How to Tackle Working in Acute Care
When people hear the words acute care, some images may pop up in their heads. Some people think about complexity, some people think of the Intensive Care Unit (ICU), some people feel fear... and some just think about all three combined. I am here to tell you that being in acute care is nothing to be afraid of. It has been one of the most experience filled, exciting, and interesting settings one can be placed in. For some students and new grads, this setting will probably be your new home, and I’m here to give you seven tips and tricks to navigate this beast!
Safety Awareness
Patient safety is the most important aspect of acute care (or in any setting). It is crucial to understand the environment and how to best manage your lines, facilitate safe transfers, and ensure all of the boxes are checked before touching your patient. Make sure you have checked in with the designated nurse, ensure that the room and bed are clutter-free, and review any precautions the patient might have before getting started. Use appropriate assistive devices as necessary such as dressing sticks, reachers, transfer boards, commodes, and universal cuffs to assist with ADL participation, and monitor the patient’s cognitive status throughout your treatment session. Some side effects of common medications administered may cause dizziness and nausea, and as a result, affect balance. Monitoring your patient for adverse reactions is crucial.
Time Management
Acute care is known to be a very fast-paced environment... and for a reason! Lots of staff, family members, and health care professionals will be around requesting things from you, and it’s important to understand how to balance multiple priorities. One tip I have found beneficial for me is placing my patients in terms of prioritization and distinguishing between urgent and non-urgent needs. For example, patients at risk for discharge, those post-surgery, and those needing immediate interventions are going to the top of my list. Managing my time with an efficient chart review of my caseload and allocating time based on patient needs and complexity has helped me figure out how I will navigate my day. Acute care is extremely unpredictable, so remaining flexible is key! Don’t be afraid to reschedule a session with your patient if needed.
Important Precautions
In a setting like acute care, it’s important to note that patients are often critically ill and injured. It is crucial to adhere to important precautions that can prevent complications, reduce errors, and ensure that everyone has improved well-being. Hand hygiene, personal protective equipment (PPE), and isolation precautions are the basis of patient care in acute care facilities. Depending on the population you are working with, some precautions are important to brush up on before your first day. For example, when working with orthopedic patients, it’s important to note hip/knee replacement, spinal, weight-bearing, and fracture precautions. Reach out to your team lead for any educational handouts or information that could be provided to you for further explanation.
Interdisciplinary Staff
One thing that really brought me to love acute care was how many different professionals I encountered throughout my time working in a hospital. Having interdisciplinary collaboration is key to providing patient-centered care in these facilities; and as OTPs and students, we work closely with several professionals to ensure effective treatment and safe discharges. Some professionals you will surely encounter during your time in acute care include nurses, physicians, social workers, dietitians, respiratory therapists, pharmacists, rehabilitation aides, and of course your fellow physical therapy practitioners and speech-language pathologists. By working with everyone on the patient’s team, you can enhance patient outcomes and contribute to a holistic approach that addresses all important aspects of a patient’s recovery and safe discharge.
ICU
As an OT, I have had the opportunity to work in the ICU and play an important role in early mobilization; ADL training; preventing delirium and deconditioning; contracture prevention; maintaining function while ventilated; and focusing on balance, mobility, and overall strength needed for ADL participation. One major factor as an OT working in the ICU that I find the most beneficial is promoting a sense of normalcy. Having patients perform simple ADL tasks, such as washing their face or engaging in a simple leisure activity, can restore a sense of normalcy for them in a hospital setting.
Emotional Resilience
I won’t lie, working in a fast-paced setting like acute care can get stressful, traumatic, and emotional. There are cases that really stick to you and you feel a personal connection to. It is important to manage these feelings to avoid burnout and maintain your mental and emotional health throughout your career. I always recommend practicing self-care whether it be taking a walk, meditating, reading, or just watching your favorite show to decompress. Connecting with your coworkers and fellow students, and sharing your experiences and emotions can help provide mutual support. I’m a huge advocate for work-life balance and I can’t stress it enough!
Having Fun!
Yes, acute care is a serious and fast-paced environment that at times can feel tense and overwhelming. However, fostering moments of joy and lightheartedness can significantly reduce stress, promote overall well-being, and bring a sense of fun into working in this type of setting. For example, try to involve yourself in as many activities your facility offers. You will always catch me wearing mismatched socks and backwards t-shirts on Tacky Day. Activities like this can help build camaraderie with your coworkers and fellow students, and reduce stress. Creating a solid friendship crew is always a good idea, and it’s amazing having someone you can lean on to make your bad day into a good one. All in all, working in acute care is a challenging but fulfilling setting. You can do this, and remember, everyone was in your shoes when they first started their careers in acute care.
Arianne Zarate is an occupational therapist who has been working in sub-acute and acute care for 2 years. She has practiced in a variety of settings and is now currently working in the ICU. She graduated from Florida International University in December of 2021. Arianne’s interests include running, reading, beach time, and spending time with her puppy and kitty.