Welcome to the world of occupational therapy (OT). You are about to learn about a profession that can truly make a difference in a person’s life.
As a practitioner in OT you can improve the lives of people, from newborns to the elderly, by providing them with the knowledge, skills and abilities to achieve independence and enjoy life to its fullest.
“I truly enjoy my profession because of its uniqueness,” says Kashala Erby, OTR/L, who works for Sundance Rehabilitation’s Montgomery Village Health Care Center in Gaithersberg, M.D.
“I think the fundamental knowledge that we learn, coupled with clinical reasoning and creativity, makes us a distinct profession,” Erby continues. “I value occupational therapy as a means to influence, restore and rehabilitate.”
A Career in OT: Challenging, Rewarding
Occupational therapy, or “OT” as it is often referred, is a health care profession that uses occupational, or “purposeful,” activity to help those individuals whose tasks of daily living are impaired by developmental delay, physical injury, medical or psychiatric illness, a behavior problem, or a psychological disability. Practitioners in OT evaluate function through an analysis of human performance, relationships and situations. They also engage clients in experiential learning and problem solving activities. Specialties within the field include, but are not limited to: gerontology, pediatrics, developmental disabilities, mental health, prosthetics training, spinal cord rehabilitation, school-based practice and hand therapy.
OTs need to be both people-focused and science-oriented. They must be creative, innovative and well trained in the functions of the mind and body.
Good communication skills are also a hot commodity in the OT field. Brushing up on such skills will greatly benefit all prospective or current OT employees. Emily Groth, who is in the process of completing her master’s degree in OT and serves as the South Carolina representative to the American Occupational Therapy Association (AOTA) Representative Assembly, agrees that communication skills come in handy in occupation therapy, especially for OTs working with children.
“I greatly enjoy interacting with the families and teachers [of my young patients] in order to determine the best placement for them in the school system,” Groth says.
There is no question that occupational therapy is challenging work, however, there are plenty of rewards that come from making a dramatic impact in patient’s lives.
“I really enjoy finding the modification to an environment or activity that will allow a child to be as successful as possible,” Groth adds.
If occupational therapy is an area of allied health that you’re interested in pursuing, you’ll be please to know that this is a great time to enter the field. As the number of middle-aged and elderly individuals increases, the demand for therapeutic services, including occupational therapy, also multiplies. Currently, job growth within nearly all health care disciplines are projected to increase at a much faster rate than other field, but the job outlook for practitioners in OT in particular is expected to increase by 21-35%, according to the U. S. Department of Labor, Bureau of Labor Statistics.
Salaries for practitioners in OT are also on the rise; according to the ADVANCE 2003 Salary Survey, full-time practitioners in OT salaries show an average increase of $9,000 in the past four years. The new national annual average salary for OTs is $51,352, which takes into account professionals in all work settings and with all degrees of experience and education. Occupational therapy assistants, based on all settings and levels of experience, show an average annual salary of $35,635 in the past year $8,000 higher than the average in 1999.
An OT Overview
Occupational therapy is a career for individuals who care about people and have a desire to learn, achieve, and contribute their best to society and the profession. OT’s ultimate goal is to help their clients lead independent, productive and satisfying lives.
“Occupational therapy allows me to interact on a deeply personal level with people from every walk of life and with all levels of ability,” Groth says. “I am able to assist them regain independence in activities of daily life that are easy to take for granted, such as dressing, bathing, eating, and participating in play and leisure activities.”
Practitioners in OT may implement physical exercises to increase the strength and dexterity of their patients, or paper-and-pencil exercises may be chosen to improve visual acuity and the ability to discern patterns. A client with short-term memory loss, for instance, might be encouraged to make lists to aid in recall. One with coordination problems might be assigned exercises to improve hand-eye coordination. Practitioners in OT also use computer programs to help clients improve decision-making, abstract reasoning, problem-solving and perceptual skills, as well as memory, sequencing and coordination, all of which are important for independent living.
For those with permanent functional disability, such as a spinal cord injury, cerebral palsy or muscular dystrophy, therapists instruct in the use of adaptive equipment, such as wheelchairs, splints, and aids for eating and dressing. They also design or make special equipment needed at home or at work. Therapists develop and teach clients with severe limitations to operate computer aided adaptive equipment that helps them to communicate and control other aspects of their environment.
Some occupational therapists, called industrial therapists, treat individuals whose ability to function in a work environment has been impaired. They arrange employment, plan work activities and evaluate the client’s progress.
