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 closely with a team of healthcare professionals, and are confident and calm under pressure. (And enjoy doing very thorough chart reviews.) Some people prefer ICU to working on the floors because of lower nursing to patient ratios and monitors constantly showing the patient’s vitals.
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.
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, Potassium 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.
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
If you’re a new therapist, orthopedics is a great place to start. For the most part, bones are straightforward and predictable. Charting For this service, it is important to pay special attention to: Precautions Weightbearing status Hemoglobin and hematocrit levels Pain Treatment Give special attention to premedication for pain. Pain medications should be administered 30 min to 1 hour before therapy. Check orthostatic blood pressure readings, SPO2, and heart rate.
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