from a SNF, quite rehab to work and academia. There > are plenty of jobs. > > But, the problem is not the location. The problem is the therapist. If > an OT focuses on occupation, they WILL NOT BE UE THERAPISTS. You can't > be both! Many people claim to do it, but I think that's a line of junk. > > I fully understand that being in a SNF is VERY tough. The primary > problem in that setting is not UE ~vs~ occupation, its fraud ~vs~ > medically necessary treatment. I got fired because I REFUSED to treat > patient's like cattle. Neither the 'system' nor I were willing to > change, so they let me go during my probationary period. No harm and no > foul, but there was no way I was going to cheat Medicare and rob > patients in that system. > > I first started practicing occupation-based treatment while working at > an in-patient rehab hospital. It was routine to see 2 patients at a time > and 3 at a time wasn't unheard of. I couldn't spend an hour with each > patient but the time I had WAS spent on improving their desired > occupation(s). I wasn't perfect, but in my opinion, it was a heck of a > lot more therapeutic than having patients fold laundry, do dowel > exercises in a large group, wash windows, cook group, "sanding" a table > top, playing childish games, etc. > > At times, I despise my profession because of the way so many adult > phys-dys OT practice. Our professional identity STINKS. In fact, I don't > even think we have an identity. And if we do, it's pretty dang crappy. > Today, I made up a flyer to distribute to my home health company's > nurses. Here it is: > > ================================================================= > > Occupational Therapy: What Is It? > > 1) Education: > > a) OT’s have either a bachelor, masters or doctoral degree > > b) OT assistants have an associate degree > > 2) Definitions of occupation: > > a) Any activity that occupies a person's attention > > b) Activity that a person does to take care of themselves and be > productive > > 3) History of OT: > > a) Founded in 1914 > > b) Originally performed by nurses > > c) Use of crafts to restore meaning and value to injured and > impaired soldiers returning from war > > d) Later, moved to the medical model of care > > 4) Current Practice: > > a) Very diverse profession > > b) Work across the life span because all people have > occupational needs/issues > > i) OT works with neo-nates to terminally ill > > c) Some OT’s focus on treating the upper extremity, i.e. hand > therapists > > d) Some OT’s focus on treating occupation > > 5) Common Misconceptions about OT: > > a) OT is above the waist and PT is below the waist > > b) OT is small muscles and PT is large muscles > > c) OT is about helping people find jobs > > 6) When to Refer to OT: > > a) Patient has difficulty taking care of themselves or being > productive in their home: > > i) Can’t safely dress, bathe or toilet > > ii) Can’t safely access bathroom, shower or other areas > of the home > > iii) Can’t safely transferring to/from bed, chair, > wheelchair, etc > > iv) Can’t safely cook, clean, care for animals, laundry, > etc > > 7) Bottom Line: > > a) When a patient has difficulty or is unable to take care of > themselves and be productive in their homes, regardless of the > cause(s), an OT evaluation is indicated. > > ============================================================= > > Why in world is it necessary to distribute a flyer to a HOME HEALTH > company explaining OT? How can we be so far off the radar map that a > HOME HEALTH company is unsure when to refer to OT? > > IT'S A SAD STATE OF AFFAIRS, THAT'S HOW!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! > > Ron > > ~~~ > Ron Carson MHS, OT > www.OTnow.com > > > > ----- Original Message ----- > From: Diane Randall <spark...@rcn.com> > Sent: Thursday, July 23, 2009 > To: OTlist@OTnow.com <OTlist@OTnow.com> > Subj: [OTlist] Vision ~vs~ Reality > > DR> I am with you about the UE problem in rehab but I really need to > DR> know how we can fix this...I have 14 patients to see within 6 hours, > DR> some are ADL's but I cannot have one on one treatments most of the > DR> time. I cannot do a shower transfer and have 6 patients waiting in > DR> the gym. I am kind of at a loss and wondering what a typical gym SNF > DR> would look like in ideal circumstances. I think a lot of blame is > DR> one therapists when we are the ones in the trenches just trying to > DR> get the minutes in and figuring out how to do it and it is the > DR> corporate structure that has forced UE rehab into the SNFs as a > DR> majority treatment by packing the gym full of patients each day. > DR> Home health is totally different. There is so much you can do one on > DR> one especially within the home. I am doing my best and frankly...I > DR> am Peds is my first love and I will be dong outpatient one on one in > DR> a a clinic full-time by sept. I will continue PRN in the SNF but it is > overwhelming at times. > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com _________________________________________________________________ Windows Live™ Hotmail®: Celebrate the moment with your favorite sports pics. 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