We touched on this a bit earlier this month when we talked about quality vs. quantity. But now that I have had the opportunity to provide care across all nursing shifts, I want to talk a bit more about how to provide excellent care in spite of our circumstances.
When you work in healthcare, no matter what profession you work in, there will be situations and circumstances that are simply beyond our control. And sometimes this can pose a seeming threat to the flow of our session.
So how do we adapt to the unexpected?
One way that I do this is by mapping out my day immediately after I punch in. I take a sticky note or a half-sheet of paper and I list out my patients in groups: ADL, AM exercise, lunchtime assistance, PM exercise. Then next to each patient’s name, I write a quick note to remind me of the main goal for the session and a plan B option: ‘pulmonary endurance’, ‘lower body dressing’, ‘upper body exercise’, ‘wheelchair mobility’, ‘hand-to-mouth scoop’. This gives me a bit of control and guidance over each day.
From there, I take a quick walk through the facility, scope out the current situation, and grab report from the nurse on each unit. Quick Disclaimer: my facility is 62 beds, with two units. The building is one long hallway, with a small hallway that extends off one end. I can literally walk the entire building in less than 3 minutes, so I have the option to do this. If you are working in a larger facility or hospital, this might not be an option for you, and you may need to instead log onto the documentation system to read up about each patient’s night.
Of course this will not prevent unexpected circumstances from happening. However, it helps me to better roll with the punches.
For example, let’s say I have a patient who I’ve saved for last because she usually prefers to sleep in, and performs better after lunch. She is my last patient of the day. I’ve looked for her all over the facility and I finally find her in the activity room, about to play Bingo. Now, if there’s one thing you should know about geriatric care, you don’t mess with Bingo. My initial plan was to perform lower body strengthening exercises followed by transfer training. But now that Bingo is on, that ain’t happening. But my plan B was to work on global endurance and standing balance. From here, I can quickly adapt Bingo into a standing task; move the Bingo chips just out of reach, and suddenly I have added a dynamic functional reach component that further facilitates standing balance.
Our specialty is adaptability. We are able to take any simple, daily ADL or leisure task and transform it into a stimulating, meaningful, and challenging therapeutic intervention.
This is how we ensure excellence. We view each and every task through the eyes of OT activity analysis. We allow the patient participate in the planning process. We remain intentional about each and every intervention we provide, each and every goal we write.
What are some ways that you work to be intentional in your OT practice?