Working Overtime?
In many clinics today, caseloads can really vary. One week you might be busy, but the following week might bring fewer new clients and leave lots of open space in your schedule. With the fluctuations in caseloads, what is done in your clinic to assure all patients receive their therapy?
Many of the places I've worked at restrict overtime. If you are close to your 40 hours for the week, you get sent home. I've also had times where I show up on Friday, having 35+ hours on the clock for the week, and am given just enough treatments to hit the 40 hour mark.
The patients that have not been scheduled on my load will usually be seen by a contractor or a part time therapist. While I am glad that the patient gets their therapy, I am saddened by the fact that the fill in therapist, not knowing what the current status of the patient is, may repeat things done in prior sessions. This is not very cost effective in many ways.
First, having the patient repeat lessons previously learned can be demeaning to the person. Although repetition is a good teacher in some cases, it does not always lead to enhanced knowledge.
Secondly, many temps will cover only the basics. They are there mainly to generate minutes so the SNF and contracting company don't lose money. This usually means having the patient complete a set of exercises, some transfers, or other mundane task. And I don't mean to be hard on temps since I've been there and done that, but not knowing the patient does limit the possibilities.
Third, I think of continuity. This is why temps are limited to what they can offer the patient. It takes time to get to know someone, their needs and deficits. Having the same therapist for the entire rehabilitation process has always been a key issue of mine. I tend to note a faster recovery of patients that rehab with one therapist.
Finally, since the salary for a temp therapist is always quite a bit higher, where is the savings for the company? Even at time and a half, I don't earn as much per hour as many contractors charge. I always wonder where some company's heads are at here. You have your full time dedicated employees trying to earn a living, but then give the best part away to some contractor who is only there for a short time, and often just because they can demand that big hourly wage.
Some companies are quite limited in this thinking too. In one position I've held, when the caseload grew and temps were not available, we were just expected, no questions asked, to stay and work to cover the caseload. When we hit overtime, our supervisor would complain. However, when a few temps became available and overtime was out of the question, our supervisor then complained about the cost of the temps.
It's never a perfect world, is it?
Until next time, hope all your thoughts are good,
Tim