Observations Part 3

My next observation was in a skilled nursing facility.  I was currently working there as a Certified Nursing Assistant and met the OT there.  She allowed me to observe her after my shift was over.  All in all I observed and assisted in therapy sessions with older adults, both on the rehab floor and other floors.

I observed the OT working with patients who had knee replacements, hip replacements, and other diagnoses.  Most of the sessions focused on balance and motor planning.  I observed patients walking around obstacle courses, picking up different colored cones from various hiding places.  I watched patients gain endurance on stationary bikes, and by walking the halls of the facility.

Most of the therapy sessions were based on gaining endurance and evaluating the patients strategies for moving around their environments.  On the surface the sessions seemed boring and simple.  Make a obstacle course, walk a patient around the halls, talk with them while they ride a bike.  After thinking more about and asking what each exercise was doing for the patient, I discovered that most of the work on the therapist part was done before the session.  She was making decisions on how to improve the patients function and how to engage him or her in such a way to further the patient's endurance, strength, and motor planning.  So much of what a therapists does can seem easy and basic but like an iceberg the real "mass" is below the surface and goes unseen during therapy sessions and observations.

Some good questions to ask in this setting are how to manage behaviors, how long therapists spend on notes and paperwork, and what strategies they employ in working with other therapy professionals and nursing staff.  In the last post I mentioned why managing behaviors is important.  Paperwork and notes are a constant thing in OT.  No matter in what setting you work, you will need to write up what you did, your goals, and what to do in the future.  I have found that using SOAP notes is a easy way to write good notes.  SOAP stands for subjective, objective, assessment, and plan.  You can google SOAP notes and read much more about them.  The strategies employed with other professionals will give you an insight into what team meetings are like, any in-services that therapists may be responsible for and the kinds of things that an OT needs to communicate to others in the setting.