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  • The Skilled Nursing Facility Conundrum

    Last week I was involved in a discussion regarding membership in the APTA. For once the topic wasn't new graduates but therapists who were members but no longer are. The question was, what would it take to bring them back in? What do they value? I responded by describing how a SNF functions. Fix that chaos and they'll return. SNFs are unique. ...
    Posted to Toni Talks about PT Today (Weblog) on September 2, 2015
  • Treating a Difficult Patient

    ''I'm paying to be here and be taken care of. You will do what I tell you.'' It's bad enough we struggle for respect from physicians and occasionally other disciplines. I would say the majority of the population doesn't know what we do or the amount of education required to be a therapist. Usually if we work hard and prove ourselves, the respect ...
    Posted to Toni Talks about PT Today (Weblog) on May 20, 2015
  • The Criteria for Our Priority List

    Last weekend I was at a horse show, which means I was off on Friday. One of the things I do is manage our list for who gets out of bed over the weekend. We start the list on Monday, adding names as the week progresses. We have a tech who works the weekend, getting patients out of bed. Sometimes he gets to everyone and sometimes he doesn't. This ...
    Posted to Toni Talks about PT Today (Weblog) on January 14, 2015
  • I'm Not Going to CSM Next Year

    For the past few weeks, I've been receiving email reminders that early registration for the 2015 APTA Combined Sections Meeting (CSM) is underway. Separate emails inform me of how to reserve housing. Another batch tries to entice me with the various topics. Naturally I go immediately to the neurological section and see how many courses will ...
    Posted to Toni Talks about PT Today (Weblog) on November 4, 2014
  • Strategic Meeting

    As part of my leadership program, I attended the Texas Physical Therapy Association (TPTA) strategic planning meeting last weekend. The idea was to get newer and upcoming leaders to meet and mingle with people in leadership positions. We also got insight into how decisions are made and what is on tap for us in the future. I loved it. I chose to ...
    Posted to Toni Talks about PT Today (Weblog) on July 22, 2014
  • Just Do What the Family Wants

    Earlier today I had a conflict with a demented, agitated patient's wife. She wanted me to get the man out of bed with a gait belt and hoist him over into the chair. I declined, stating I didn't feel comfortable doing that and it wasn't very therapeutic. She insisted. I apologized and told her I would assign the patient to someone else tomorrow who ...
    Posted to Toni Talks about PT Today (Weblog) on May 7, 2014
  • Blatant Rudeness

    Usually when I go on a teaching trip, I have wonderful students. For the most part they pay attention. I get good questions. Some have fallen asleep because they drove three hours to get there. Others are obviously there for the CEUs. Last week I had someone who disrupted the class. I encourage questions and discussion with attendees. This time ...
    Posted to Toni Talks about PT Today (Weblog) on April 22, 2014
  • Agitation or Aggression?

    Recently we had an elderly man on caseload with a diagnosis of advanced dementia. It was obvious he was in the later stages of the process. He couldn't follow commands. His swallow was diminished. He was disoriented times three and demonstrated poor motor planning with any voluntary movement. However, he could still move and verbalize ...
    Posted to Toni Talks about PT Today (Weblog) on February 18, 2014
  • Dosage Matters

    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 case of a static activity. In both cases, more is considered better. Last weekend I worked at a ...
    Posted to Toni Talks about PT Today (Weblog) on February 11, 2014
  • Well-Meaning Relatives

    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 we try to do. In this case, it was a daughter who hadn't visited all week. Like many people, ...
    Posted to Toni Talks about PT Today (Weblog) on December 5, 2013
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