medically necessary

Hi!  I'm B, a new OT who dates a rising 4th year med student, long distance.  I like to write about my experiences as a new therapist figuring out how to do the right thing, and my experiences as a girlfriend... figuring out how to do the right thing.  I'm thrilled to link up with Medical Mondays this week!



This is a bit of a repeat post of this one, but slightly edited to be shorter. :)

I'm an occupational therapist.  While my work is medical-related, it's not blood/needles/discovery channel medical.  Too many people don't know what exactly I do.  No, I don't get people jobs.  No, I'm not just a physical therapist for the upper extremities.  No, I'm not a nurse.  Yes, my job is amazing.

I get to wear nice, cute clothes to work and I get to take my time, stop and have a lot of conversations with really interesting people... but I also sometimes get pee/poop on my clothes/shoes, am in a hurry all the time to meet productivity quotas, and can only take so much story-telling.  And my non-medical friends can only take so much of my story-telling... hence the blog!

I travel from an independent-living retirement community to a dementia/memory-support unit for folks with advanced Alzheimer's to a low-income assisted living facility to a skilled nursing center treating people from ages 50-something to 103.

I go from physically assisting a person to clean themselves after going to the bathroom, to training a lady how to use a power wheelchair when cooking a meal in her house, to engaging a resident with dementia in a craft project to curb their agitation, to teaching thera-band exercises and drawing stick figures on handouts so people can do them on their own, to measuring range of motion of every finger of the hand, to teaching a CNA the best way to help a non-ambulatory resident get into their shower, to enforcing hip or weight-bearing precautions following an ortho surgery.

My personality, tools, plan, and schedule changes every 45 to 60 minutes for 8 hours a day. I have to be articulate, detailed, and professional-sounding, and then I have to be simple, friendly, and personable so that people will understand what I'm saying.  I need to be assertive enough that other staff and professionals will listen to me, but I have to be approachable enough so I don't come off as a rude, arrogant practitioner.

On the evaluations, notes, reports and discharge summaries that I write (and write and write), there are always categories and questions relating to the "medical necessity" of the services I provide.  My creative mind mixed with my impatience for typing a lot of information makes me really good at quickly coming up with reasons for justifying 10 minutes I spent counseling a daughter on her father's transition to assisted living, or why it's meaningful for me to help the "pleasantly demented" lady to get to go to the sing-along (since she otherwise wouldn't know how to get there even though it's two doors down).  I get to justify why exercising all your fingers and squeezing putty is essential to a person being independent to brush their teeth or open their pill bottle... and I explain why installing a bed-rail to a person's bed is an essential that improves their quality of life.

What would all the medical stuff mean if the important (and some not-so-important) things you do every day still weren't achievable?  What if you got your hip replaced but still couldn't figure out how to put on your pants?  What if your doctor prescribed you medications that then kept you from being able to drive your car anymore?  What if you survived a stroke thanks to the miracles of medicine, but you had to depend on a caregiver to brush your teeth for you?  Or would you?  With OT, maybe all those "couldn't"s would be "can"s and "do"s.


Thanks for reading, and I hope you will follow along!!!!