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 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
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.
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.
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.
As you gain more experience in the hospital, you will find your own style and methods of performing evaluations and treatments. Here is a sample that can be revised and tweaked as you gain experience: Introduce yourself at the start of the session and give a brief explanation of your role in the hospital. Perform the interview to find out the prior level of function and home environmental setup. Try to talk directly to the patient, not the caregiver.
In the hospital, you are part of the medical team consisting of many healthcare professionals, which is responsible for treatment and safe discharge of the patient. In the hospital, a therapist’s role is primarily acting as a movement specialist and preparing the patient for an appropriate discharge placement. Here are members of your team, their roles, and how you can help as a therapist. Nursing Role in a nutshell - Responsible for a patient’s wellbeing and executing doctor’s treatment orders while in the hospital.
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