name: Kashala Erby

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

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.”

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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.

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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.

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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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