i thought it would be helpful for ot students to make a general video about how to prepare for acute care specifically this information might be applicable i'm thinking to other settings as well such as acute rehab and skilled nursing but i'll try to make a separate video series for this as each setting has its own specifics and i don't have any specific experience so far with skilled nursing besides my pre-ot shadowing so i hope that i'll be able to bring a guest on to share this with you especially since they have had more experience in these settings but if you guys know anyone in the comments who would be good candidates let me know so that we can bring them on while this is intended mainly for level 2 fieldwork students who are expected to demonstrate competency as a generalist ot this video is a good preview for level one fieldwork students as well to see what you probably need to prepare for when it comes time to to do your level two field work and if you're new to this channel my name is jeff a board certified and licensed occupational therapist practicing here in america a common misconception is that occupational therapists help people to find jobs but instead they help people to do the things that they want to do that are meaningful to them my goal is to increase awareness about the profession of occupational therapy to help people live healthier and happier lives if this resonates with you consider subscribing to this channel and joining to be a member check out the video description for other ways too that you can support this channel i'm jeff the ot dude and let's get functional so acute care will take place in a hospital and one thing that differentiates one hospital to another is for example the level of care that they can provide for example a level one trauma center is the most comprehensive in services that they can provide for the care for their patients so they can take care of almost all emergencies especially so this is what it means when you see say level one versus level two and what the difference is just a broad general difference between the hospitals themselves of course each has their own say more specifics in terms of like the rules and regulations what units they have but that's beyond the scope of this video most patients enter the hospital system via the emergency room from say ems services or they may self-admit themselves to the emergency and there is actually sadly a growing trend of people being unable to afford the ems service such as an ambulance and having to call other private transport such as uber and things like that and this can be very risky because these personnel drivers aren't trained like the ems professionals are and what some ots may do is they may see patients in the emergency room for say quick screens if there's an order for ot but this ot is kind of like really quick and discharge like quick and dirty so not as involved is in the rest of the acute care settings in within the hospital and another broad categorization of patients who enter the hospital are acute trauma or for medical either acute or chronic so traumatic or medical there of course could be overlap like one patient may have both but there's usually one main reason or what occurred first so if it was like a heart attack while someone was driving a car the heart attack would precede it and be the main reason or if someone had say a car accident so it's traumatic it may have a medical condition like an underlying chronic one that may exacerbate because of the traumatic so that is an example of a second situation so based on these two kind of categories the patients may go to the respective department or they may even go into surgery if it is something more serious such as a cardiac cause like a heart attack for example but a common place that they may go for very like serious things is the icu and this is the most acute as in the medical stability that the ot would often first encounter the patient i won't go into the icu side of things as you likely won't experience this especially in the very beginning for a level 2 field work you'll probably start in other units in acute care as this is considered a more specialized practice area the icu units that you'll commonly find within the hospital include neuro or neurology cardiac or telly sometimes these may be separate or combined and there's also remote telly which means that there is some cardiac issue that is being monitored remotely like a box that is hooked up to their leads but they may be in another unit not necessarily a cardiac or tele unit and there's also general medical surgical or med surg which is really a catch-all for diagnoses that don't fall in other unit categories so or if there are say no beds available sometimes depending on the hospital psychosocial patients may be located in med surg or there may be a dedicated psychosocial psych unit and there's also oncology and palliative or for hospice sometimes these may be combined as well and so far the units that i've explained are just mainly the adults in geriatrics but for pediatrics there's generally their own units such as the nicu and there's also i think i forgot to mention orthopedics too some hospitals also have a step down unit the pacu is also a similar unit and patients come out directly from surgery and from the pacu some hospitals also have maternal wards and women's health for safe pregnancy and also some hospitals may have rehabilitation units like the aru acute rehabilitation unit which is considered different than acute care so it's acute care and acute rehab are you and last some hospitals may have more long-term cares kind of like skilled nursing facilities but they don't call it that and it's mainly for patients who may have extended lengths of stay for reasons such as lack of insurance chronic conditions or any other reasons that may not warrant them for quick discharge other complications and things like that to just back-to-back that may make them kind of a high risk for going into the community or other settings such as even the skilled nursing facility i won't go into the examples but it's