So, What Time Would You Like Therapy?
When I arrive to work every day, I'm faced with a list of patients and expected therapeutic minutes to achieve for the day. What's missing on my list, you might ask? Scheduled therapy times. This translates to me knocking on many of my patients' doors in the a.m. to tentatively "schedule" my day of treatments. In many cases, because I've worked with the patients on a regular basis, I know which of them prefer morning to afternoon therapy sessions. This leads me to consult with the treating OT or COTA, as overlapping schedules have a tendency to happen frequently.
Most days, my schedule falls into place and I'm able to treat most of my patients. But more often than not, I'm chasing after a patient who left for the activity room or is being given a shower by nursing. If I sound frustrated, it's because I am. As a PTA in a SNF, every minute of my day will be measured toward my productivity. Not to mention the intense pressure to secure minutes to meet the patient's RUG level. A few years ago, our rehab department attempted an hourly schedule for each patient. Unfortunately, for the exception of one or two "appointments," the patients weren't able to keep their schedules due to fatigue, illness or simply to use the bathroom.
One of my colleagues mentioned how she enjoyed the "freedom" of having the flexibility of scheduling her patients vs. a "set time." Her point was that certain patients may require a 70-minute treatment session and others can only tolerate a 40-minute session. I see this advantage, but I would still prefer a more developed framework for my day. The responsibility would focus on patients' compliance with their agreed scheduled time compared to my open-ended question of, "What time would you like to do therapy today?"
If you work or have worked in a skilled nursing setting, are your patients given hourly therapy schedules? Is this system successful for you and your patient or do you find yourself constantly rescheduling throughout the day? I suspect the more staff supporting the patients' therapy schedule (nursing, CNAs, activity dept.), the chance of participation increases as well.