Inpatient Rehab?

[BlueJayBae]

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Hey guys,

I have an upcoming clinical in inpatient rehab and am kind of nervous about it because 1) I disliked Neuro and didn't feel like I really grasped it or liked it from the little exposure that I had to it and 2) working with TBI patients who are combative or agitated kind of freaks me out. But at the same time, I think it would be so rewarding to see the progress they make in such a short time and to be a part of it... 🙂

I'm just curious to know more about how it works, like I know it's more intense and that patients are seen for like 2-3 weeks and then discharged. But when do they come to IP Rehab, like after they've become medically stable from the hospital? What Ranchos stage are they usually in when they arrive and are d/c from IP Rehab, if they're a TBI patient?

Any insight would be much appreciated! 🙂

 

[Azimuthal]

Patients are medically stable before entering Acute Rehab (doesn't mean they always remain that way). The Ranchos scale is case dependent.

 

[Beach55]

My next clinical is also in IP and I'd like to know more about an average day in this setting.

I know a lot of this depends on the patient and the clinic that you work at but how are the evaluations different than an OP setting, being that we already have a pretty specific diagnosis? Do you do a lot of evals compared to OP? Do you spend most of your day in the gym area? Is any time spent in the pt room doing bed mobility, etc. ? Any general input would be greatly appreciated. Thank you!

 

[Azimuthal]

Less evals as you tend to stick with longer term patients. First, the patient entering acute rehab often want to be there and assessed to be able to tolerate 3 hours of therapies per day. Patients will be downgraded to SNF level and often transferred if nonparticipating. Often, you schedule their times along with OT and SLP the day before. Your treatment times are usually 45 min+ AM and PM depending on how the specific institutions do things. You meet regularly with other disciplines, come up with multidisciplinary goals with team members, along with occupation (PT) goals. You're also responsible for updating your part of any outcome measures, such as FIMs, and updating the physiatrist and other team members of patient progress during weekly rounds for each patient. Communication standards between multidisciplinary team members are high, in many cases a PT and OT are paired up in teams to see the same patients. SLP when needed.

 

[PhysioMD]

What types of treatments are you doing in the 45 minute time frame? all hands on balance and gait stuff? do you guys use any interesting modalities?