pretty straightforward for neural you'll see things like stroke tbi cardiac is obviously like cardiac conditions like a cabbage from a myocardial infarction respiratory it'll be like for respiratory reasons like coven 19 oncologist cancers of the body from anywhere mainly and it's the main diagnosis there may be other comorbidities and other chronic conditions underlying it but mainly it's the cancer and for what other units are there ortho it's usually from traumatic accidents it can be chronic as well so one way to differentiate it in orthopedics is collective surgeries and non-elective surgeries too so sometimes it may be a surgery that's elective such as like a hip replacement a knee replacement something like that if it's non-elective then it happened because say from a car accident or fall or like a workplace injury and things like that as mentioned earlier general med surg or med searches for a catch-off for the rest of the patients who don't really fall into it or they may not have like a specific diagnosis and it's kind of unclear too it may go there as well i thought it'd be kind of fun and interesting to cover some of the other miscellaneous units that ots may venture in or may encounter or may need to work in these specific places or more often than not find things in these places so number one is the kitchen in the miscellaneous list and you sometimes come here actually and to grab things like food for special diets say for patients on a cardiac diet low salt or they may have other like allergies or whatever or it may be more physical problems such as dysphagia or it could be cognitive as well so you may come here to grab say different specific foods that aren't deliverable on a tray or weren't delivered in time or you may be special ordering it if you're doing things like a meal prep such as iadl meal prep activity then you may have to come to the kitchen to pick things up and it depends on the hospital system where you work sometimes you as an ot may keep the adaptive utensils in your own unit or in your own place or may have to go through the kitchen so this is why you may actually have to visit the kitchen and return things or grab more things then there's imaging and this is where patients may go for say mris and x-rays like that and these days actually x-rays they're often done on a mobile x-ray unit that can be wheeled into like the patient's room by their bedside but you'll find other things like ct other larger equipment and sometimes these are not located like in one unit themselves they may be scattered around or even like outside on a mobile what do you call them like a mobile i don't know what you call it and of course these things that you get come from a central place like a supply distribution center after it they're offloaded from the trucks or they're stored somewhere in the hospital right and you may actually come here for larger objects such as tlsos for example or large braces and these items need to be picked up by hand because they're so large what's also really neat is that in hospital iwork for example they have a tube system kind of you went to like costco or was it price club a while back they had those tubing systems like by the cashiers and like in the ceilings where they like think they sent checks there actually i'm not quite sure probably some payment i would think or receipts it's a very similar system they have in the hospital where you have these actual like canisters and they're like hard plastic and they remind me of like a submarine like missile or something but you can place pretty a lot of things in there like forms hand braces like for hemiparesis i fit like slings in there or i've had the person delivering it anyways send me it in there and shoot me these things via these this transportation system can't i don't know what you call it but sometimes things such as tls are like larger than that so you'll have to go to central and what you typically do is you call them up and tell them hey like i'm coming here to pick this up do you have it and can you put it out on hold for me so that it helps to give them a heads up so when you go there you don't be like wasting time and they say oh we don't have it and we need to reorder some more but this is also another method where you may call them and they'll shoot it over to you of course each hospital has their own system so it depends on the policies and how things work where you work but if you have these tube systems or you've seen them around they can be used for ot and depending on where things are stored in the hospital where you work say for looking for wheelchairs walkers como's you know common things that you would get as an ot and as a pt some of these things may be located even within the same patient room some may be within that unit some may be like next door like maybe further away so it really depends so this is why it takes a lot of planning and thinking like when you go see a patient you do your chart review they say maybe for an evaluation and they may be unsteady on their feet then you may be thinking about grabbing some things like a walk or wheelchair especially if you're the first therapist to work with this patient especially to mobilize them out of bed after they have admitted and depending on the hospital where you work sometimes these things go with the patient if they were to do a room change within the hospital sometimes it stays there and in which case you would have to get new equipment when they switch units so to speak but when patients switch units what typically happens is they typically get to stay in their bed if it has like wheels and it's not too far like you don't have to go across the street and their belongings come with them but they don't have to like so change beds even that's kind of cool but sometimes they may change beds too so they may have to go on to like a from a bed like a hospital bed to a gurney which is like more mobile and more narrow and meant to really roll around so so far it sounds like you'll be walking around in random rooms a lot too right so a lot of these rooms are locked by a keypad