A day of hospital OT

This past week I spent a day with an occupational therapist at one of the hospitals in the city. Four different situations give a pretty good idea of the main things OTs do in a hospital setting.

Occupational therapists help people do the things they need and want to do in their lives. The things we need to do start with our morning routine of washing and dressing. Most of us do these tasks without much thought but they can be more of a challenge for someone in an acute hospital setting. One woman we worked with wanted to wash her hair and I was introduced to waterless shower caps. We heated the cap briefly in microwave. She put it on her head, massaged it for a couple of minutes and her hair was clean -- all without leaving her chair. This particular woman wasn't really sure she had the strength to wash up at the sink but we helped her out of her chair and she used the walker to maneuver around the bed. When she finished, we helped her get situated in bed which would allow for an easier transfer when they came to take her for a procedure.

A big part of any type of therapy in the hospital is to get people moving. Everyone has had the experience of feeling weak after spending a day or two in bed. The less a person is able to move, the weaker a person becomes. That's part of why we encourage people to do everything they can for themselves even if it is as simple as brushing your teeth. Movement helps blood flow, fluid drainage and the general healing process. One young man agreed to go for a walk. He got himself out of bed on his own, donned a second gown for a bit more modesty and together with his IV pole we made two laps around the unit. That was 10 minutes of walking. We left him sitting up in a chair looking like he was a bit more ready for whatever the day held for him.

Another part of the OT's role is to evaluate whether or not someone can benefit from therapy. The therapist I was with likes it to feel like a conversation of two people getting to know each other. The questions usually focus on three big areas. One is their living situation. How many stairs are there to get into the house? Do you have to go upstairs or downstairs on a regular basis? What's the bathroom like? We also ask questions about whether or not they were having difficulty with any of their daily activities before they came to the hospital and whether or not they expect to have problems when they leave. One woman we talked with had a good set up at her home. A walk-in shower was being put in while she was at the hospital. She had people that did some of the heavier cleaning and the only real concern she had was her balance and lack of endurance. We watched her get out of her chair and walk on her own in the hall. There were a few times she seemed a bit unsteady on her feet but there was nothing she needed OT for. Instead, the therapist encouraged her to do PT while she was in the hospital and to continue once she returned home.

One of the things we have learned to do this semester is moving people's joints when they aren't able to do it themselves. This is especially helpful in the ICU when patients are unconscious or sedated. Even though they can't move themselves, it is still beneficial to move all of their joints through the full range of motion for them to ward off some stiffness and swelling. I was hoping to have the opportunity to do that but the nurse said the woman on our patient list was too sick that day.

All in all, the day gave me added motivation to keep studying since I will soon have the opportunity to use what I'm learning in real life situations.