Hi guys,
My post this week refers to my astonishment at the poor relationship between the OT and PT department. This week I had a patient who is 91yrs old and living at home with his wife. He came into see me in a wheelchair post-fall (only soft-tissue injuries) with reduced mobiulity. Prior to the fall the man was ambulting with a WZF and transferring independently. Now however, he can only be transfered from wheelchair to recliner chair and back (unable to get into bed). On arriral to the session I noticed the terrible condition of his wheelchair (uneven foot plates, broken back rest, very poor brakes and lots of rust). The wife stated that they have no rails in their house and no aids to assist with washing/ADLs. When I asked about seeking assistance from an OT, the wife stated that she had alreadly been referred to the OTs and when they refused to provide her with a better wheelchair, she declined their services all together. After treating the patient personally, I discovered that the need for OT intervention was paramount, so I referred the patient back to the OTs.
The relationship between OT and PT is not very healthy in my particular facility: the OTs do not like to associate with the PTs and they have a particular dislike of students all toghether. Thus after I referred the patient back to the OTs they were less than impressed. The OT involved told me that the patient would go straight to the bottom of the wait-list and that she would get to it in a month or perhaps later. I felt particularly hopeless in this situation as I know my patient is in desperate need of help but a) they already declined the service and b) I feel that the OT does not trust in my clinical judgement. I went about organsising silverchain as an interim to the problem and have had to accept the wait-list for OT.
In this situation I feel that students are not taken seriously enough. Given that we are given patients to manage independently I feel that the system ends up affecting the patient the most. Have any of you guys out there experienced similar problems and do you think there would be a better way to deal with more experienced health professionals more equally.
Kate.
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3 comments:
Wow what a pity!! In all my placements, the PT and OT departments have had a really good relationship and have worked together to keep patients in their own homes if this is still a safe option. Were you able to speak to the OT dept directly and explain your thoughts, or did you have to send a paper referral through? It’s not really a good option for you, but would your supervisor have been able to get the patient seen by OT more quickly? At least you were able to organise assistance through Silver Chain.
Mel
It's shocking to see that it can ever be happening! What does your supervisor think of it?
Are they any other ways of bypassing the system? What about RITH or an ACAT assessment? Anyone can refer for falls clinic, if you refer onto them and get them to arrange for an OT Ax.
It's ridiculous how the OT dept has been handling this situation! In both geriatric placements I've been to, the OT and PT depts worked hand in hand to serve these patients. What this patient needs is a MDT approach!
Hey Kate,
Isn’t it great when you actually meet another allied health professional (OT, speech path, social worker etc) who seems to actually KNOW what physios can do, seems keen to work as part of a multidisciplinary team, AND seems to listen to what a student has to say!?!?! They are out there, and a respectful multidisciplinary team does make life heaven, but I’ve also had dealings with allied health pros who don’t seem to take students seriously. I guess if we try to look at it from their point of view, they would see different physio students come and go weekly (some 4th year, 3rd year, 2nd year, curtin and notre dame) so may have had some dealings with some inexperienced students, or with physio students who showed them little respect for their role in patient rehab. I don’t know if you have also found this, but by the 4th week of prac I really start to feel like part of the multidisciplinary team, and have developed a rapport with other physios and health team members. The first few weeks though are still about feeling my way around, getting to know people etc. I can see how OT’s etc get frustrated with different students coming and going, and I’m sure if we got to deal with them on a daily basis over a period of weeks or months, they’d start to listen and appreciate our views and opinions a bit more seriously. I guess it’s just one of the (many) things that suck about being a student!!! Ezza
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