Practitioners in OT may work exclusively with individuals in a particular age group or with particular disabilities. In schools, for example, OTs evaluate children’s abilities, recommend and provide therapy, modify classroom equipment, and in general, help children participate as fully as possible in school programs and activities.
Groth, who works with children aged three to 18 with various levels of ability ranging from severe autism and orthopedic handicaps to mild coordination disorders and difficulty with handwriting, says, “Educating the child, the family and the educational team on how to improve fine and visual motor skills, self-care and sensory processing skills is the biggest component of my job.
“The children I work with bring me incredible joy and often teach me things about life that I’ve never considered before,” she adds. “The first time they can form their name independently or fasten the button on their pants or play with a special toy all by themselves is a very cherished moment.”
Practitioners in OT in mental health settings treat individuals who are mentally ill, mentally retarded or emotionally disturbed. To treat these problems, therapists choose activities that help people learn to cope with daily life. Activities include time-management skills, budgeting, shopping, homemaking and use of public transportation. They may also work with individuals who are dealing with alcoholism, drug abuse, depression, eating disorders or stress-related disorders.
Recording a client’s activities and progress is an important part of any practitioner’s job. Accurate records are essential for evaluating clients billing and reporting to physicians and others.
Practitioners in OT are employed in a wide range of workplaces hospitals, schools, nursing homes and home health care programs and they serve as employees of public or private institutions or as private practitioners.
Groth has worked in acute, sub-acute and outpatient hospital settings, as well as in an assisted living facility for the elderly. “The diversity of practice areas insures that one will never be bored or lose interest [in the field],” she asserts. “No matter what the setting is, the goal of the therapist is to help restore [their patients] to their highest level of independence.”
Choose Your Role
Along with registered occupational therapists, OT assistants and aides are in increasing demand to assist a ever-growing elderly population. Insurance carriers are also encouraging more occupation therapy to be delegated to OT assistants and aides because it helps reduce the cost of therapy.
In the field of OT, education determines at what level one will work. Those who complete an associate’s degree or certificate program work under the direction of a registered occupational therapist as occupational therapist assistants. Occupational therapist aides however, receive most of their training on the job. Since aides are not licensed, they have more limitations on what they can do in comparison to the range of tasks an occupational therapist assistant is required to do.
However, both OT assistants and aides generally provide rehabilitative services to persons with mental, physical, emotional or developmental impairments. Their ultimate goal is to improve clients’ quality of life by helping them compensate for limitations. For example, a therapist assistant will help an injured worker reenter the workforce through improved motor skill development or may assist a client with learning disabilities increase his or her independence.
Occupational therapist assistants record their client’s progress with rehabilitative activities and exercises outlined in a treatment plan and report back to a registered OT. They make sure clients are performing the exercises and activities properly and provide encouragement. The aide prepares materials, assembles equipment used during treatment, and is responsible for a range of clerical tasks. Duties can include scheduling appointments, answering the telephone, restocking or ordering depleted supplies, and filling out insurance forms.
Those entering at the assistant or aide level of OT should also be aware of the physical endurance that is necessary on the job. Assistants and aides will need some strength in order to lift patients, and they may be required to kneel, stoop or stand for long periods of time. For most, however, this is a minor concern and is overshadowed by the thrill of watching patients succeed and improve through proper care and encouragement.
Occupational therapist assistant candidates interested in improving their admission chances should make sure they have mastered high school algebra, chemistry, biology, English, computer skills and have completed volunteer hours in the field. Training to be an OT assistant includes an introduction to health care, basic medical terminology, anatomy and physiology. During the second year of school, course work will involve mental health, gerontology and pediatrics. Students will also complete 16 weeks of supervised fieldwork. Upon successful completion of academic coursework, assistants must pass a national certification examination in order to receive the title of certified occupational therapist assistant.
Becoming an OTR
Presently a bachelor’s degree is sufficient as a minimum education requirement for entry into the OT profession as an occupational therapist registered (OTR). Starting in January 2007, however, all new occupational therapists registered will be required to complete a master’s degree. In both cases, however, candidates must also pass a national certification examination in order to become an OTR and then receive licensure in the state where they will practice.
Occupational therapy course work includes physical, biological and behavioral sciences and the application of occupational therapy theory and skills. Completion of six months of supervised fieldwork is also required.
