Now, to take the class for advanced practice hands. Yay!

One of my co-workers said, “I’m so sick of butts and guts!” That’s where the title came from. These pts typically have drains, catheters, IVs, abdominal binders, they might have rectal tubes, epidurals. They move pretty well except that there is a tremendous amount of pain when bending the legs up, rolling or sitting up. As an OT, it’s important to show them how to get in and out of bed with log rolling technique, teaching lower body dressing compensation techniques either with the reacher or different range of motion, early mobilization and toileting transfers.  These things might not sound fun but are very important before discharging home.

S: “Well, I don’t want to be a PT, because I don’t think I can handle being a doctor.”

M: “What do you mean?”

S: “Well, I don’t think I’m ready to do all that studying to have a doctorate.”

Time passes throughout the day and I encourage her to ask more questions.

S:”Well, maybe I will just get my Master’s in OT and work for a little while and then when I feel ready, I will get my doctorate in PT.”

I’m sorry…but I had to restrain myself. This is the stupidest thing I have ever heard. I explained to the student that it would be redundant to go to PT school after going to OT school, because you do learn many similar things in PT and OT school. Plus, why would you want to be both? You don’t get paid more money if you have both certifications. You can only work as either PT or OT because you will be reimbursed only providing one service, not both simultaneously. Plus, that’s two certifications to pay for and renew every 2 years. I just couldn’t understand her thought process. The doctorate for PT school is an ENTRY LEVEL doctorate. The Master’s from OT school is an ENTRY LEVEL masters. This is not like getting a PhD or a medical degree! The DPT requires more research during the coursework, that’s why it’s an entry level doctorate. It is no way the same as a PhD or an MD degree. The DPT is similar to the PharmD. It is the minimum requirement for that field. You can’t be a pharmacist without the PharmD, similar to how you cannot be a PT without the DPT starting in 2014. It’s called degree creep and it’s how universities get more money, while saying they are advancing their profession. The sad part about it is that you could be an RN, with only an associates degree and get paid as much as a DPT or an MOT. Therapists as a whole, get paid much less (compared to other healthcare professionals) when you consider our schooling and our level of expertise. Radiation techs get paid almost six figures for just an associates degree, but then you have to be exposed to radiation every day.

Anyway, the original reason I was going to post was that I am getting annoyed by the number of people who tell me that they are applying to OT school because they don’t think they can get into PT school. News Flash: it’s hard getting into any healthcare profession school. PT, OT, SLP, radiation therapy, respiratory therapy, physician assistant, nursing, the list goes on. The fact that people think getting into OT school is easier than PT school perpetuates the myth that OT is a lesser therapy. That drives me nuts! Just ask the stroke pt who can walk around just fine but has no use of his Left arm.  He is walking around, not bumping into things, but he can’t brush his teeth on his own or can’t even eat a hamburger  because he doesn’t have both hands to hold the fat, juicy gourmet burger he wants! Or the beautiful old lady who just wants to be able to put her jewelry on, but can’t because she has lost sensation, strength and dexterity in her fingers. Or the kid who was in a bad car accident that his abdominal wall became necrosed, had to to have surgery and can walk around his hospital room, but can’t put on underwear or get on/off the toilet because he doesn’t know how to move s/p abdominal surgery.  Seriously, OT is very important because it’s very functional, it’s client centered and it’s holistic.

If you want to just treat one part of a person, be a PT. If you want to give client centered, holistic, functional therapy, be an OT.

I feel so lucky that I went to OT school when it was less competitive. I can’t believe that admission into therapy school, of all disciplines (PT, OT, SLP) is so difficult now. I can’t imagine. I wonder if I’d get in today. I’m glad I don’t have to think about that. I’ve been thinking about other things I should have mentioned when I gave that lecture. Here’s what I forgot to mention.

