This morning there was a patient on the floor so the request went out for lifting help. Four people responded, including me, a PTA, a male CNA and the patient's nurse. The patient was a big man, weak and in a narrow space so it wasn't going to be easy. As we were positioning ourselves to lift him the nurse stepped away. She said she didn't lift ...

This morning while I was walking a patient, I overheard another patient walking behind us. She was telling the CNA taking her to the dining room that she recognized me from the weekend. She was upset with me because I came to take her to therapy and she refused. Her daughter was coming later that day and she didn't want to get up. I don't know ...

Last week I questioned what the definition of skilled therapy was. I had worked with several patients the previous weekend whose only deficit was the need for supervision. I've realized I wasn't clear in describing those patients. All of them had been on caseload for a while. Previous safety issues, such as Berg and Tinetti scores, had been ...

I've been noticing a disturbing trend lately. More and more facilities are considering the need for supervision as a need for skilled therapy. Back in the day, patients referred to SNFs and outpatient had an obvious need. They had trouble walking. They couldn't transfer. They'd recently undergone total joint replacement. The knowledge and skill of ...

Someone was fired last week. The rumor is going around that she was fired because she didn't smile. I don't know if that's true or not but in Texas it is legal. Here an employer can fire an employee for any reason, even if they make it up. Nor do they have to prove it's true. There are no laws preventing it. Maybe the woman smiled. Maybe she ...

Now that I'm home from CSM, I've had an opportunity to process all of the information. Most of the presentations were excellent. Those that weren't purely theoretical had a common theme. We have to maximize what we do because we're spending less and less time with patients. We have less time to spend because there isn't money to pay for our ...

Yesterday I heard something that's still bothering me. I was evaluating a woman. Her husband told me the following. He couldn't tell me when the problem started, just that for the past few weeks she couldn't sit up without leaning on something. He had been taking care of her at home and calling a grandson to help move her. Finally he couldn't do ...

There's an old saying the squeaky wheel gets the oil. In healthcare that translates to the patient who complains the loudest, is the most uncooperative or makes the most unreasonable demands, also gets all the attention. Often this means other patients are ignored. It never fails to amaze me how this happens over and over again. Last weekend was ...

In a recent blog for ADVANCE, Jason Marketti talks about having several per diem jobs to help him afford large purchases. That reminded me of when I used to do the same thing. I can remember when most of my coworkers worked a few extra days. No one did it regularly, or if they did, not for very long. That isn't true today. Almost every therapist I ...

Last week one of my horses, Expsychment, made his debut as a therapy animal. It was a win-win situation. The residents love him and I got to spend the day with him and still get paid. Dogs, and sometimes cats, are frequent visitors to rehab facilities. Some are certified therapy animals. I think half the therapy they provide is being warm, furry ...