Volunteering in a variety of OT areas during one’s education is a critical step in deciding where one would like to work in the field. When students understand what role they want as a therapist, it can make their OT education experience more focused and enjoyable. Kashala Erby, who was a grad student intern and practice associate at the American Occupational Therapy Association, advises practitioners in OT to find a mentor in the field, volunteer in various practice areas, and get involved with the AOTA as a student member.
Erby also brings up the issue of lack of diversity in the occupational therapy field. She believes that the profession needs to embrace and encourage more minorities to enter OT. “While this is a female dominated profession,” Erby says, “as a minority woman in [OT], I face some of the same challenges I would have to face in any other profession.”
The ADVANCE 2003 Salary Survey shows that women greatly outnumber men in the profession. However, men report higher average salaries. The male survey respondents reported average salaries of $55,216 for occupational therapy and $37,425 for occupational therapy assistants; women reported an average salary of $48,763 for OTs and $32,927 for OT assistants.
Paving the Way to a Career in OT
Of course not everyone who ends up in OT initially starts out pursuing the field. When Emily Groth graduated from high school, she aspired to become a pediatric physical therapist. “I went to the University of Central Florida and enrolled in the appropriate prerequisites, however, I soon realized that it wasn’t a perfect fit for me,” she explains.
“My school guidance counselor gave me a test [to determine a more appropriate field]. Occupational therapy was in my top ten fields, and after I job-shadowed an occupational therapist at work, I knew it was for me.
“Engaged with people on such a personal level, the ability to truly help them regain independence, and the diversity of the practice areas drew me into this field,” Groth says.
As she asserts, the diversity of work environments is a plus for many in the OT field. According to the ADVANCE 2003 Salary Survey, most OTs reported that they are employed in schools or in skilled nursing facilities, but therapists can work in hospitals, offices, clinics, home health agencies, nursing homes, community mental health centers, adult daycare programs, job training services and residential care facilities. As an occupation therapist, your career options are truly never-ending.
Those who will succeed in OT are individuals who have patience and strong interpersonal skills to inspire trust and respect in their clients. Practitioners in OT have ingenuity and imagination in adapting activities to individual needs, a strong commitment to serve people, and an interest in social and biological sciences. And, according to Groth, no matter what area you choose, a career in occupational therapy is “so valuable to society.”
Luckily for you, allied health professionals are in great demand. Unluckily for you, getting and keeping the certification you need can be a challenge. Between ever-changing educational requirements, certification exams, continuing education requirements and the confusion surrounding certification versus registration versus licensure, it’s no wonder that your head spins when you think about becoming certified in your field.
Help is at hand. We spoke with execs at allied health organizations and members of certification boards to clearly map out the route to becoming certified in several fields.
Please note, however, this is only a brief sampling of allied health careers. If we were to cover all the important areas of allied health, we’d wind up writing a book! If you don’t see your specialty covered here, it doesn’t mean Diversity: Allied Health Careers is ignoring your profession. A terrific source of information is your allied health discipline’s professional association Web site.
Speech-language-hearing pathologist
You can call yourself a speech-language pathologist as soon as you have your degree. However, to be certified you must go through the American Speech-Language-Hearing Association (ASHA). “ASHA certification is a voluntary process, but it gives individuals mobility, a standing with employers they might not have with just licensure and rights to bill for Medicare and Medicaid,” says Georgia McMann, director of certification administration at ASHA. “In some positions, certification is what employers look at when they’re deciding on salary increases or promotions.”
Forty-eight states have licensure laws, and most of them are very similar to ASHA’s certification requirements. “State licensure boards will accept verification of ASHA certification and will not require that an individual present all of the documentation and go through what can be a very lengthy process for licensure,” says McMann.
Requirements: To be certified, you need a master’s degree. This involves 75 hours of coursework, of which 36 are graduate hours, and 350 hours of practicum, of which 250 are in speech and language disorders. ASHA’s code of ethics also requires students to sign a basic ethics statement.
The Exam: The exam is a two-hour, multiple choice test with 150 questions. The pass rate is approximately 87%. Many students take the exam during their last semester. The exam is given six times per year and can be taken at major universities across the U.S. For dates and locations, contact ASHA by phone or online, or visit the Educational Testing Service at www.ETS.org. You must pass the exam within three years of your academic coursework being approved for ASHA certification.
Help: ETS publishes two study guides: one for speech and one for audiology.
Continuing Education: In audiology, continuing education requirements start this year. For speech-language pathologists, the requirements will start in 2005. Certified members will have three years in which to complete three Continuing Education Units or 30 contact hours. Check the ASHA Web site for more information.
