I work in health care as an Occupational Therapist. Before you ask, no I don’t get people jobs, I’m not the same as a Physical Therapist and I am not a Bath Aide – SO many people think I’m one of those, LOL! As an OT, I re-teach self-care skills after someone (in my case, usually a senior citizen) has been sick or injured. I have a BS in OT (because if anyone should have a BS degree, it’s me), am nationally certified (which means I pay the national organization a buttload of money every few years) and am licensed to practice in the state of Florida (which means I pay the state of Florida a buttload of money every 2 years after paying a buttload of money for continuing education units through each 2-year period). I currently work in Home Health, which means that I go to see my patients in their respective homes, usually after they’ve been discharged from the hospital or Rehab facility. These are the people who are considered to be “home bound,” which means it would be a hardship for them to go to an Outpatient facility for therapy (because they’re too weak to tolerate the ride, they’re in too much pain, etc.). My services are paid for by their medical insurance (in my case, usually Medicare but sometimes private insurance).

I didn’t always work in Home Health. I’ve been an OT for over 20 years and although I’ve been doing the Home Health thingy for nearly 12 of those years, I also worked on a Psychiatry unit for 11 years (weak or physically sick people have to be strong enough to safely take a shower with or without adaptations and compensatory techniques…mentally ill people have to know it’s important to take a shower daily so you don’t smell and you have to have the organization skills to do it), worked in a handful of nursing homes on and off, and had a Rehab. Manager position with an Outpatient facility for 2 years (and yep, I know it all adds up to more than 20 years – I worked part-time a Home Health company in NY at the same time I worked full-time on the Psych unit for about 5 of those years). So I’ve certainly been around the block a few times when it comes to having patients.

I don’t work full-time anymore…instead I work “PRN” or “as needed”, which means the schedulers of the companies I work for offer me patients and I have the option to say yes or no (possible reasons why I say no: if they live far away from all of my other patients (if they’re 45 minutes from everyone else, it’s just not worth it), if I already have a lot of patients on my caseload, etc.). Once I see the patient, I decide if he or she needs me, for how long and what we will do to help them to be able to do as much as they can for themselves the best they can be. That can vary from person to person but on average I usually see people 2-3 times a week for 3-4 weeks. Give or take. I can ask for more time if it’s justifiable (read: it looks as if he/she can continue to improve with therapy) and I can discharge them early if they’re doing better than originally anticipated. I like it better than working in a facility because I don’t have to worry about anal retentive, cost effective accounting for my time and I have a little more control in calling the shots when it comes to what I do with my patients. Plus I think working with the patients in their own homes is especially rewarding…teaching them how to do things in their “real life”, instead of the sterile, not always realistic environment of a hospital or rehab place…I like that. It’s also given me the chance to see and work in all kinds of neighborhoods and homes, from RV’s to mansions and everything in between.

Having had lots of patients over the years has led to having lots of patient stories. The best ones, in my opinion, were the stories from the Psych unit…when the lady with Schizophrenia ran up to me one morning to tell me that she had choked on dinner the night before and they had to give her the Heineken. Or, during our Religion Group, how one lady was thanking her god for her family, for the staff, for Cigarette Time and for the books on the bookshelf. And the lady who would only talk to yell out Bingo numbers. And the one who had $15,000 hidden in her rat’s nest of hair. Or the agitated, hallucinating guy who almost killed me. And the endless confused, disorganized people who walked down the halls naked.

Home Health has its own share of stories though. Keeping to the “naked” topic, there was the guy with the brain tumor who I was visiting for the very first time – I had never met him before and was there to do an initial evaluation. His wife opened the door, I introduced myself and she said, “You’re the OT? Oh wonderful! He’s stuck in the shower and we can’t get him out…maybe you can help!” So within 15 seconds of walking into the house, I met “Larry”, naked as  jaybird. That’s my world record for seeing a patient naked, by the way.

I met a new lady today, her name is “Dolly”. She had had a prolapsed uterus for 30-something years and it got worse and worse until something really gross happened and she had to have surgery to get it fixed. The daughter-in-law was telling me stories about how it was hanging out and how it squished when she would sit down. Yeah, I know…ewww (and that wasn’t even the gross part I was talking about!). Anyway, Dolly wound up with a lot of blood loss, was in the hospital for a week and change and, as a result, is very weak now.  So anyway, I go to do my initial evaluation today and when I get there, sonofagun, Dolly’s stuck on the toilet and the daughter-in-law asks if I can come in and help her up. I’ve learned a lot since treating Larry and it’s not really very safe to help someone do major physical stuff when you don’t know them from a hole in the wall…you don’t know how steady they are on their feet, how much help they need (so you can give too much or too little help and can hurt yourself or the patient in the process), etc…so I told her I couldn’t do much until I had a better idea of what Dolly’s problems were and to do whatever it was that they’ve been doing. Well, they tried. They really did. But Dolly, who apparently has been a mean, nasty bitch her entire life, had suddenly become a whiny pile of jello. Being sick can do that to a person. And she started crying on the pot. Well I couldn’t take that so I went into the bathroom to see what I could do about Dolly. I did eventually get her up (thanking god she wasn’t very big – helping people transfer from one surface to another, like the bed to the wheelchair or the toilet to standing, is the one thing I can’t always do because I’m so small – if they don’t need much help or if they’re little I’m OK. But once their center of gravity is above my head, or I have to do most of the work, or they have 50# on me, all bets are off) but it was touch and go for a few minutes. Meanwhile, the daughter-in-law told me that they had fixed the prolapsed uterus through the anus – not that I needed to know this but really, I had NO IDEA that’s how they fix that problem. And to help in healing, they had a bidet installed on the toilet. Well, that was an issue because the lady obviously needed a commode over the toilet so the seat would be higher and she’d have “chair arms” to push off of. So I needed to see the bidet to make sure the commode wouldn’t block it. The daughter-in-law took that to mean that I needed to see how the bidet worked, so she got it all set up and showed me. The problem is, the thing was retrofitted into the toilet and there’s not a whole lot of room so she had to lean over the toilet (the button was on the far/wall end). And in showing me, she squirted bidet water





Fortunately, she had a good sense of humor about it, because as professional as I usually am to NOT laugh at awkward patient-related situations, I just couldn’t help myself. BWAAAAAhahahaha! When I got my composure, I reminded her that the water was from the tank and so was relatively clean, but I’d still recommend washing her face if for no other reason than psychological.

She smiled and agreed. And then we both giggled again.

I love my job.