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Raising the Bar in Rehab

Patient Inconsistency

Published August 6, 2009 7:41 AM by
On acute care, every day is different.  There are days when my schedule works perfectly; other days, every patient is at a test or procedure, or refusing therapy.  Likewise, there are days when my patient requires total assistance for mobility and the next day performs all transfers and ambulation with supervision.  What's the deal?

I think a big part of it is motivation.  If I asked my friends to come to a tour of religious and architectural influences in modern day Madrid (which exist, by the way), I'm sure they would be total assists as well, on that day.  But ask them to come with me for a day of shopping and sushi, and they would probably reach their max heart rate racing to the car. 

I guess it's one of those things you learn to love about physical therapy, how every day can bring something new.   It's just difficult, not knowing what to expect, how to prepare for a day of treatments when I'm not sure what my patients will need.  But then again, life is the same way.  You have to expect the unexpected. 

posted by


Not to be sarcastic, but you are talking about acute care! Between labs way out of range (electrolyte imbalance), meds and -- dare I say it, infection/post anesthetic fog/ etc -- the status and ability of these patients can change hour to hour, let alone day to day. Don't be so quick to judge and make assumptions that effort/action = volition/motivation. In that setting there are SO many factors at work and often the least of these is motivation.

Irene Bartlett September 9, 2009 12:46 PM

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