Vol. 23 •Issue 11
• Page 6
Person to Person
Making the Best Use of Your Rehab Tech
By Jacqueline Thrash, OTR
I currently work in a skilled nursing facility, and I sometimes help out another OTR at another SNF. Because there is a shortage of OTs and OTAs in Southern California, we utilize the help of rehab techs or rehab aides. In the past 4 years, I have worked with a variety of rehab techs: some are PTs from another country and are working as rehab techs while waiting for the permission to test; others have bachelor's degrees and are checking out the OT (or PT) field to see if they want to continue with their education to become registered therapists; others aren't planning on furthering their education at this time.
I have been working with Alice Murphy lately, who has two years of experience and is quite good; she has been accepted to the Mount Saint Mary's physical therapy doctorate program beginning Sept. 2007. Even though her interest is more in PT, she is has shown an interest in learning what she can about OT and does well with the clients.
She is open-minded about learning ADL and dressing techniques. She knows the functional outcome for sit to stands, or "chair ups" as she calls them: for clients to be able to stand and balance while cleaning themselves in the bathroom or pulling up and down their pants. She even knows the difference between s/p ORIF and total hip precautions.
She is an asset to me by doing the little things that take up treatment time, like copying forms, running for charts and cleaning the rehab room after the day is done. She enjoys doing the therapeutic exercises with the clients, and helping them brush their teeth. Even though she is bright, she doesn't get an attitude when I ask her to do the small jobs.
We were having a discussion about the relationship between rehab techs and OTs, and what she thought we OTs should know from a rehab tech's point of view. Here are some of the things she pointed out:
Invest time into your rehab techs; they can be a huge contribution to your everyday treatments and paperwork.
Teach the rehab tech to connect with another human being on a caregiving level.
Teach the rehab tech how to comfort patients when they become frustrated or confused.
Teach the rehab tech how to build patient rapport and how to encourage the patient.
Teach the rehab tech how to resolve conflicts with nursing, such as when the patient he or she went to pick up isn't up in the wheelchair yet, or is still in bed with a dirty diaper. To whom does the tech talk to for resolution?
Sometimes therapists do not realize that they are constantly setting examples for rehab techs, who may be future therapists. It makes a huge difference in the tech's work ethic to see that the supervising therapist is treating with care and creativity and is a hard worker.
Become friendly on a personal basis with the tech. You would never want him to hold back questions or make assumptions.
Teach the tech how you want her to report progress to you; for example, min mod or max assist? Poor, poor plus, fair minus, fair or fair plus?
Do not leave the tech alone. Allow some independence (across the room) but never leave the facility while supervising a tech.
Remember to explain different health insurance plans to techs. This way they can understand why certain decisions are made, and there will be no resentment or confusion.
Many times, your rehab tech is your student–do not hesitate to pass on your skills and knowledge to make this career better for our future therapists.
I have heard horror stories from the various techs I have worked with about the OT leaving the building while the tech was seeing patients. Wow. Besides being against the California licensing laws governing OTs, this is foolish. If something were to happen, that therapist would be liable and could very well lose his/her license. Not worth it. This also sets a bad example for a rehab tech who is planning to become an OT or PT.
I really see the opportunity for OTs and PTs to teach rehab techs about the benefits of activity, ADL and exercises, as well as the creativity and care involved in rehab. This input can make them better techs and may influence their career paths. I teach my tech about different aspects of the diagnoses of my clients, why I am choosing a certain activity, and how to make it fun for the patient. I don't expect her to have the same knowledge as I do, since she hasn't gone to OT or PT school yet, but it doesn't hurt her to understand the deeper effects of illness and disability.
I believe if you are blessed with a tech whose mind is like a sponge, go ahead and teach her the whys and wherefores of therapy; it makes what can be a menial job more interesting. If you are a maturing therapist like me, it is beneficial to have a young(er) person around to help with the transfers, crawling under the mat for the ball or under the bed for shoes, and putting the footrests on the wheelchairs. Even if your rehab tech isn't sponge-like, you can teach her things that will make your job easier and her job more interesting.
I will miss Alice (or Miss Murphy as I call her for fun) in September, but will be glad that I had an opportunity to give OT a good name in her mind, and give her some things to think about while facing case studies in PT school. I told her to close her eyes and think about our work together with these patients, and she will have a picture in her mind of the patient, the disability and how we addressed it, and, therefore, will know the answer to the questions.
Jacqueline Thrash, OTR, has nearly 20 years of clinical experience in California and Arizona, in acute care and outpatient rehab, SNF, adult day treatment, and home health. Reach her online at www.livingskillstherapy.com or by email at thrash@pinkiemae.com.
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