I was wondering what the day was like in the life an OT in an acute care setting . ( such as in a hospital). I am shadowing in april and was wondering if someone could give me feedback on what to expect. Do they start there days with pt. charts and evaluations and how does it all work. Please let me know I am very interested in this field.
This is a typical day for me. I work 10 hour days.
7:00-7:15 - chart reviews for my inpatient rehab ADL sessions and evaluations
Depending on the census in IPR that will "trump" acute care since IPR makes the money. If they are high census or someone calls in sick I need to cover. If I don't have to see IPR patients I start acute care right away. My nickname is "war and peace" because I do not like 'qickie evals". I am very client and occupation centered, so my sessions usually take an hour. The most patients I have seen in a day was 9 evaluations and 4 treatments.
7:15-8:00- FIM score ADL session to help someone get showered and dressed, teach adaptive techniques to compensate for their deficits- longer session for heavy transfers, complex patients or patients who need extra time due to severe cognitive - behavioral impairments
8:00-8:30 - FIM score ADL session, address remedial and compensatory strategies while helping them get dressed , to the bathroom and to the dining hall for breakfast-
8:30-9:30- Evaluate, FIM score & set goals for a new IPR patient. This time includes chart review for medical diagnosis and precautions, PLOF, FIM scoring their ability to shower , dress, toilet , groom themselves and eat. Assess cognition, vision, ROM, strength, hand strength (with Jamar) and write up the report on the computer (usually gets finished during your break).
9:30-10:00- finish documenting reports you were unable to keep up with while with the patient
10:00-10:30- print out my acute care list which is normally 20-50 patients. Depending on how much help I have I can divvy them up or if I am alone, prioritize, EVALS first and there are usually 5-10 new ones per day, then treats. If I am alone I prioritize in a triage method and ignore my pager because all the MD's RN's MSW's, PT's want to move "their" patient up on the priority list answering all their pages and explaining why that will slow everything down is not productive and is stressful. During this time I choose my first 4 patients that I will see & review the on-line charts which takes 10-15 minutes for a nice chart review. I scribble some notes and gather what supplies I need. I carry a folder with about 40 different asssorted handouts for education.
10:30-11:30- complex acute neuro care eval and write up in the patients room on the computer
11:30-12:30- complex neruo acute care eval and write up "
12:30-1:00 - lunch and catch up on paperwork
1:00-2:00- acute eval & treat
2:00-3:00- acute eval & treat
3:00-3:30- simple ortho eval
3:30-4:00- simple ortho eval
4:00-4:30- treatment
4:30-5:00- treatment
5:00- 5;30- finish paperwork, print out and reconcile billing, make notes for next day therapy coverage, phone calls , emails.
that would be 3 IPR patients and 8 acute patients- which is a typical day. Otherwise - for me- seeing 10 acute care patients would be about average for me - usually 8 evals and 2 treats.
I am the critical care OT which includes neuro. I have 3 other OT's on the acute floor. One covers ortho, one medical and one cardiac. If one or more of us is on a day off or gets pulled out of acute to cover IPR or outpatient we have to cover the other areas of the hospital as well
Hope that helps. Now you know why they call me "War and Peace". ;-)