A Day in the Life
The alarm goes off so you roll over and get out of bed; it's time to head to work. This process, repeated five times per week or more, is the typical American employees' life. We work to earn the money we need to pay the bills we create when we are not working.
Our daily occupational roles vary as much as there are job titles, and I often think what would it be like to be a doctor, truck driver, actor, or whatever else my mind wanders into. However, even within the same job title the role could be very different, such as a COTA working in a school versus a COTA working in a long term care facility. Anyway, I thought I would relate the story of a day in the life of a COTA in a long term care facility.
The story is one of my most horrendous days ever. A day when no one is ready, schedules fall apart, and anything that could go wrong does. On my next blog, I'll post a more typical day.
In the door and straight to the paperwork drawer, fill in a daily log with my patient list for the day. Find the master minute log and figure out how many minutes each person needs. Log on the computer and check the e-mail in case there are any meetings, care conferences, incident reports or other changes on patient status. Then head up to the gym. On my list today I have fourteen patients to see for a total of 465 minutes, plus a care conference at lunch time.
My first scheduled person for an ADL is sick and refuses therapy today. I head to the next person to find out they are currently having an IV infusion for the next hour. My third and fourth person are now being served breakfast, so I head to my fifth person as they have a self feeding goal.
I find this person reclined in bed with their nose about touching the bedside table, trying to reach up for the food. It takes me five minutes until I finally find someone to assist me to reposition this person so they can eat. Three bites later, with two bites dripping down this person's gown, they announce they are full. Hands, face, chest and gown are sticky with jelly and syrup. This turns out to be a complete bed bath and dress. The person falls asleep several times, and I end up being in there for about twenty minutes more than I need to be but the job had to be finished.
I head back to the gym to find three of my patients there, so I begin with one then another, bouncing back and forth as I address their goals and set them up with activities. The third is still in PT, so I can catch them after that. Finishing with the first two I find that the other person has headed off to the beauty shop, but another has arrived in the gym so I begin with that person. I send our transporter to find another person, but no one else is available.
The morning is already half way over and I still have ten people to see. Both the transporter and I roam the halls for fifteen minutes without success. There are two of my afternoon people in the gym now though, so I head back to see if they are agreeable to seeing me when they are done with PT. One agrees, but the other is so short of breath they need to rest. Ten minutes later the one is done with PT and I begin their session. My hairdresser person returns, things are going better until the other person asks to use the restroom. Setting my hairdresser up on an activity we head off to the restroom to find that this person needs a total change. I spend about twenty five minutes with toileting, cleaning, and changing clothes with this person. Back at the gym, the hairdresser person has tired of waiting and went back to their room but another has arrived. I finish with one as I start the next. It's getting close to lunch time and there are still seven people to see and more time to get in with the hairdresser person.
One more arrives at the gym and begins their treatment, and by lunch I am down to having five people to see. Three of these are room treats, meaning the person is in isolation and will need to be seen one on one. One more is scheduled for shortly after lunch time, one of my regulars.
Now it's time to head to the care conference though, finishing up late with the last morning person means waiting until afterwards to eat lunch. The conference lasts forty minutes, way longer than most, as the family is split on a decision and asks many questions. With just twenty minutes left to eat lunch until my scheduled appointment, I head back to the gym to pick up my paperwork.
On the way, one of the nurses stops me asking how one of my patients transfers. This was an opportunity to get in a couple of minutes of therapy, as this was one who refused earlier. So I head to the room to find two nurse aides struggling to get this big guy into a wheelchair. I set things up and instruct the aides on how to assist. In the middle of the transfer one of the aides releases her grip. The guy plops into his chair bending forward enough to pop his colostomy bag all down my leg.
It takes me thirty minutes to get cleaned up and into new clothes, and I've lost my appetite but manage to choke down a banana on my way back to the gym. My appointment is there waiting "You're fifteen minutes late" he says "and I have a doctor appointment in thirty minutes." Twenty minutes into the session the driver comes to pick him up.
I spend the next three hours doing room treats, trying to find the hairdresser person between each room so I can complete those minutes. I also look for my other missing person. They are a social butterfly, spending time visiting in several rooms and attending all activities. Two of the room treats are in rooms so hot I am sweating profusely after each visit. One of the treats is actually easy, Oh No! It's almost four in the afternoon before I find both the hairdresser person and the social butterfly. In the gym we complete their sessions, then I head to the office.
Logging all the visits takes 10-15 minutes, adding the minutes to the book another ten. Then there are four progress notes to be written. Finishing those I open the e-mail again to see that there are three that need a response. After about an hour total in the office the day is finally done.
Then tomorrow's alarm goes off...........
Until next time, hope all your "Thoughts" are Good-
Tim