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Toni Talks about PT Today

Dosage Matters
by Toni Patt
There were two common themes at CSM this year: dosage and intensity. Every clinical presentation I attended mentioned one or the other. Intensity was defined as how hard the patient is working. Dosage referred to the number or reps or duration in the Read More...
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It's Time for CSM
by Toni Patt
It's almost that time of year again when thousands of us gather for the APTA Combined Sections Meeting. This year we're in Las Vegas. According to what I've read, they're expecting more than 10,000 PTs and PTAs to attend. I'm going. To use a Texas-like Read More...
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Holiday Staff
by Toni Patt
The holidays are upon us and everyone wants time off. Mangers scramble to cover for vacations, illnesses and unexpected accidents. It's a given there won't be normal staffing levels from mid-December through the first of the year. Every year I ask the Read More...
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Well-Meaning Relatives
by Toni Patt
The first thing I heard when I got to work Monday morning were tales of the well-meaning relatives. We all know the type. They try to help but only make things worse. Or, with the patient's best interest in mind, they interfere with just about everything Read More...
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Prioritizing Patients
by Toni Patt
In order to compensate for escalating case loads and inadequate staffing, prioritizing who to see each day has become a way of life. Sometimes my day is easier because patients are unavailable. Generally I start every day deciding who needs therapy the Read More...
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Wheelchair Races After Dinner in the Parking Lot
by Toni Patt
At the SNF where I work part-time, the parking lot behind the building is built on an incline with a bend about three-fourths of the way down. There is a curb along the entire length of the descent. Last weekend, a resident told me it's possible to descend Read More...
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Nursing Isn't the Problem
by Toni Patt
There's an ongoing struggle between PTs and nursing over who is responsible for getting patients out of bed. Both agree patients need to get out of bed. Easily transferred patients get out of bed regularly. The disagreement arises over max and total-assist Read More...
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'I'm Not Going Back to That Place'
by Toni Patt
Last weekend I evaluated a woman who had been readmitted to the facility after yet another hospitalization. Before I could start taking a history, she told me she was never returning to that hospital. She was particularly upset with the therapy department. Read More...
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The Declining Census
by Toni Patt
In previous posts, I've discussed staffing issues where I work. Those problems continue. So does the return of the frequent flyer. Now we have something even more troubling. Our census continues to drop. The facility is at one-tenth of its capacity. There Read More...
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Comeback Stories
by Toni Patt
"Frequent flyer" is a term given to any patient with serial admissions to a facility. They discharge. They admit. They discharge. They admit. Eventually everyone on the staff will have worked with the patient. Some are remembered fondly. Some never see Read More...
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What's the Purpose of a PM & R Doctor?
by Toni Patt
Until recently, I had never worked closely with PM & R (physical medicine & rehabilitation) physicians. When I worked at the "evil empire," I dealt exclusively with neurologists. Some were good. Some weren't so good. Either way, their purpose Read More...
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‘I Can't Wait Until I Can Walk Again'
by Toni Patt
Last Saturday, one of my patients at the SNF was a woman with left femoral neck and humeral shaft fractures. She'd undergone an ORIF to repair the hip and the arm was immobilized. She was NWB on both extremities. Like many of our patients, this was not Read More...
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Sometimes Even the Doctor is Wrong
by Toni Patt
I had a good laugh this morning. A doctor was ranting and raving that an order he'd written two weeks ago still hadn't been followed. The order was for a pressure-relieving shoe for a patient with a plantar wound. The doctor was very upset. He was making Read More...
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Overtime Issues
by Toni Patt
I've noticed a growing trend to prohibit overtime. Until recently, overtime was frowned on but permitted if caseload supported it. That isn't happening anymore. The same is true to a lesser extent for using contract labor to fill staffing gaps. Many facilities Read More...
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Secondary Gains
by Toni Patt
If you work in physical therapy, sooner or later you're going to encounter a patient, friend or relative who is making secondary gains off the patient's illness. In my experience, this usually revolves around money or special attention. I have a patient Read More...
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