Advice: “Our certification standards are changing, so for individuals who are enrolled in a graduate program, apply as soon as you get the degree so you won’t face the situation where you were trained under earlier standards and now new standards are in effect,” says McMann.
Radiologic Technologist
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) generally requires technologists to be registered as well as certified. The American Registry of Radiologic Technologists (ARRT) annually registers the certificates of individuals who agree to comply with the ARRT Rules and Regulations, continue to comply with the ARRT Standards of Ethics and meet the Continuing Education Requirements. Whether you need to be certified and/or registered depends on your state. To find out, call your state department of health, or check out the list of state contacts on the ARRT Web site.
About 35 states require a license as well as a certificate. “In all states that require a license, if you are ARRT-registered you can get the license without a problem,” says Ginny Haselhuhn, B.S., R.T.(R), assistant executive director of the ARRT. While right now the states are in charge of whether to require licensure, the American Society of Radiologic Technologists (ASRT) is working with other groups to create a federal minimum requirements licensure program. This is called the CARE bill, for Consumer Assurance of Radiologic Excellence, and it’s just been introduced in the House of Representatives. This bill would require all states to have strong laws regarding licensure and certification.
Requirements: How much education you need for certification depends on your modality. The primary modalities—radiography, nuclear medicine technology and radiation therapy—have accredited programs. Most radiography programs are two years long, but some last four years. Nuclear medicine technology and radiation therapy most often require an additional year beyond radiography.
To become certified as a radiologic technologist, you must also uphold the ethical standards of the ARRT. “You can’t have been convicted of a felony or a misdemeanor,” says Haselhuhn. “You also can’t have lied on your application or something of that nature. We don’t want people who have been convicted of murder or rape or assault to be working with patients.”
The Exam: The exam is a computer-based, multiple choice test with 200 questions and takes about three hours. The exams are scheduled at the student’s convenience at multiple test centers across the U.S. You can take the exam up to three times in three years. If you aren’t successful after three tries, you have to go back and do remedial activities such as independent study to retake the test one last time, within a year.
Help: The ARRT’s certification handbook has a content outline of the exam to help you study. You should receive the handbook from your program director when you’re about to finish the program, or you can order it on the ARRT Web site.
Continuing Education: Every technologist must complete 24 hours of continuing education every two years.
Of those 24 hours, a minimum of 12 must be “Category A,” which means that the educational activity has been evaluated by a RCEEM, or Recognized Continuing Education Evaluation Mechanism, such as the ASRT.
Advice: “Clinical experience as well as didactic knowledge—understanding why you do what you do—is really what it’s all about,” says Haselhuhn. “Understanding the ‘whys’ makes all the difference in the world.”
Respiratory therapist
Certification is considered the entry level into practice for respiratory therapists. “Most hospitals want at least a minimally certified credentialed respiratory therapist,” says Pam Bortner, MBA, RRT, president of the National Board for Respiratory Care (NBRC). Forty-four states plus Puerto Rico also require licensure; to gain licensure, you must be certified. To find out what your state requires, check out the NBRC Web site.
Requirements: Anyone enrolled in a program beginning after January 1, 2002, must have a minimum of an associate degree from a respiratory therapy education program supported by the Committee on Accreditation for Respiratory Care (CoARC), or its predecessor, the Joint Review Committee for Respiratory Therapy Education (JRCRTE) or accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). Individuals enrolled in an education program before January 1, 2002, must have a certificate of completion from a respiratory therapy education program supported by the CoARC or the JRCRTE or accredited by the CAAHEP.
The Exam: The entry-level test is the CRT. The examination is given via computer and consists of 160 multiple-choice questions distributed among three major content areas: clinical data, equipment and therapeutic procedures. Candidates are given three hours to complete the CRT exam. The exams are given Monday through Friday, and there are testing centers in every state. The test is given at AMP Assessment Centers, many of which are located within select H&R Block tax offices. You can take the exam as many times as you need to, and there’s no time limit.
Help: An overview of the test is available in a book that you can order through the NBRC Web site. You can also take self-assessment exams on the site; one version is free, and there are also secured exams that require a fee.
Continuing Education: A mandatory competency program went into effect in July 2002; every five years you must either take a specialty exam, take a self-assessment exam or complete continuing education credits. “It might sound like a lot, but it’s really not,” says Bortner. “Most of the states that have licensure have a mandatory requirement to maintain between 12 and 18 continuing education credits in two years. So if you maintain your licensure competency, you would automatically keep your credential competency.”
