Leave it to me to be able to apply an episode of ''Downton Abbey'' to health care! Without creating any spoilers for those who may be catching it at a later time, a situation arose in last night's episode that I have seen play out time and again in health care. A character chooses the advice of a health care provider who is famous... the best in ...

I've tried wearing different brands and styles of shoes in the clinic that will protect my feet and stand up to the demands I place on them. Every single pair have split at the ball of the foot due to those demands. I hesitate to wear sport-type shoes because I don't think they look professional enough in the clinic. I like the feel of Italian ...

Therapy can be monotonous at times, especially if I'm seeing too many total joint replacements. Don't get me wrong, I love what I do, but going through the same routine every day can be a bit boring. I will try and break up the session of therapy and do the exercises in the morning and the higher-level balance activity in the afternoon. Anything ...

A while ago, a patient came into the facility and we were given two weeks to make the patient stronger and safer to go home. The two weeks was what the patient's insurance company authorized. Research shows that a person will need to increase caloric intake and lift heavier weights with shorter repetitions to increase strength. The person should ...

A therapist's gym is a multipurpose room not only for the staff but also patients. For the staff, it's used for in-services, luncheons and meetings. For the patients we see, the gym is used for exercises to get stronger, a place to encourage and become encouraged by others, and a safe place to express frustrations. Often when I'm with patients ...

As new nursing staff members begin to work, I will often introduce myself to them and explain that certain patients would need pain medication prior to therapy. One nurse I spoke with told me he had assessed pain on several people and they did not want to have anything for pain. The brief conversation went something like this. ''Can we get these ...

Let me vent about this whole system of seeing patients for a designated time in relation to reimbursements in a SNF setting. It does not work. If a patient comes in and is set at 720 minutes but we only see him for 700 minutes in the assessment reference date period, we get reimbursed at the lower rate of 500 minutes. We do not get reimbursed ...

Working in a skilled nursing setting definitely has its benefits and drawbacks, as I am constantly discovering. There is a huge advantage to working with the same patient every day of the week. Watching him make gains and meet goals, sometimes daily, is extremely rewarding. On the other end of the spectrum, working with many who have end-stage ...

Last week I finally went for my annual physical with my doctor. I was a twinge nervous, as I've been exhausted recently and well, I haven't had a doctor's appointment in more than three years. Luckily, all was fine -- and I was given some valid (if not obvious advice). She suggested that one way to curb my ''low-energy'' issue was to drink more ...

I was treating a patient and we were alternating between LE and UE exercises. So we rested the legs and worked the arms. I instructed the patient to do ''21''s (a fallback to my body-building days) and we really blasted those biceps. Then I was thinking about the poor OTs who had to treat this guy after I am done with him. The guy's arms looked ...