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Life of a PTA

The Rehab Department: Does Size Matter?

Published April 25, 2014 4:30 PM by Allison Young

A few weeks ago, I began a new PTA position at a long-term care/skilled nursing facility. Although the setting may be the same as my former job, the facility is run completely different. Transitioning from a large established rehab team to a small, newly formed therapy department has had its highs and lows, as I'm finding out.

Due to a smaller caseload of patients, I'm currently one of only three clinicians (including the rehab director) who make up our fledgling team. Initially, I was expecting this to be a disadvantage, as working with multiple PT and PTAs was something I always considered a strength in a therapy team. If I had a question or sought advice with progressing a patient, an experienced PT or PTA would be there to offer help. As well, with a deep pool of OTs/COTAs making up the other half of the department, discussing shared patients and planned co-treatments would happen daily.

The downside to having such a large rehab staff is that the patients would be seen by two, three or sometimes four different therapists within a week or two. As well, a few of the primary PTs worked part-time, so consulting about the patient's plan of care could get difficult (when in doubt, I would consult with my DOR, of course). At times, this would leave me feeling disconnected from the primary therapist and frustrated with the process.

As I'm discovering in my new facility, working under just one primary physical therapist solves many of the problems I faced in the larger team atmosphere. This therapist is present every day and each patient is discussed to some degree or another throughout the day. If I have questions or thoughts regarding the plan of care, I know she will be able to field the discussion within the same day. Having a single "PT-PTA" team seems to be working on our small rehab department and I only expect it to grow stronger as we gain more experience with each other and our clientele.

Do you work in a large clinic or a smaller private setting with less staff? What advantages do you see with the size of your rehab department? I'm interested in your input and I'll let you know how it continues in my setting. Thanks!

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