Advice: “If you complete the requirements of the program fairly satisfactorily, you should not have too much problem with the examination,” says Bortner. “We spend a lot of time with the educational people as far as making up examinations. When we look at the requirements for an examination, we share that with the educational programs, so their curriculum is very much professionally based.”
Physician Assistant
Physician assistants are licensed in all 50 states, and certification is required for licensure. The requirements for initial licensure are fairly consistent in all states. “What varies are the requirements for relicensure or licensure renewal,” says Ragan Morrow, director of governance and communication for the National Commission on Certification of Physician Assistants (NCCPA). “Nineteen states require certification for licensure renewal, and three others link certification to prescriptive privileges.”
Requirements: Candidates must graduate from a physician assistant program that’s accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Most programs take two years on top of a bachelor’s degree.
The Exam: The initial certification exam is called the Physician Assistant National Certifying Examination (PANCE). The computer-based test has 300 multiple choice questions and takes six hours. It’s offered 50 weeks out of the year at over 300 Prometric centers across the country. You must pass the exam within six years of graduation or within six attempts, whichever comes first. “In the entire history of the organization, less than one-tenth of one percent of PAs did not pass within their first six attempts,” says Morrow.
Help: The American Academy of Physician Assistants(AAPA) offers a list of exam review courses at www.aapa.org/cme/review-cert.html. There are also several study guides, including A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants, which includes a CD ROM with a practice test (AAPA members: $32.95; Non-members: $37.95; Contact: API: 800-708-7581). An updated version of this book is now available.
Continuing Education: The initial certification is good for two years, after which certificate holders must log 100 hours of continuing medical education (CME) every two years. After six years, you must take a recertification exam. Four organizations either provide the CME or approve other organizations to provide the CME; one of the biggest providers is the AAPA. PAs can also go to any CME that’s accredited for physicians.
Advice: “People who do well in their PA program are generally going to do very well on the certification exam,” says Morrow. “Put in the hours when you’re in your program, and certification should just be one last step to a great career.”
Occupational Therapist
Forty-seven states require licensure to work as an occupational therapist, and certification is part of the licensure requirements. NBCOT offers two types of certification: the Occupational Therapist Registered and the Certified Occupational Therapy Assistant.
Requirements: To become an Occupational Therapist Registered, you must be a graduate of an accredited occupational therapy program and complete fieldwork. Some programs are at the bachelor’s level, but most are at the master’s level. Becoming a Certified Occupational Therapy Assistant requires a two-year technical degree from a community college or technical school plus fieldwork. All candidates must sign a code of conduct; every three years, you must reattest to the standards.
The Exam: The exam, which is administered by computer, consists of 200 multiple-choice questions and lasts about four and a half hours. The exam is given at the candidate’s convenience at more than 300 Prometric Test Centers throughout North America, including Puerto Rico and the Virgin Islands. If you fail the test, there’s a waiting period of 90 days to retake it. You can take the exam as many times as you need to, and there’s no time limit.
Help: Some companies, such as F. A. Davis Company, offer study guides for the NBCOT exam. Search the Internet with the keywords “study guide” and “NBCOT” to find others.
Continuing Education: Every three years, you must attain 36 hours of professional development activities, which may include taking college classes, attending workshops, authoring a book and lecturing at a seminar. “The opportunities are very cost-effective and attainable,” says Paul Grace , MS , executive director of NBCOT.
Advice: “A quality certification exam needs to measure what you do in practice,” says Grace. “Where students put that to task is in their fieldwork experience. So besides going to a fine school and getting a degree, their fieldwork should offer them a variety of experiences so they can truly experience the breadth of the profession. When they see questions on the exam about particular scenarios, they’ll have their fieldwork experience to draw from.”
education: Master of Science, Health Services Administration, California State University, San Bernardino; Bachelor of Science, Occupational Therapy, Howard University, Washington, D.C. title: Occupational therapist workplace: Sun Dance Rehabilitation
Kashala Erby was raised in California, but she moved to the east coast to attended college at prestigious Howard University-a school with a solid reputation for providing top-notch education to African-American students. Erby has been an occupational therapist for the last six years, and during this time she has worked for Catholic Healthcare West, American Occupational Therapy Association (AOTA), and finally with her current employer, Sun Dance Rehabilitation. Occupational therapy (OT) has been a rewarding career for Erby because it blends several disciplines including the sciences, sociology, psychology and education. It also involves getting to know patients’ history. “In my case the patients are elderly people,” Erby says, “so it’s fun to learn about who they are and then assist them with their progress.”
