Small Gym, Big Caseload
How many of you work in a facility where the rehab gym is quite small? Or possibly between all the walkers, wheelchairs, parallel bars and other equipment needed in the gym, there is hardly any floor space left? Are you able to comfortably seat 20% of your caseload in the gym at the same time without stepping on feet or over objects?
In addition to being a safety hazard, a small gym can also be a distraction to some of the patients. People sitting too close together tend to chat. Others may tend to withdraw due to the close proximity of "sick people" near them. And some may be claustrophobic and not tolerate being in a small area.
I tend to find that most small gyms also lack storage. All the rehab equipment, from weights to paperwork, must be sprawled about the room in any place stuff can fit. Items tend to get lost or buried under other things. Many times, there is a serious lack of equipment to work with due to the space limitations.
Safety-wise, in a small gym you might find that equipment that is hanging on the walls will be inaccessible once a few patients in their wheelchairs are parked there. Having to step over foot rests, walkers, etc. to get to a piece of equipment can lead to a fall or someone's toes getting stepped on. In addition, activities like transfers, ambulating and standing balance tasks are difficult to complete when you're cramped for space.
I remember one place I covered years ago in a small town where we actually worked out of a storage closet! In this closet we had all the spare walkers and wheelchairs, two cabinets for supplies and equipment, and a desk for all the paperwork. If someone was sitting at the desk, you couldn't get in the room. In another facility I worked, the therapy room consisted of the director's desk and a storage cabinet. This room was located at the end of a hallway and ended in what used to be a small resident sitting room converted into the therapy gym. Both were tough spaces to work in. However in another facility I worked where there was a nice sized gym, the caseload was so large that the room always seemed crowded anyway.
I know there isn't much one can do when you're faced with this situation. Pleading to the facility administrator for more space is like asking for their first born. Bringing a sledge hammer to work and having patients do demolition work isn't a good option either. I've always been big on keeping things organized though, and in a small space that really helps. A place for everything, and everything in its place (most of the time, anyway).
Until next time, hope all your thoughts are good-
Tim