What About Acute Care?
Something is bothering me. I want to know who is going to treat acute care patients in the future. No one I know wants to work there. None of the students I've talked to want to go there. Some of the therapists I know who work there want to change to something else. Then there's me, always different. I love acute care but can't do it anymore. I feel it at the end of the day. After a few days like that I'm not at my best. If I'm going to be sore the next day, I prefer it to be from something fun.
In my case I've moved to an outpatient setting where there is less lifting and more help when lifting is required. I'm getting older (40+) and feeling more with less effort. Acute care patients can be hard. Some of them can practically jump out of bed. Many others can take two or three people and be unable to assist. A fresh hip replacement or a recent CVA can be minimally involved or dead weight.
What about the other person? Frequently there are one or two aides for an entire department. Administrations are moving in the direction of fewer people doing more work. Let's not even mention obesity. The bottom line is the patient doesn't get the appropriate care. I've had many experiences where I did bed level therapy due to lack of assistance.
We have two PT schools in Houston. Both require one rotation in an acure care setting. Of all the students I've met this year, all but one want to work in an orthopedic outpatient clinic. The other one wants to work in neuro outpatient. The reasons I was given were: "anyone can walk a patient," "I don't clean patients" and "that's too much work." I'm curious where those ortho wannabes end up if they don't get one of the limited jobs available. It's not any better to have someone working in acute who doesn't want to be there.
I have another question. What if that was your loved one who didn't get therapy because there weren't enough therapists to see everyone? I know of at least one hospital in Houston where that is true. Seeing someone for 10 minutes and doing bed exercises because you can charge a unit doesn't count as therapy. Walking someone 100 feet and putting them back to bed doesn't count either if they can do more.
As PTs we know the value of early intervention. We know the value of therapy to improve outcomes and functional status. What is going to happen with those patients? Who is going to treat them? The therapy community as a whole will have to address this question. Something is going to have to change. Increasing salaries to attract therapists won't be enough. Change will have to come from therapists, administrations and elsewhere. We need to start asking ourselves these questions.