Threshold of Thursday

Doing my scrubs washing tonight so that I can go into work tomorrow (my day off) and Friday, and Saturday. bummer. Actually got some new, cool, non-kid tops that I can wear and be fashionable in at the hospital (not that the elderly don't get a kick out of my Land Before Time, Rugrats, and Spongebob shirts). Anyway, I usually don't go in on Thursdays as long as everyone is healthy and happy. But this week is our first week of evening pediatric schedule. Since it's been a short week, I can't say that I've really learned a whole lot yet (except for the fact that a 530 pt makes it very hard to get to your 600 meeting). I've been handling the peds on my own now since last December, and tomorrow marks the handoff of twice-weekly kids to the COTA. I am not worried about this, for the following simple reasons 1) her slots will be used primarily to see the "twice-weeklies." By definition, I will also be seeing these kids at other times during the week, and will be reviewing their notes weekly by necessity. I have been seeing both these kids for many months, they have great involved parents, and they are both OT/PT cotreats. 2) I trust the COTA. We're in the same office at least 3 days a week with ample time to discuss treatments or issues.

I'm confident that the COTA has the basic skills to easily succeed in this. My only worry is whether the girl who has autism will adapt to seeing different faces Tues/Thurs. She, however, is not as confident. As she pointed out today, it is a totally different world going from the inpatient environment to pediatrics. There is really very little transfer between the two worlds. Yes... we're still OT, still client centered, still focused on ADLs. Still, VERY different. One big difference is that even when our adults have comorbidities, it doesn't change your overall treatment plan too much. A person with a knee replacement often has the same general treatment course as a person with a knee replacement and a typical comorbidity. Yet the comorbidities that the kids have generally have a profound impact on your treatment activities. Think co-occurring SPD with autism; TBI and CP; dyspraxia and dyslexia. Both environments can be overwhelming until you're adjusted. We've chatted about the different kids, discussed goals and treatment ideas, but I think she's still a bit nervous. So, we're teaming up tomorrow as a reintroduction to peds, and then next week (due to massive scheduling problems) she'll do all the cotreats solo.

I expect the whole fall transition and dealing with vacations will be hectic, but not overlly problematic. My main problem is getting (certain) parents to be responsible and make appointments. The pediatric PT is bemoaning her full schedule... I wish I had that problem. Can't really get all into peds if I don't have the caseload to do it. We do finally have a speech therapist, but I don't know if she is interested/able to take on pediatric outpatients. And until we have someone to do that, we have been discouraged from actively marketing our pediatric services. So we're basically left to whomever wanders in. I did make a good connection with a family therapist who specializes in Asperger's Syndrome, and she said that she would be speaking with the doctor about OT referral for sensory issues. For now, we wait.