like you punched in the code like a four-digit code or something like that so there will be a lot of codes depending on where you work but in general you'll have like units each have their own code that they like to use and you'll have like a lot of codes to be familiar with so what i recommend pro tip is to carry around like a small notebook so that you can write these codes down in it or you could store it on your phone if your clinical instructor allows you to do that but typically i would stay off the phone as a student so there are less distractions looks more professional anyways so notebook is a good alternative then there's of course the rehab office and you may come here say in the morning for morning huddles to get your assignments for your patients you may do charting here in the middle of the day or at the end of the day you may do more administrative tasks such as printing your productivity reports etc or when checking your email too and nursing units this is kind of self-explanatory and obvious but each unit typically has their own nursing unit and they're spread out throughout the hospital you may call a certain unit and this is where you would usually call like a nursing unit to talk with say the nurse is there and typically there is a lead nurse there may be a resource nurse which kind of helps out and does like break and relief and you have the nurses that have their own specific list of patients that they are responsible for and each unit typically they have like a white board or whatever board sometimes they're digital now too actually that's kind of nice of who the lead nurse is which nurses are on in that unit whether some of them are on break or not what their patients are that's typically they're laid out and shown on this board and also what else else i'm gonna say oh there are extensions too so you can write that down in terms of like the numbers that if they have a phone on them you can page them or phone them depending on where you will do your fieldwork the culture sometimes nurses like to be called and ask questions sometimes they don't sometimes they prefer in person so you'll often as an ot also work with social work talk to case management so where are these personnel located oftentimes they're kind of i feel they're just scattered around or they try to find a computer that's available and so they may be at a nursing station sometimes they have their own little offices too so like a unit may have their own dedicated space in here you'll find the nursing staff you'll also see who else was i just talking about oh case management social workers and doctors of course and doctors assistants like pas and nurse practitioners they'll be all fighting for a computer sometimes you'll see pharmacy too and other staff like administrative management but besides these typical places you'll also have more administrative places like offices and there's also management offices medical records so patients would go here to pick up their medical records say for a family member for themselves there's also janitorial services and this is a sometimes called evs environmental something services actually not sure maybe e is for environmental yeah anyways you actually sometimes go here too to pick up some things like random like garbage bags i like to grab garbage bags sometimes say to wrap up patients for a shower you're only grabbing other things that patients may need replacements for like sometimes they have like emesis bags at the side table and if like a patient has other needs for more of them or sometimes like good storage bags for other things or sometimes even towels i've seen come to find that some towels are located in the janitorial room so good to know where this is because they have a lot of goodies actually if you're allowed to go in there at least you don't want to make any enemies of course especially as a student so with all these it may seem overwhelming like all these places to be familiarized with but don't worry you'll kind of get the hang of it once you work there and you'll have to go through it day by day so don't worry about like memorizing a map or something like that but one pro tip is especially to learn where the stair cases and stairs are not just only where the elevators are because well elevators are typically very slow sometimes they you may have to share them with the public but in some hospitals personnel have their own elevators but still it's typically a long wait time so stairs are good to know of course because of emergencies and if there may be fire not supposed to use the elevator right but also because they're fast and it's good exercise too so you'll learn your way around and learn some of the more of the shortcuts too and this is where you may find some interesting places like the morgue you'll get an orientation i'm sure but familiarize yourself also with things like where the emergency exits are where the fire extinguishers are where the chemical wash stations are like the showers things you pull on or the eye wash stations where certain documentations are like the chemical spills book are things like that because while you're not necessarily going to be asked these questions by like jayco when they come around it's just a general good thing to know for safety especially when you're working in the hospital and i also made a video i think yeah i did on hospital codes too so hospital codes like code blue code red code white good to familiarize yourself with that too so far we have talked about the hospital flow of patients and where they typically go what the units are and other miscellaneous places and some tips such as knowing where the stairs are in the next video for this series i will review the personnel like the actual staff besides the ot because we're all part of a health care team so i'll review and explain kind of what each common staff that you interface with as an ot and what their role is and how they may help you and how you may help them so stay tuned for that and if you have not already subscribe to this channel so that you'll get notified when these types of videos drop