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Life of a PTA

Time Management 101

Published May 13, 2011 1:54 PM by Allison Young

As a recent former student in clinical, my experience with juggling patients and a daily schedule was next to nothing. I was "given" a few token patients (AKA the straightforward cases) each day and left to write a few overly detailed daily notes (hand- written, full-page SOAP notes, anyone?). I tripped over myself given the chance to assist my CI with a two-person transfer. In my final outpatient affiliation, I thought a rough day was having back-to-back patients without a chance to get a start on their respective notes. So after a few weeks of full-time PTA work, I'm beginning to see how easy I had it as a student.

The good news is I love the work. Skilled nursing PT is exactly what I thought it would be; busy, slow, frustrating and rewarding all in a nine-hour day. I begin every day with the optimistic thought, "I will have enough time to work with all these patients today - and they will want to work with me!" The reality is I'll have to treat a few patients concurrently and more than a few will refuse my request when I pop into their room multiple times a day.

I seize my chance and treat as many patients as I can squeeze in my four-hour morning, which leads me to the OT room, of course. The OTs, whether more convincing or better organized, always seem to be halfway through a treatment with more than one of my targeted patients. Once I find a willing patient, another one shows up in the rehab room having changed her mind - and behind them - the patients from OT, eager to finish all their therapy in the morning.

So I have learned to juggle - and not well, I'll admit (I'm new to this after all). Most of the time, I feel like I'm chasing my tail. A 60-minute session can drag out to 90 when I'm filling portable oxygen tanks (that weren't filled overnight), tracking down nursing or waiting for bathroom visits to be finished. When I admitted to one of the PTs that I felt "unproductive," she just smiled and said that was all part of the job. In helping with bathroom transfers, clothing changes and even rest breaks in between gait training, we have opportunities to address issues such as static balance and functional ADLs.

Documentation opportunities, I ask? Well, that gets easier too, she said. You'll get quicker and more proficient with time, she added. For now, I'm slowing down for the patients. If I can listen and go at their speed, I'm hoping they will be more inclined to work with me every day... and that managing my time will become an easier task to tackle as well.


Jason- Yes, you're right.  thankfully there seems to be "easier" days once in a while.  In general, learning 'the ropes' of SNF physical therapy while adapting to a new facilities EMR system can be danting at times.  Other therapists have mentioned they are also still learning after many years (esp. if they adopt a new computer system).  Everyday gets a little better.

Shelby, I'm sorry I didn't elaborate on the OTs I work with (perhaps fodder for another blog?  hmmmm....) Actually, the OTs are fantastic and we all work very closely together to help the patients reach their goals.  I consider occupational therapy and PT equally important in the skilled nursing setting.  On a daily basis, I have found communication with OT and COTAs to be exceptionally important in assessing patients progress and status....not to mention generous and patient to this newbie therapist.  Thanks for the question!

Allison May 16, 2011 10:14 PM

How are you finding the PT/OT interactions?  Do the two groups tend to work together collaboratively for the patient or is there a bit of hostility (not the right word?) toward the other for the overlap?

Shelby S May 16, 2011 12:39 AM

Some days are easier than others.  I have gone from 3-4 hour days to 10 hour days in a week.  Time management is something I am still learning despite the 15 years in the field.  I'm glad you don't give up on the patients at the end of the day.  

Jason Marketti May 13, 2011 9:04 PM

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