hospital ot

Lab values

October 4, 2024

When I was trying to break into acute care, I remember having the impression that knowing lab values was the most significant difference between working in a SNF vs a hospital, which was an oversimplification of the truth. The important things to learn as a new acute care therapist is the role of the staff at the hospital and your role, how to spot red flags in the chart and in person that a patient is not stable to be seen by therapy, and the procedures that the hospital has at it’s disposal to rectify issues.

ICU

By Tiffany Lai in floors of the hospital

September 27, 2024

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.

Notes in the Hospital

By Tiffany Lai in hospital culture

September 25, 2024

Writing notes in the hospital Your evaluation and notes in the hospital setting is not too different from the notes you write in the skilled nursing setting or home health. One of the most tricky things will be learning to use the hospital documentation system. Not all, but most hospitals use EPIC which isn’t typically used in other OT settings. Likely there will be a procedural flow of how a therapist takes notes that will involve inputting sections of information at a time.

Neurology

By Tiffany Lai in floors of the hospital

October 18, 2023

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.

Cardiology

By Tiffany Lai in floors of the hospital

September 1, 2023

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.

Medicine and Med/Surg

By Tiffany Lai in floors of the hospital

September 1, 2023

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

By Tiffany Lai in floors of the hospital

September 1, 2023

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

Orthopedics

By Tiffany Lai in floors of the hospital

September 1, 2023

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.

Calling for help in the hospital

By Tiffany Lai in hospital culture

August 14, 2023

The hospital employs different ways of calling for help to deploy qualified personnel in a timely manner. If you encounter an issue during your session, here are different ways of calling for help: Patient Call Light (Non-urgent help) Can be used to call nursing assistants to assist with pericare or linen changes, to call nursing to request pain medicine or to disconnect IVs to make line management easier. Help may not come right away.

The Different Discharge Settings

By Tiffany Lai in therapy in acute care

August 13, 2023

Here are some common discharge options across hospitals from most intensive therapy to least. Acute rehab A rehab setting delivering short term aggressive therapy with the goal of the patient returning home afterward. The patient needs to be able to tolerate 3 hours of therapy a day, 5 days a week for about 2 weeks. The patient needs to be motivated, have enough stamina to participate, and have a potential to improve rapidly.

Lab values

ICU

Notes in the Hospital

Neurology

Cardiology

Medicine and Med/Surg

Oncology

Orthopedics

Calling for help in the hospital

The Different Discharge Settings

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