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Raising the Bar in Rehab

Therapist’s Needs

Published December 17, 2009 1:23 PM by
An old classmate of mine called me last week and asked my opinion about a situation he experienced at work.  I'd like to describe what happened, and ask you for your input, advice or what you've experienced.

At my friend's clinic, two therapists are staffed on Sundays. My friend was one, and a 5-month pregnant coworker was the other therapist on staff that day. The pregnant therapist kindly asked my friend if he would consider taking all of the max-assist patients from her caseload in exchange for all the supervision/min-assist patients for herself. My friend was agreeable to her plan and was understanding that she wasn't feeling up to working with heavier workloads on that day. However, at the end of the day my friend was exhausted. With 12 treatment sessions of mod and max-assist patients, he had worked harder than most days. 

What's the optimal solution here? If the coworker asked for help with their caseload for whatever the reason, should it be expected that the second therapist take on those physically difficult patients?   There is always give-and-take with our coworkers; whether for max assist patients or to see a vestibular patient when our "Hallpike-Dix" skills are rusty. In a career based on helping others reach their goals, it is imperative that we work as teammates in the therapy department instead of an every-man-for-himself approach. 

One answer is to utilize aide staff during those treatment sessions. The other option would be to dove-tail PT/OT sessions so the therapists could work together for transfers or other heavy mobility pieces, but still maintain separate treatment sessions. 

What have you done in these situations? What is the best way to address our own needs as therapists, but still provide successful treatments to patients? 


I agree with Janey.  If a therapist is unable to perform their job they should not come to work.  Someone is at risk of injury whether they are max assist or SBA.  (I have had SBA gait patients fall and/or LOB)

Jason December 18, 2009 10:24 AM

If a five month pregnant therapist can't see some mod-max assist patients, she is not fit to do therapy that day and needs to call in sick.  If she ascribes to the belief that no five month pregnant therapist can treat max/mod assits patients then she is not doing effective therapy and needs to rethink what her "therapy" is accomplishing.

My first pregnancy I was doing contract work in a new state.  Going in (coincidentally, at five months pregnant), I didn't have any established relationships with any of the staff.  But, seeing my belly, other therapists/aides offered to help.  Feeling like I had to prove I could carry my weight, I declined unless I really needed it.  Even pregnant, you can use good body mechanics - until pretty far along - to achieve a safe therapy session for patient and pregnant therapist.  

This scenario was with me coming off a post-surgical leave for a gyn surgery that had been performed at the end of my third prenatal month.  But I was physically fit going in to it, so even though I was still seen by a high risk OB for the remainder of my pregnancy, I had been released to full duty.  

I didn't do anything stupid or risky, but I wasn't a whimp either.  I had taught body mechanics in a previous position and I knew my limits.  

The other factor is, by this point, I had learned that max assist is a work out for the therapist, not the client.  I didn't do a lot of max assist anything.  I tailored the therapy sessions so the patient was the one doing the work, not the therapist.  I didn't participate in "drag" therapy.  My sessions were effective, in large part because they didn't pander to the false concept of the patient "ambulating" when in reality four people held them up and drug them five feet.

Janey Goude December 18, 2009 1:13 AM

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