Future employers most likely will not care what therapy school you went to. It’s important that you go to an accredited school, but public vs. private…most times, the employer only cares that you are board certified and have a license to practice in that state. I will say that there is a local OT school that my company believes isn’t good. As Grandma Borge would say, “they don’t know their ass from a hole in the ground.” I would not want to be a graduate of that school…to have paid thousands of dollars to have a bad experience and not be an attractive potential employee.

Think about your internship experiences. A better person will try to get a varied rotation of experiences. If you only work in the outpatient setting, you’re limiting the jobs you can apply for and decreasing your versatility. I think you should have pediatric experience, acute care experience, outpatient, skilled nursing facility and mental health experiences.  OT is deeply rooted in mental health and OT is a holistic profession. We look at the mind-body relationship all the time.

Get as many volunteer hours as you can. Yes, as a hospital or other organization’s volunteer, you will have to do other activities such as filing, copying, faxing, sorting but get over it. We all had to do our time. You need to volunteer so that you get exposure and that you really know you want to be a therapist.

Visit schools and get a feel for the campus. Study the cirriculum. Does it make sense? Are you doing anatomy on plastic models? Do you participate in student-run clinics in therapy school? The more experience in therapy school you get as a practicing student therapist, the better.

If I think of more things, I’ll update this post. April is OT month and I am so proud to be an OT! OT is under-appreciated and that needs to change. Time for an OT revolution!

Little old Japanese-American lady who has never been married. Fell and broke her hip while gardening in the backyard. Screaming at the top of her lungs, “Oww! Oww! Oww! I’m not screaming, I’m not screaming. This hurts! I’m not screaming!” She was really funny because she worked herself up so much, that just the thought of moving her leg, caused her heart rate to jump  to the 140s. She wasn’t even moving! And when she tried to move, she would freak out! But then, she would be able to reposition herself with no problem. I felt really bad for her roommate.

Homeless guy found, after a fight, laying on the trolley tracks, with a gash on his forehead and a broken collar bone. I evaluated him the next day and he was having auditory and visual hallucinations in the middle of the tx session. He had no idea where he was or what happened. The hospital wanted to get him out ASAP because they believed he had a psychiatric illness and they wanted him to get back to the homeless shelter before he had a meltdown in the hospital.

82 y.o. military veteran who said he’d had 500 acupuncture sessions, 500 massages, 500 physical therapy appts and many chelation therapies. He believed that cancer was pretend and that cancer was just people eating the wrong kinds of food. He was in the hospital for a hip replacement.

One pt was a Christian missionary in Kenya for the last 15 years.

Often, I get pts who are professors emeritus of the local university. Or current researchers. Some times there are famous pts. I once had a popular skateboarder as my pt. He was paying cash for his hospitalization.

I love hearing other people’s life stories. Everyone has a story, that is why we are all unique. We have different experiences. I think it is neat to hear about it from my pts. They might have good advice, or be totally nuts!

I work in a very diverse setting now. I work in acute care. I see brain tumors, joint replacements, leukemia/lymphoma, cancer surgery, strokes, heart problems.When I work outpatient, I see hand injuries, Parkinson’s, Lou Gehrig’s disease, strokes. I love the diversity. It keeps my on my toes and I love all my patients. All my patients bring something special into my life.

My student only did inpatient. She did a pretty good job. She acclimated to the routine well and the acuity of the patients. But the thing that got my goat was….I didn’t even get a thank you card. And before I finished giving her her final evaluation, she asked if I could provide her with a letter of recommendation in the future. Am I getting older? Is this some new thing now? I remember that for every fieldwork I ever did, I always gave my supervisor a handwritten card, expressing my appreciation for their knowledge, expertise and patience in teaching me new things. I remember my professors impressing this upon us prior to the start of our fieldwork. The fieldwork can essentially be a job interview. During your fieldwork, you are acting as the student occupational therapist. You are trained in the system of the department and learn the work dynamics. It is a great time to get your feet wet and network with people. If you like the fieldwork, you might want to get hired there someday! It would seem that you would want to make the best impression throughout the whole fieldwork, from start to finish.

