Friday, October 25, 2013

What constitutes an Occupational Therapy Emergency?

Sometimes getting someone occupational therapy services is urgent. I have stayed late to make a splint for a patient who has had a fracture. Or to start ROM exercises with a patient who just got out of surgery before scar tissue sets in. Or to teach a a patient who has had a hip replacement who is going home and straight to outpatient physical therapy how to dress with adaptive equipment and to order anything needed.

But sometimes there are paperwork emergencies. Today a patient needed an OT evaluation to go to a rehab hospital. The OT evaluation was just a formality, it all comes down to PT: can the patient walk? That is what the insurance company cares about. But they do require an OT eval.

And it was a Friday, and the inpatient therapist called out sick and so I had to go cover and do that evaluation just to get that done so he can go tomorrow. So that was the OT emergency that kept me late at work today.

Generally, it was a stressful day. I got some negative feedback at work. It was not unjustified, but it was also a freak event and I don't know how I could have handled the situation differently. It is not something likely to happen again.

Still, it hurt. But not as much as it might have. I am very sensitive to criticism. I think on the lower Zyprexa dose, I would have been more devastated. Instead, it just hurt, it stung, but I didn't get stuck in it.

I know that is what the meds do. And at times I complain that they make me numb- but the also give me freedom to live that I don't have when I am trapped in my negative emotions that arise from every day events. I think I am less inhibited on meds, which is generally a good thing.

1 comment:

Just Me said...

My worst emergency ever was being paged at 7 pm because a patient who had been sent to the ER after her thumb was caught in a hoyer lift and fractured was discharged back to the nursing home with no splint, no pain meds and an order for "OT to splint". She had end-stage dementia so I knew that anything complex was going to require a COTA to help me. I went in, grabbed a bunch of stuff I thought might get her through the night, had the nurse give me about 4 miles of roller guaze and the patient as much tylenol/ibuproferon/whatever possible and I made something that immobilized her hand for that night. It took hours because I didn't have appropriate stuff and the swelling kept making whatever I did require re-adjustment. I finally got it immobilized so that she was ok for the night, left a note for my supervisor that I would probably be with her for several hours that next day and that I had been at work for 4 hours that night and left. Because we weren't trained or equipped for acute splints it was a complicated process and until we ordered different splint material we were re-splinting nearly daily for pressure points. I was a new grad and I learned a LOT in those 2 months but I have never quite forgiven the ER doc who was not willing to put a cast on there.

Negative feedback stinks and I think it's worse when you know it is valid but you cant do anything. I still sometimes will find myself bothered by things that came up when I worked and that's over 2 years ago now.