Where's My Aide?
Several companies I worked for in the recent past have eliminated the PT aide position. Since the aide is not a billable service, I understand why. Instead of having the patients brought to me, I have to locate them. And if I want to do a group activity, I have to "park" everyone outside the gym doors since the patients are not allowed to stay in the gym unattended. (But they can wander the grounds outside unattended).
As I was walking a patient the other day, I needed two hands on him to facilitate weight shifting and advancement of the involved leg. At the same time, I had to swing one arm back to pull the wheelchair behind us in case he wanted to immediately sit. This posed some concern because I would have to release the facilitation and risk him losing balance and momentum of gait. What usually worked in the past was the aide following me with a wheelchair. I was able to concentrate solely on the facilitation and not worry about where the chair was going to be.
I could use the parallel bars and go 12 feet maximum, I could set up another chair across the room and hope the patient is able to go that far without collapse, or I could enlist the CNA to push the chair because that person has all the time in the world to help therapy.
And incidentally some family members think I learned how to pull a wheelchair behind me while doing gait training in school. No, that "skill" was learned in acute care from some amazing CNAs and PT aides. They also showed me how to tie oxygen tanks to IV poles and attach those to the wheelchairs for easy transport. Families offer to push chairs but I hesitate only because they may not fully recognize when their loved one is having difficulty with mobility and may not bring up the chair when I need it the most.