When I first decided to switch career directions I was terrified. My identity has been more about being a hand therapist than an occupational therapist. I have worked very hard to get where I am. I have put up with crazy schedules, demanding surgeons, patients in pain or just scared. I have seen patients who had fingers or thumbs amputated, had their arm snapped in two, and who were in horrible accidents. I can take out stitches, clean a wound, make a splint, and deal with whatever surprise walks into my office. But I chose to walk away from that for a new adventure.
So in the world of therapy there is this unspoken hierarchy. I guess some would say that outpatient orthopedics is near the top of that tier and they are the ones shaking their heads at my choice. Outpatient is usually clean, your patients arrive dressed, they (usually) can carry on a conversation, they usually excuse themselves to the restroom and do not require any help.
On the flip side is the hospital and SNF (skilled nursing facility) where patients can be in gowns, they usually always need help with toileting. They can be confused and sometimes combative. They don’t always smell so great. You may get barfed on or worse. A lot of therapists start out in these settings and then move on. But I have a lot of respect for those who stay in the trenches.
And I will say it now – there really is no hierarchy. It’s a bunch of baloney.
You may have to know more specific information and have more experience to fix a patient’s flexor tendon but it takes a lot of heart to sit with someone’s 89 year old grandmother and teach her how to put on her underwear after a hip fracture. Not everyone is cut out for the type of work it takes to do the not so pretty parts of OT and PT. But when done right – that part of rehab can be the most rewarding.
So where does home health fit into all of this? Well I am finding out. I will not just be an OT but a guest in someone’s home. I went on a visit with one of the PT’s and I listened as a daughter fretted about why her mother with Alzheimer’s isn’t feeding herself anymore. She made sure her mom ate every bite of her lunch while she answered the PT’s questions and reviewed the medication list. At one point she looked at us both and said “I sure hope someone takes care of me when it’s my turn.”
That’s what I want right now – I want to help all the husbands and wives, daughters, sons, nieces, and families who are trying to keep their loved one out of the hospital. I want to sit on their couch and listen to their story. I want to help each patient be able to take care of themselves as independently and safely as possible. I am not afraid to get dirty and I’m sure I’ve made the right decision.