Neurology Neuro was one of the more difficult subjects for me to grasp as a new therapist. One thing I found that helped was to start with a comprehensive checklist of focal deficits to check during an evaluation. It helped me not to miss anything and helped my evaluations looks more comprehensive. As with everything on this site, this is meant to be a quick guide for you and not something overwhelming.
I have worked in four different hospitals throughout my career ranging from community, trauma and county, managed care and academic hospitals. Types of hospitals This will give you a general idea of what I’ve experienced. Work hours at a full time position In my experience, I have not ever been required me to clock in and out at a hospital job, although you needed to a badge to get into the hospital and they are able to track that information if needed.
It was a routine hip replacement surgery, but this poor man had bled badly on the operating table. He was a Jehovah’s witness by faith and therefore, declined to receive blood transfusions both during and after the surgery was over. By the time I saw him, he had had several days of severely low hemoglobin levels and his chart stated that he had multiple watershed infarcts. When I first met him, his wife was in the room sitting dutifully at his side.
It was fall of 2020 and COVID was at the peak of it’s notariety. I had been working in the COVID ICU for several months now. My patient was an indian woman in her early 30s. She had just given birth a few months prior when she contracted COVID. She had been separated from her newborn baby for months while fighting for her life in the ICU. Medical personnel had to help her remove and throw away her breastmilk.
I had an evaluation order for a new patient who was admitted to the ICU for COVID. He was a very fit, middle aged man. When I was assessing his mobility and independence, he was pretty much independent except for being extremely short of breath at every movement and needing a high flow nasal cannula to maintain his blood oxygen level. He told me he was the principal at a Christian church in his city and loved to go camping and backpacking.
This patient had just been discharged from the ICU. We were so happy. Our survival percentages were pretty bleak at that time and this was one of our survivors. He was a young guy in his 30s, completely covered in tattoos. He was a real edgey guy, was an avid surfer. His wife had been prodded him to get vaccinated but he just didn’t end up doing it. They ended up catching COVID together.
The important aspect of this floor is to assess if the patient cardiovascular system is appropriate for the challenge of mobilization. And to monitor signs and symptoms to exercise the patient to a moderate level of exertion. Charting Lab values: Check the troponin level Vitals trends: BP, SPO2, HR The trend of the troponin lab value is more important than the actual number itself. Larger readings are a bad sign and progressively smaller readings may indicate the patient is stabilizing.
After you’ve worked in acute care for a bit, perhaps you’d like to try working in the ICU. You might enjoy ICU if you have high attention to detail, enjoy collaborating with a team of healthcare professionals, and are confident and calm under pressure. Some people prefer ICU to working on the floors because of lower nursing to patient ratios and monitors constantly showing the patient’s vitals. Therapy in this setting also tend to be cotreats with PT or with a rehab aide.
The range of diagnoses you see on these floors is enormous. Here are examples of some common ones: Abdominal surgeries Method could be laparoscopic or open abdomen. Abdominal precautions for open abdomen surgeries. If you visualize the incision, you will see a vertical or horizontal cut on the belly. No bending, lifting, twisting, or lifting >5 lbs. Teach adaptive technique for lower body dressing, toileting, and bed mobility (logroll). Lung diseases (COPD, bronchiestasis) Check the doctors orders for SPO2 parameters.
Oncology Chart Platelet count Neutropenic precautions - ANC (neutrophil count) Weightbearing status of any affected bones Evaluation/Treatment Cognition Energy conservation See patient inbetween or before chemo treatments
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