Anyone who reads my blog with regularity knows the last year has been a struggle for me. I lost my beloved job. I was fired for being ethical. I encountered more than my share of unethical and self-serving people. During all of that, I hung on and kept going to work. Every so often I made a difference to someone, which kept me going. For the ...

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 ...

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 ...

SAN DIEGO -- Just like my fellow ADVANCE blogger Lauren, I'll be attending the APTA Combined Sections Meeting in San Diego. CSM happens this week so I'm already in my hotel. I've registered and picked up my materials. I attended my pre-conference workshop on item writing. I'm ready for things to begin. Unlike most of my fellow therapists, the ...

When I started my current job, I was given a request. Help Jenny (not her real name) walk again. Jenny had a devastating stroke four months prior to that and was just beginning to wake up. At first they didn't think she'd live. Then they didn't think she'd wake up. She fooled them all. When she became my responsibility, she was awake, following ...

I don't know about anyone else but I can't wait for Christmas to come and go. Things need to get back to normal, or what passes for normal. I'm not a holiday person. I don't go out of my way to celebrate them. Holidays are actually my favorite days to work. No one else is there so the day is peaceful and productive. The patients are appreciative ...

Reading Jason Marketti's blog last week reminded me of a discussion we're having here in Texas. It's called RC-3 and is an amendment to the Texas Physical Therapy Practice Act. It proposes unlicensed individuals such as athletic trainers and massage therapists be used as PT extenders. These extenders are to provide care as directed by the physical ...

Last week, I wrote about my experiences teaching my first CEU course. I mentioned how much work it was but didn't go into details. It took me nearly four months to finish, including two months of working at least an hour or two every night. Now I'm going back and revising the content. I'm beginning to think that is an ongoing process. In the ...

A few weeks ago, I wrote about using the Nintendo Wii and wondering how much help I should give my patients. Since that time, I've settled into helping them to either prevent frustration or teach a new motor program. That creates higher scores while enabling motor learning. The only exception is the red fish. One of the games we play involves ...