Erby learned about occupational therapy from a college advisor and quickly became hooked on the field. “It didn’t take long after learning about the profession that I felt this was the path for me,” she says.
As far as advice for up-and-coming OTs, Erby offers this piece of wisdom: “[Occupational therapy] is a profession where you truly must be a person who can deal with a variety of personalities and temperaments. It’s important to know that although you are working one-on-one with patients, you must be someone who can collaborate with others because there are multiple professionals who are involved with the patients care and well being.”
8:30 a.m. to 9:15 a.m.
First thing every morning, I work on management activities. I do case load organization, review paperwork and notes, communicate with colleagues, make copies, do faxing and check my email.
At the start of my day, I also determined what patients are to be seen and the length of their sessions based on a weekly census. Typically I treat about five to eight patients per day. Short- and long-term goals are established for each patient after an evaluation, and a treatment plan is also developed. Patients who receive non-inclusive care are those who have had strokes, heart attacks, orthopedic surgery, generalized weakness, arthritis or neuropathy.
Before a therapy session begins, I check the gym area to make sure it’s clean and presentable. I communicate with colleagues in physical therapy and nursing about any occupational therapy issues that need to be addressed and address any new patient or family issues.
In the morning I also need to be mindful of the breakfast service and other scheduled activities slated for patients.
9:15 a.m. to 3:34 p.m. For the bulk of my day, I provide direct patient care. During each session I teach the patient a self-care task like dressing, grooming or personal hygiene. I also work with the patient on a therapeutic activity like balance, coordination or a reaching task, or help them with a therapeutic exercise like upper extremity exercise with or without resistance, which is aimed at improving flexibility, strength and movement.
The sessions are guided by short-term goals, which are determined by their long-term goals. The main goal for most patients is to restore their ability to engage in daily activities based on what is desired by each person. I want to be able to get my patients to maximize their performance in their daily activities while utilizing specific treatment techniques.
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Here is an example of how a typical days progress: A patient comes to the facility with orders from a physician for occupational therapy. There is an initial OT evaluation exam with the patient, which includes a chart review and discussion with the patient in their room. During this exam I will determine their condition and prior levels of function. I also share with the patient what we will do in therapy and the goals we will accomplish. Upon the conclusion of our interview, I complete an OT evaluation appropriate for their diagnosis and condition. In general the evaluation includes the patient’s range of motion (ROM) manual muscle testing, and an assessment of their activities of daily living (ADL) status.
After the initial evaluation, I begin to formulate a treatment plan, which will detail the frequency and duration of their therapy. Treatment frequency is generally three to five times per week, and each session is once a day from 30-60 minutes.
The duration of therapy can be one to four weeks; adjustments are made based on the patient’s progress.
During the final phase, I document the evaluation and place the appropriate paperwork in the resident’s chart. I also notify the doctor that the evaluation is complete and what the treatment plan will be. From start to finish an evaluation is typically 45-60 minutes.
On this particular day, the resident I evaluated is being treated for a stroke and is exhibiting weakness on his left side. His goals are to improve his upper body strength so that he can push his wheelchair to the dining room and dress his upper body independently. He would also like to improve his left hand coordination so that he can brush his teeth and use the restroom independently.
The treatment process begins by teaching him how to roll his wheelchair to the OT gym using both the left and right side of his body. If his left side was too weak, I would teach him a one-sided technique. If his family members had been present, I would have taught them the process as well, so they could have coached and assisted him.
3:45 p.m. to 4:30 p.m. At the end of a typical day, I handle the necessary paperwork and prepare for the next day. However, sometimes I may do paperwork in the morning prior to meeting with patients.
In order to assess each patient’s care, I converse with a multidisciplinary team, and I look at chart documentation and dialogue from weekly team meetings on each patient’s care. Through conversations with team members, we discuss patient’s tolerance for treatment, progress, change of status, and any other issues regarding their care. I compile their diagnosis, rehab potential, clinical expertise, and input from the patient’s family and decide on the best possible therapy for each patient.
My days do not function by clockwork; there are not set times that I do a particular activity or see a specific patient. I may be scheduled to visit with a patient, but if they are visiting with a family member, still receiving care from another colleague, sleeping, or just not available at the time I was planning to conduct their therapy, I move to a different plan. I may check to see if my next patient is able to meet with me earlier than scheduled, or I may finish some paperwork.
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