So, when I didn’t get a thank you card or even a verbal thank you…I was miffed. And a brief Google search for “business etiquette” and “thank you cards,” was not very productive. Has the world gone mad? Don’t people value those simple two words anymore?

I do, and I know my supervisor does. When she was interviewing for the open OT position, she made a point of letting us know which applicants thanked her for her time. I think you would be shooting yourself in the foot if you didn’t thank people during these opportunities: job interviews, fieldwork, giving/receiving information during learning. It just doesn’t make sense. And in the setting where I work, which is inter- and multi-disciplinary….not having good business etiquette will not get you far.

If anything, writing a thank you card is another way to be memorable. People have your name written down, they can remember more easily how they know you and in what context. I can only thing of good things that can happen from writing a thank you card. For example, at work, we have a lot of volunteers trying to get hours for admission to either PT or OT school. Volunteers who finish their hours and don’t write a thank you card or let us know they are leaving/done….how would we know or remember them? There are 10 volunteers a week. And then they expect a therapist to write a letter of recommendation for therapy school? Good luck, buddy. You better have been a really outstanding volunteer or at least written a thank you card.

Okay, I’m done blowing off steam now.

Our poor, new OT. She’s used to people getting better. A third of our patients are going home with hospice or dying in the hospital. It’s taking a little bit of time for her to adjust to this new population. I’m telling you, this is not for the emotionally vulnerable.

And my student! She’s had so many patients with brain tumors. She’s having a hard time seeing them go home with hospice or die. It’s depressing her a bit, but that’s how life in our hospital is. As the OT, you have to think of what is client-centered and what you can do to improve quality of life. Calming, self feeding, exercise, cognitive activities, anything.

Isaac is a respiratory therapist, and a very cool cat. The following is his post- showing just how important and amazing respiratory therapy is.

I get paid $50/hour to do occupational therapy with these people. This is definitely not how much I get paid doing my full time job. I typically work 7 hours x $50= $350 for one day out of my weekend. It’s nice to have that drop into my bank account. However, I think I am spoiled by academic medicine and working in a large hospital. I don’t think I could ever be happy working full time, 40+ hours/week in a SNF. There is too much pressure to be productive. There is so much paperwork. The whole facility is Medicare driven. There are so many rules for therapy. Every MINUTE is accounted for. The clientele can be fussy or unmotivated. As an occupational therapist, I am one of the most educated people on staff! In most nursing homes, the nurse assistants have a certificate. Most SNFs do not have full time RNs, or if they do, there is only one RN per shift for the whole building. Currently, to be an LVN, you just need a certificate training program. Maybe an LVN has an Associate’s degrees. RNs can either have Associate’s, Bachelor’s or Master’s, but you can bet that most Master’s level nurses will not want to work in a SNF unless they are the managers/directors. The MDs who are responsible for caring for the pts.. I never see them on the weekend. I don’t know if they come by during the weekdays. So when you think that the therapy staff, is the most educated and consistent staff for the facility…it blows my mind. I am used to being around MDs, NPs, PAs, Master’s level RNs, PharmDs. On the other hand, you can be more creative in the SNF setting. There are actual, home-like bathrooms, to practice grooming and hygiene ADL. There is a stove to practice cooking (cooking is a big OT intervention/assessment tool). There are arts and crafts. You can take the pts outside or to the mall for community integration. There is better exercise equipment than in an acute care hospital.

I think there is quite a large number of OTs that work in SNF setting. Most of my OT cohort work in SNFs. They get paid more money than I do, since I work in an acute care hospital. But for me, I like academic medicine. I love being there post-op day #1 after a brain tumor surgery. I love being there from the beginning and getting people started on their therapy journey. I like talking to people who are as educated as me (sounds awful, but true). I like all the learning opportunities I get at work. But if I worked in a SNF, they might be able to pay for my American Occupational Therapy Association membership, pay more money for continuing ed classes. I know that every other Friday, the staff gets free lunch at the SNF. I wouldn’t have to pay for parking if I worked at the SNF.  Both settings have their ups and downs. You have to pick what’s right for you.