This is the second post in a series about occupational therapy in acute care. Read the first post in here.
One of the constant refrains of my occupational therapy program’s faculty was that we were all “change agents” with the power – and responsibility – to see and do things differently in order to achieve optimal outcomes for our patients and our profession. As a change agent, I make an effort to give my best and make positive change wherever I work, even when it’s easier to stick with the status quo. This is especially true in the acute care setting, where time, financial, and resource restraints can be huge barriers to holistic, occupation-based OT practice.
To be perfectly honest, I’ve had more meetings with management than I care to admit during my brief tenure at the hospital, typically to discuss my goals and plans of care for patients with needs that were deemed “not appropriate” to address within the acute care setting or goals that other team members “wouldn’t be able” to address after my initial evaluations (apparently because they weren’t BADL or exercise-based goals…). It hasn’t been easy, and each meeting is a valuable learning opportunity for me to learn what others think OT is or should be – and a platform for me to provide education and advocate for my profession and scope of practice. Without going into too much detail, I’ll simply say that I think there is a long way to go before truly holistic, progressive, and occupation-based occupational therapy is the norm – rather than the ideal – in most hospital settings.
This is Part 1 of a series about OT’s role in the acute care setting.
In August 2018, I had my one year anniversary as an OT working in an acute care hospital setting. If you’d asked me two or three years ago where I thought I’d be working, I NEVER would have thought I’d be in acute care! Ironically, my first-ever OT fieldwork experience was with an acute care OT at a large teaching hospital, and while I enjoyed the learning experience I was certain that the setting was not for me. I disliked the hectic pace, limited opportunities for occupation-based practice, and short time spent treating clients. Ultimately, I felt that I was better suited for a setting where I would be able to do things with clients that initially drew me to the profession – such as cooking, leisure activities, home modification, and community outings – and acute care didn’t seem conducive to any of these goals.
Fast forward three years, and I found myself working with a small team of OTs and one OTA at a 650 bed community hospital on an interdisciplinary acute rehab team. Initially I spent much of my time on the ortho floor, evaluating and treating patients after hip, knee, and shoulder surgeries. From there, I branched out into providing care for patients on the neuro, general medicine, oncology, bariatric, intensive care, and cardiac units. It has been a whirlwind experience, and I am learning something new every day – including what my managers, coworkers, and teammates believe is “within the scope” of OT practice in the acute care setting. I don’t always see eye-to-eye with them about what types of OT interventions are appropriate in the acute care setting, but our ongoing discussions and my desire to learn more inspired me to dig into the literature, talk with professional mentors, and reach out to other acute care OTs to learn how how I could serve hospitalized patients while still practicing in a way I know is skilled and demonstrating my distinct value as an occupational therapist.
Read on to learn more about the precarious position of acute care occupational therapists in today’s demanding healthcare environment.
Note: The video for this VideOT post wouldn’t embed in WordPress, but it is linked below!
This past week I was on my Fieldwork I assignment, working with an occupational therapist in an acute care setting in a large hospital. While I was there, I heard a therapist talking about a treatment so ancient I never thought I’d see it in a modern hospital!
The treatment is called “hirudotherapy,” and it involves putting LEECHES on a client to facilitate healing!!! I was shocked, but then a nearby PT confirmed that leech therapy occurred commonly at the hospital he had previously worked at. After doing a little research, I learned more about why hirudotherapy can be an effective treatment – when done appropriately and by trained professionals.
As I mentioned, hirudotherapy is an ancient practice that has been around for thousands of years and used by people and civilizations around the world, from Egypt to Greece to the early Americas (Abdualkader, Ghawi, Alaama, Awang, & Merzouk, 2013).